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HomeMy WebLinkAbout1141 DANIELLE DR - Building Permits. (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.BgFLDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1141 DANIELLEDR Suite: Vicinity: 1ST AND 2ND FLOOR Status: ISSUED Applied: 06/24/2003 Issued: 09/03/2003 Parcel Number: 41207166 Zoning: R1 R1 Applicant: SCHELL, JENNY Address: 1141 DANIELLE OR _ - ISSUED BY: Phone: 714-434-3778 COSTA MESA, CA- " Zip: . 92626-1634 , Owner: SCHELL, JENNY Address 1141 DANIELLE DR -" Phone: 714434=3778 - COSTA MESA, CA - Zip: 92626-1634 , Contractor: - - Address: Phone: Zip: License: - - Arch : Eng: FOERSTEL ENGINEERING Address: Address: 2377 S EL CAMINO REAL Phone: - Phone: 949.492-5981 SAN CLEMENTE, CA Zip: License: 92672 License: SE957 SCOPE OF PERMIT ADD 1314 SQ. FT.ADDITION (134 SF AT FIRST FLOOR AND 1180 SF NEW SECOND FLOOR) TO AN EXISTING SFR AND 115SF NEW DECK. SCOPE OF WORK TO INCLUDE: 2ND FLOOR MASTER BEDROOM, MASTER BATH,. 1ST FLOOR TO INCLUDE EXTENSION OF BEDROOM, ONE BATH AND DINING ROOM. WORK ALSO INCLUDES REPLACEMENT OF 6 WINDOWS ON FIRST FLOOR; REROOF OF EXISTING FIRST FLOOR TO MATCH NEW ROOF; NEW SIDING AT FRONT; NEW RANGE AND OVEN IN KITCHEN; NEW SKYLIGHTS IN EXISTING LIVING ROOM. - EXISTING 3 BEDROOM TO BECOME A 4 BEDROOM. 2 BATH RESIDENCE WILL BECOME A 3 BATH RESIDENCE. MINOR DESIGN REVIEW NOT REQUIRED FOR SECOND STORY ADDITION BECAUSE PROPERTY IS ZONED PDR -LD. 40% OPEN SPACE REQ., 55% PROVIDED. ELEVATION TREATMENTS AND WINDOW LOCATIONS APPROVED BY HOA -VIA LETTER DATED 8/11/03. OVERALL HEIGHT IS 25'-8-. FEE SUMMARY Plan Check: $860.70 Calc Valuation: $158,605.28 Permit: $1,324.15 Claim Valuation: $0.00 SMTP Res: $15.86 SMIP Coni: $0.00 Other: $0.00 Inspection:, $0.00 Total: $2,200.71 PLANNING & ZONING NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and.all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit FOR INSPECTIONS CALL: (714) 7545626 / 244646 (600) \ / DECLARATIONS WORKERS' COMPENSATION DECLARATION-.'• I hereby affirm under penalty of perjury one of the following declarations: r ❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. - ❑ I have and will maintain workers' compensatlon Insurance, as required by section 3700 o1 the Labor Code, for the performance of the work for which this permit Is issued. My workers' compensation Insurance carrier and policy number are: Cartier: Polity Number, (This section need not be completed it the permit is valued atone hundred dollars ($150) or less.) hK—I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that it I should become subject to the workers' compensation provisions of Sec n 37 of the Labor Code, I shall forthwith comply with these 'ions. ��^ _ Applicant Signetur Date: IvRJ WARNING: FAILUREO UR WORK S' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARE 100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and effect. Lir,. q Class 0 Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a comaruction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city Or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (Commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not Intended or offered for Gale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a Contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exam t nder sec.--�—�—;� Business and Professions Code for this reason: Signature: ��7�d.� .fin 1 / Date: Owner ID veliflad by driver license. as ❑ No Drivers license No. : Expires: /04/0 7 Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 6, California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and cartify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Masa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at stantlard temperature and pressure). .._..__..._..._.... r Will ........................._ .._............._..._._.....................__....file a regis__...........form fo_._........._.....__.—___. ........_.... ..___....__......u. 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous meterials7 ❑Yes ❑ No (Section 25,633 of the California Health and Safety Code, with some exceptlons, requires registration With the Costa Mese Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). . ...................................... ...................................................... ................................................. ............................ _.........................................................._........................................................................ _................ ................................................ .._ 3 es Does yoor will th❑a e applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? (Section 25534 at the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, ceniiication and filing w0h the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ._......................................................................... _........................................................................................................................................... _............. ....................................... _................................................... ....................................................... 4 If an RMPP is presently required, hes Section .. of the California and Safety Code been fully compiled with? ❑Yes ❑ No 5 Does or o the applicant present or future building occupant require for the work which is the subject this a pe plication artnil for such construction or motligcation S from the South Coast Air Quality Management District or from any other air pollution control dktricl or agency? )? Ves LJ No (Section 65050.2 of the California Government Code requires that the requested Information be furnished on applications for non-resldential building permits). _ .... ..........................................................._...___......................__..................._................._.__......................................... 6 Will any par of the facility to be constructed under This permit be within 1000 foot from the outer boundaries of a schCol7 ❑Vas ❑ No (If W. the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ... _.............................._.............................................._................._._............._.._....................._................._......................_.__..............._......__........._._._._..___............ _..... .................. __................ _.__............. 7 If a permit from the South Coast Air .Oualiry Management District or other air pollution control district or agency is required for the work which is the subject of this appilcation, have all of the disclosures presc bed by Calflomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No .. ............... ..................... .........................._................................ 8 (If yes-, attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the Information given above is correct. I agree to comply with all State laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE Of COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and slate that the information given is correct. I agree to comply with all state laws and city ordinances relating to building Construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for insp pu es. I agree not to occupy or allow occupancy of any building author by IN permit until final inspection. � / �� 3 OBJ S gnature Of Legal Owner(s) 1 Date And/Or Authorized Applicant 01, ' Date CODE f, iNSPECT1211TYPE 2&¢. IiiIMAUS CODE INSPECTION TYPE DAM 7yTIMALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pad Spa Final 208 Final Plumbing _ 200 Final Re-Roof 210 Final Electrical 201 Final BIOck)Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Buildmg/Occupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1141 DANIELLE DR Suite No Vicinity: FEE SUMMARY Parcel Nunmber: 41207166 Applicant: SCHELL, JENNY Address: 1141 DANIELLE DR ISSUE FEE COSTA MESA, CA Owner: SCHELL, JENNY Address 1141 DANIELLE DR $0.00 COSTA MESA, CA Contractor: $0.00 0 Address: $0.00 ELECTRICAL PERMIT Phone: 714-434-3778 Zip: 92626-1634 Phone: 714-434-3778 Zip: 92626-1634 Phone: Zip: License: Status: ISSUED Applied: 01/08/2004 Issued: 01/08/2004 SCOPE OF PERMIT REF. 603-01079. ELECTRICAL TO INCLUDE: 16 LIGHT FIXTURES, 15 OUTLETS, 17 SWITCHES, 1 SERVICE TO 200 AMPS AND 1 SUB PANEL TO 200 AMPS. NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21.92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work Is suspended or. Lned for a period of 180 days. /(Z INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2446.48 (SM) FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System / Lighting $0.00 0 Temp service test $0.00 Busway /1001t $0.00 0 Res. a/c package $0.00 Standing Section $0.00 0 New Res (1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res (3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool / Spa $0.00 0 ................up to 10 kva/kw $0.00 0 Lighting Fixts $17.60 16 .................up to 50 kva/kw $0.00 0 Recept Outlets $16.50 15 .................up to 100 kva/kw $0.00 0 Switches $18.70 17 ..................over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System / Ckt $0.00 0 Service to 200a $30.50 1 Misc. Conduit $0.00 0 Service to 1000a $0.00 0 Misc. Conductor $0.00 0 Service over 1000a $0.00 0 Circus ( gen or ride) $0.00 0 Motors to 1hp $0.00 0 Circus (mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 1 00h $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $30.50 1 Plan Check Fee $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21.92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work Is suspended or. Lned for a period of 180 days. /(Z INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2446.48 (SM) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit is Issued. My workers' compensation Insurance carrier and Policy number are: Cartier: Policy Number: (�Th�is section need not be completed i/ the Permit Is valued at one hundred dollars ($100) or less.) certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' _ compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with thesens. -Appn ant Signature:�\ �,c�' t -^,4 (—� Q /�O y -WARNING: FAILURE TO SECURE WORKE S' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMIIOAL PENALTIES AND CML FINES UP TOONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full farce and effect. Lic. N Class q Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby offimn that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions o1 the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' �-I; gs owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions ,66de: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am ex t under sec. Business and Professions Cade for this reason: -Sgnatu ar—Date:"- •/ O _OwnerN sniffed by drivi6is license. es ❑ NoDrivers License No. _ - xpires: Verification of Ownership by (type of docu n i.e. - property tax bill or deed ----rte- L - DIVISION OF INDUSTRIAL SAFETY PERIIT CERTIFICATION: ❑ 1 hereby certify that no excavation five5) or more feet in depth Into which a person Is required to descend, will be made In connection with work authorized by this hat permit, and cno building structure, bolding, talsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ......................................................................_._....._........................................ ... .............................................................. __............................._.............................................................................................................. _..............................._..... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑ No (Section 25533 of the California Health and Safely Code, with some exceptions, requires registration with the Costa Mese Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ............................................................................................................................................................................................................................................................................................................................................................................................ 3 Does or will the appplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .............._....................._.................................. ..................... __._................................................ __.................... _.......................... .._._...................... _............................. _... _.._........................ _............... __............. _.............. _............. _ 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes [I No ........................................................................................................................................................................................................................................................................................................................................................................................... 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plication apemit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency! Yes ❑ No (Section 65850.2 01 the California Goverment Code requires that the requested information be furnished on applications for non-residential building permits). .......................................................................................................................................................................................................................................................................................................................................................................................... 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundades of a school? ❑ Yes ❑ No (If yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ........................................................................................................................................................................................................................................................................................................................................................................................... 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed byCalifornia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ........._.......................__..... _............................ _........................................... _._................................... __..................... __.......................... _.... ................................................................_._...... ....... _.._._.................................. __......... ..... e (II yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the Information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Data: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given H correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property fo�pt pecp'on purposes. I agree not to occupy or allow occupancy of any building authorized by this permit un it final inspection. Signature 01 Legal Ownsr(s) ' Date �. And/Or Authorized Applicant Date CODE I. INSPECTION TYPE RrlIE INTIDdLS COOEI INSPECTION TYPE PAIF. QITTALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Rcof 210 Final Electrical 201 Final Blcok/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval " 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 03-17-2005 Inspection Request Reportin Page 33 4.07 pm COSTA_MESA, rA - CITY OP A/P/D Information Activity: E04-00011 Const Type: Owner: Applicant: Description: Notice: Reauested Insnection(s) Item: 150 MISCELLANEOUS INSPECTION Requestor: Comments: did not state Assigned To: Action: Time Exp: _ Requested Inspect Date: Friday March 18 2005 Site Address: 1141 DANIELLE bR CM Type: ELEC2 Sub Type: Occunancv: Use: Status: ISSUED Insp Area: 17 SWITCHES, 1 Requested Time: 08:00 AM Phone: Entered By: BLDTEMP K Inspection History Item: 150 MISCELLANEOUS INSPECTION Item: 34 TEMP ELEC SERVICE OR POLE Item: 36 UFER GROUND Item: 38 ELEC CONDUIT- UNDERGROUND —Approved 03/16/04 Inspector: RHB Action: AP APPROVED Comments: EDISON STUB Item: 40 ELEC LIFER GROUND Item: 42 ROUGH ELEC - CONDUIT Item: 44 ROUGH ELECTRICAL -WIRING Item: Item: Item: Item: Item: Item: Item: Action: 'ED AT THIS TIME. CO Corrections)) Required NOT READY F / 12 INSPECTION Action: PA Partial approval Action: PA Partial approval Action: PA Partial approval OK EXCEPT GARAGE AND WHERE THE OLD PANEL IS Action: PA Partial approval s ector: RHB Action: CO Correction(s) Required pCESS AND COVER FOR SPA OUTLET 11.. REPT131 Run Id: 12530 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1141 DANIELLE DR Suite No Vicinity: Parcel Nunmber: 41207166 Applicant: SCHELL, JENNY Address: 1141 DANIELLE DR COSTA MESA, CA Owner: SCHELL, JENNY Address 1141 DANIELLE OR COSTA MESA, CA Contractor: OWNER BUILDER Address: Arch / Eng: Address: PLUMBING PERMIT Status: ISSUED Applied: 09/11/2003 Issued: 09/11/2003 ISSUED BY: Phone: 714-434-3778 Zip: 92626-1634 Phone: 714-434-3778 Zip: 92626-1634 Phone: Zip: License: 000000 Phone: Zip: License: SCOPE OF PERMIT REF: B03-01079. RESIDENTIAL ADDITION AND REMODEL. 1ST AND 2ND FLOOR. PLUMBING TO INCLUDE: 1 BATHTUB, 1 LAUNDRY, 1 SHOWER, 2 WASH BASINS, 1 TOILET, 1 WATER PIPING. OTY AMT FEE SUMMARY 1 AMT CITY 0 AMT ISSUE FEE $23.50 0 Laundry Tub / Washer $9.80 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 Backfiow Preventer $0.00 0 P -Trap $0.00 Bathtub $9.80 1 Pressure Regulator $0.00 Clarifier System $0.00 0 Process Piping (per 10 ft) $0.00 Connect (Ice,Soaa,etc) $0.00 0 Receptors $0.00 Dental Units $0.00 0 Septic Tank $0.00 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 Drain, Floor $0.00 0 Sewer Connect $0.00 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 Drain, Roof $0.00 0 Shower $9.80 Drinking Fountain $0.00 0 Sink, bar $0.00 Expansion Tank $0.00 0 Sink, commercial $0.00 OTY AMT OTY 1 Sump Pump $0.00 0 0 Swimming Pool $0.00 0 0 Trap Primer $0.00 0 0 Urinal $0.00 0 0 Vacuum Brkr Bkflow(1-4) $0.00 0 0 Vacuum Brkr Bkflow(5+) $0.00 0 0 Wash Basin $19.60 2 0 Wash Basin Set $0.00 0 0 Waste and Vent System $0.00 0 0 Water Closet (Toilet) $9.80 1 1 Water Heater / vent $0.00 0 0 Water Piping (Inst or Rep.) $9.80 1 0 Water Re -pipe $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21.92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2446-46(6M) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insuran as required by section 3700 of the labor Code, for the (performance of the work for which this permit is Issued. Myworkers'compens`ation ure artier end er are: Carrier: \ Policy Number: is s tion need not be competed if the permit is v ed at one hundred dollars ($100) or less.) certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to be ome subject to the workers' compensation laws of C Ifornia, and agree that If I should become subject to the workers' compensation provisions of Section 370 01 Ithof abor Code, I shall forthwith comply with the ns. I Applicant Signatuir ��//� Date: WARNING: FAILURE rO SORE WORKER COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND 3VIL RZ UP TO ONE HUNDRED THOUSAND DOLLARE .800), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Coda, and my license is in full force and effect. Lic. It Class N Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirn that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affir i that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors 1.1cense Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant tot a pernit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am e'�R1 der sec. Business and Professions Code for this reason: Signatur 1�1 /—o�f��� Date: Owner IDWa' led 6y driverj�license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, talsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ..................................................................................................................................................................................................................................................................................................................._...................................................................... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .................................................................................._..............................._................................__........................................................._.............................._................................................._.._............__...................._..................................___. 3 Does or will theappplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ Ido (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ........................................................................................................................................................................................................................................................................................................................................................................................... 4 It en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No .................................................................................................................................................................................................................................................................................................................._....................................................................... 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication aParmit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ..................................................................................._.........................................................................................................._......................................................................................................................................................................................._. 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑ No (If 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ........._............................................ 7 If a permit from this South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No .............................................................................................. ............... ................... ............ ...................................................... .................. ............................... ...................................... I........................ . .............................................................. _ _..... 8 (If'yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the Information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all to laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the abo Abed property for ins cti n pu s. I agree not to occupy or allow occupancy of any building authorized by s rtnll unti final inspection. �- Signature Of Legal Owner(s) Date And/Of Authorized Applicant Date CODE I. INSPECTION TYPE gAjE INTIMAL S CODE INSPECTION TYPE gA¢, INITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final BuldingrOccupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1141 DANIELLE DR Suite No Vicinity: Parcel Number: 41207166 Applicant: SCHELL, JENNY Address: 1141 DANIELLE DR $23.50 COSTA MESA, CA Owner: SCHELL, JENNY Address: 1141 DANIELLE DR Contractor: Address: COSTA MESA, CA MECHANICAL PERMIT Phone: 714-434-3778 Zip: 92626-1634 Phone: 714-434-3778 Zip: 92626-1634 Phone: Zip: License: ISSUED BY: SCOPE OF PERMIT REF. B03-01079. MECANICAL TO INCLUDE: 1 INST FAU < 100K BTU, 1 FACTORY FIREPLACE, AND 2 VENT FANS/SINGLE DUCT. - FEE SUMMARY Status: ISSUED Applied: 01/08/2004 Issued: 01/08/2004 Quantity Repair / Alt Absorbtion Unit $0.00 Quantity ISSUE FEE $23.50 0 Inst FAU <100 k BTU $14.80 1 Inst FAU >100 k BTU $0.00 0 Repair / Alt Cooling/Heat $0.00 0 Inst / Rep. Recess Wall Htr $0.00 0 Refrig Sys <100 k BTU $0.00 0 Refrig Sys >100 k BTU $0.00 0 Gas Piping $0.00 0 Factory Fireplace $10.65 1 Hood w/Mech Exhaust $0.00 0 VAV Box $0.00 0 Vent Fan / Single Duct $14.50 2 Appliance $0.00 0 Fire Dampers $0.00 0 Smoke Dampers $0.00 0 Inst or Relocate Appl Vent $0.00 0 Air Handlers < 10000chn $0.00 0 Air Handlers > 10000cfm $0.00 0 Floor Furnace $0.00 0 Floor or Suspend Heater $0.00 0 FEE SUMMARY Status: ISSUED Applied: 01/08/2004 Issued: 01/08/2004 Quantity Repair / Alt Absorbtion Unit $0.00 0 Repair / Alt Refrigeration Unit $0.00 0 Ventilation System $0.00 0 Evaporative Cooler $0.00 0 Commercial Incinerator $0.00 0 Domestic Incinerator $0.00 0 Compressors /Absorption Systems Up to 3 hp / 1001k BTU $0.00 0 3 To 15 hp / 500 k BTU $0.00 0 15 To 30 hp / 1,000 k BTU $0.00 0 30 To 50 hp / 1,750 k BTU $0.00 0 Over 50 hp / Over 1,750 BTU $0.00 0 Boilers Up to 3 hp $0.00 0 3 To 15 hp $0.00 0 15 to 30 hp $0.00 0 30 to 50 hp $0.00 0 Over 50 hp $0.00 0 Other Mechanical Fee Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. 1 / INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspeotlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2"6-46 (6100) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this parmit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. My workers' compensation Insurance carrier and policy number are: Cartier: Policy Number: (Thissectionneed not be Completed If the permit Is valued at one hundred dollars ($100) or less.) •td=?,certify that in the performance of the work for which this permit Is issued, I shall not employ any person In any manner so as to become subject to the workers' _rcompensatton laws of California, and agree that If I should become subject 10 the workers' compensation provisions of Section 3700 of the Labor Code, I shall torthwlth comply with these pr visions. /� pelei� �/ /O .Applicant �� WARNING:FAILURE- ECURE W KERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMNJAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED -THOUSAND DOLLARE ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTONS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Llc. k Clan P Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a Civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). I� owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions 'Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am ex pt under Sec. Business and Professions Code for this reason: -$Ignat`u!enfied Dalener by vers license. es ❑ No-Ddvers'Ctcense'No.. Expires: L1L 07Verificatof Ownership by (type of docu nt, i.e. - property tax bill or deed). --J� r DIVISION OF INDUSTRIAL SAFETY PE MIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made In connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous materiel? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .......................................................................................................................................................................................................................................................................................................................................................................................... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ...................... ........... ........ ..................... ...................... ........... ........... ................. ......................................... ....... -.................... .................................. ............................................................................... ._............................................................. _........ 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ............-.........................._.................................................. .............. ... ................................. __...... .................... __...................... ___............... ..........__...........__—_—__._._.._......... ___.............. _.......... _.......... _........ __... 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this aMplicafion apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ............................................................................................................................................................................................................................................................................................................................................................................................ 6 Will any pan of the facilityto be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Ves ❑ No (It "yes", the facility must meet the requirement of Sections 25534 and 42303 of the Cafilomia Health and Safety Code). .......................................................................................................................................................................................................................................................................................................................................... 7 If a permit from the South Coast Air Quality Management District or other air pollution control districtagency is required for the work which Is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section..... beenn made? El Yes [INo 6 (If'yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. 1 agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authohze representatives of the City of Costa Men to enter upon the above-described propefor ins coon purposes. I agree not to occupy or allow occupancy of any building authorized by this ermit until final inspection. Stgnatu Legel'Ownegs)-. L_Dalei And/or Authorized Applicant Date CODE E. INSPECTION TYPE PATE INTnIALS CODE INSPECTIONTYPE �DATE� 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final BlocklRetaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy MINOR MODIFICATION Reference No.: Status: APPLIED Applied Date: 02-13-2004 Approved Date: 02/1312004 Denied Date: MINOR MODIFICATION NO.: MM -04-05 Project Address: 1141 DANIELLE DR Suite: Parcel Number: 41207166 Project Applicant: SCHELL, JENNY PROPOSED MINOR MODIFICATION: NEW THIGH, 26 LINEAL FT. OF BLOCK WALL ON RIGHT SIDE OF PROPERTY TO TIE INTO EXISTING WALL AT THE REAR. REQUIRt=D FINDINGS:Y The improvement will not be materially detrimental to the health, safely and general welfare of persons residing or working within the immediate vicinity of the project or to property and improvements within the neighborhood. Y The improvement is compatible and enhances the architecture and design of the existing and anticipated development in the vicinity. This includes the site planning, land coverage, landscaping, appearance, scale of structures, open space and any other applicable features relative to a compatible and attractive development. PROJECT PLANNER: NOTES: (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.cMILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1141 DANIELLE DR Status: ISSUED Suite: Applied: 07/21/2003 Vicinity: Issued: 07/22/2003 Parcel Number: 41207166 Zoning: R1 R1 SCOPE OF PERMIT 45 L.F. OF 7 FT. HIGH k- j� Applicant: SCHELL, JENNY FEE SUMMARY ISSUED BY: Address: 1141 DANIELLE DR $54.00 Claim Valuation: $1,500.00 SMIP Res: $0.50 SMIP Com: $0.00 Phone: 714-434-3778 Inspection: $0.00 COSTA MESA, CA Zip: 92626-1634 Owner: SCHELL, JENNY Address 1141 DANIELLE DR Phone: 714-434-3778 COSTA MESA, CA Zip: 92626-1634 Contractor: Address: Phone: Zip: License: Arch : Eng: Address: Address: Total: $89.60 SETBACKS MAIN STRUCTURE Front 0- 0 Rear 0-0 ACCESSORY Front 0-0 Rear 0-0 PARKING Existing: 0 Required: 0 NOTES: PLANNING & ZONING Left 0-0 Left 0-0 Proposed: 0 Right 0-0 Right 0-0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21.92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754.6626 244646 (6100) Phone: Phone: Zip: License: License: SCOPE OF PERMIT 45 L.F. OF 7 FT. HIGH BLOCK WALL ALONG REAR PROPERTY LINE. MM -03-31 FEE SUMMARY .Plan Check: $35.10 Calc Valuation: $1,500.00 Permit: $54.00 Claim Valuation: $1,500.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $89.60 SETBACKS MAIN STRUCTURE Front 0- 0 Rear 0-0 ACCESSORY Front 0-0 Rear 0-0 PARKING Existing: 0 Required: 0 NOTES: PLANNING & ZONING Left 0-0 Left 0-0 Proposed: 0 Right 0-0 Right 0-0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21.92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754.6626 244646 (6100) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which thispermit is issued. ❑ I have and will maintain workers' compensat n Ip 'nsgfance, as required by section 3700 of the Labor Code, for the performance of the work far which this permit is issued, My workers' cc e s 'o nsurance c policy number are: Carrier: Policy Number: (This section nee f be completed i/ the p if is valued at one hundred dollars ($100) a Igss.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not em!iloy any person in any manner so as to become subject to the workers' compensation laws of Cal!Vynla, and agree that it I should become subject to the workers' compensation provisions of Se tion 37 of the Labor Code, I shall forthwith r_comply_with these pro Applicant Signature: r—�C�.G_LC. Date: ��L W___ T WARNING: FAILUREE CO E WORKERS MPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT N EMPLOYER TO CRIMINAL PENALTIES AND IL FINES TO ME HUNDRED THOUSAND OOLLARE (S100,O00), IN ADDITION TO TME COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 31060E THE LABOR CODE, INTEREST, AND ATTORNEYS RNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Lic. N Class a Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code), Lender's Name: Lender's Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is s within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). �❑ 1 am e t der sec. Business and Professions Code for this reason: f aignatura11�.o�� Dale: Owner IDVenf d�b river' icense. ❑Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ............................................................................................................................................................................................................................................................................................................................................................................................ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ............................................................................................................................................................................................................................................................................................................................................................................................ 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ............................................................................................................................................................................................................................................................................................................................... 4 If an RMPP is presently required, has Section 25534 o.. the California Health and Safety Code been fully complied with? ❑Ves ❑ No ..................................................................................................................... ildi.......................................................................................................................................2ipl................................................................................................. ific............. 5 Does or will the applicant or present or future building occupant require for the work which is the subject c this a plication aIP No for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? � Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). .............................. ........ ..................... ....................... .... ........................................................................................................ ........................................... ........................... ............................................................................................................... 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). . .......................................................................................................................................................................................................................................................................................................................................................................-.................. 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No .............................................................................................................................................................11ut..............................ic-e..................................................................................................................................................................................... e (If'yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agre to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-descri property for insp Im pu oses. I agree not to occupy or allow occupancy of any building authorizepermit until al insgeclion. _Signature Of legal Owner(s) Date ...ir And/Or Authorized Applicant Dale CODE 1. INSPECTION TYPE DAFT INTITALS CODE INSPECTIONTYPE QAjF 1NTITLALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 20B Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Well /.2 1-�3 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy • THIS SKETCH IS FOR INFORMATIONAL PURPOSES - SOLID WADS/FENCES BETWEEN Yb' & 6, IN H8GHT SHALL ONLY. APPLICANT LS RESPONSIBLE FOR PROVIDING BE SETBACK AT LEAST 1V FROM FRONT PROPERTY LINE AN ACCURATE REPRESENTATION OF THEIR PROPERTY IN CASE THE SHAPE AND SIZE DO NOT CORRESPOND • SOLID WALLS/FENCES SHALL N07ID(® Y 6• IN HEIGHT WITH THE INFORMATION PROVIDED ON THIS SHEET. WITHIN 10 OF THE FRONT PROPERTY LINE PICT CURB LINE). • VERIFY DISTANCE FROM CURB TO PROPERTY UNE AND SHOW ON PIAN. VERIFICATION FROM THECT(Y5 DKINEERING DIVISION 5 REQUIRED. CALL (714) 7M -W FOR INFORMATION. X219 -moi rosPoat Lgp(P)C0B4oenrad ovePe "OluPuO Pelmmm lour 4 atR 2 P1.0A PLM W ftwqq We uglepq Aq atom IR4s Rgd Pue 9* IIIL Am 1W. M 9749" kffl ID uamw 24110 BLOCK WALL LAYOUT FOR BUILDING PERMIT PLANNING DIVISION TYPICAL 6`t CONCRETE BLOCK FENCE Cement Coping Optional 3' I r a • L TWO 3/8-0 BARS 6" 16" j � Channel Black With 1.3/8 , 16' �-WIDTH TO 16 0 'MA% c SEE CHART s Horizontal Top of all I BELOW , - INSPECTION. y Fences 0. For Fences 5' or Less Vert. Bars 3/8"q5 at 4' -0" D.C. For Fences Higher Than 5' Vert. Ban 3/8-0 at 32" O.C. Fill Cells Solid With Grout 2 °a r 'a >, x w x z Where Steel Occurs Rconforcing Steel Shall a 3 'A - Conform to Sec.A 15.39 A.S.T.M. - All Steel to be Lapped - 24'- or to Code u -'U Z - o r n --- NATURAL GRADE _ - _, 3' I r a • L TWO 3/8-0 BARS 6" 16" j � CONTINUOUS TOP 1 &BOTTOM 16' �-WIDTH TO 16 0 'MA% c SEE CHART s Hoatx•STEEL MUST BE TIED IN PLACE AT TIME OF TRENCH - I BELOW , - INSPECTION. y 0. 3 WIDTH THICKNESS DEPTH OF EARTHTOOTH SPACING OF EARTHTOOTH FOOTING REQUIREME 6' 5 14" -14„ 10'I I O" 24 20"- 12' 14' GENERAL- NOTES MORTAR: One Part Plastic Cement, and Three Parts Sand GROUT: One Part Cement Three and One Half Parts $and COPING: One Part Cement, Three Parts Sond CONCRETE:' Well Mixed 1:2-1/2.3-1/2 Mau of 7-1/2 Gallons of Water Per Sack of Cement GROUT MAY BE POURED FROM THE TOP OF THE FENCE IN CELLS WHERE STEEL OCCURS. CELLS AND AREASOF HORIZONTAL REIN FORCEMENT SHALL BE CLEAR, CLEANfL FREE OF ALL MORTAR DEBRIS, ETC. -`µms f - L .y • =DCpT H>C4' G'ARTHTCOTH s -`I ` -~ => i/3•i fHE HEIGTH Or FENCE ' sLs OW: BOTTOM OF FOOTING y _ • SCALE: 1/2n = 11 Z'1 -_,M CHART: . BUILDING DIVISION 4", 3' I 6. 6" 16" j 12" _ 16' 16' ' FROM FAX NO. : Jun. 26 2000 09:47PM P2 U: WENDY SHIN PERMIT PROCESSING CENTER SUBMITTAL APPLICATION 2%46.4 Imv. 10m1) Activity Number: — Received By: 1141 DANIELLE DR, Project Address: Costa Mesa 92626 Suite/Unit: EXISTING CHAIN LINK FENCE ❑VE.S ©NO OFFICE USE ONLY SUBMITTAL TYPE: E] Building ❑ Engineering ❑ Sanitary District 0 Fire F) Planning ❑ Grading ❑ Sign ❑ Flectrical ❑ Plumbing ❑ Mechanical Other Description of work to be performed: (please be specific) REPLACEMENT OF EXISTING ROTTING REAR YARD FENCE COMMON TO MYSELF AND NEIGHBOR WITH BEIGE 7 FT BLOCK WALL FF.N ..RF,F SIGNED AGRFFMFNT Sq. Footage: Type of Canxt: Valuation: Occupancy Type: Occupant Load: Grading: Cut/Fill cubic yds. Owner/Tenant: JENNY SCHELL PhoneNo.: 714_434_3778 Address: 1141 Danielle Dr. Suite/Unit: City: Costa Mesa Scale: Ca zip: 92626 Applicant/Agent: Phone No.: Address: Suitc/Unit: CDLN/SSH: Cirv: State: Zip: Architect/Eng.: N/A Reg. No.: Phone No.: Address: Suile/Unil: City: State: Zip: Contractor: OWNER /BUILDER Phone No.: Address: Suite/Unit: City: State: Zip: State 1_1cense No.: Class Expiration: Workman's Comp. Policy No.: Expiration: Instuancc Company: (SEE RACK FOR ITEMIZED ELECTRICAL MECHANICAL AND PLUMBING) N/A (2547-46) 2%46.4 Imv. 10m1) FROM : FAX NO. Tun. 26 2000 09:48PM P3 .nn _IC-a'l +a.ra flanM.uILLACCUAY MANACP.. Iu:anaogovina illOP 2, oXrcatnQ ADDITION -EXCLUDING PAIN -11N& Neighbor Awareness (for exterlbr additions only - excluding painting). Right Side.- Name: See Previously Submitted Signed Document Addreeel Signature: Date: Left Side: Name: Address: Signature:_ nate - At Rear of Lot: Name: MZCHAFL S_ CHERRPA AAA..... 3408 Wimbledon Way-)_--) Directly Across Name - the Stmt Addreeat Signature: nate- Description of changes) dosirod. Briefly describe purpose and/or reason of exterior modification. For sbuctusal and landscape submit two (2) sets of architectural drawings. Show location on lot, changes to exterior walls, and elevation (if appropriate). Replacement of existing rear yard fence common to Schell and Cheskes/neighbor,with masonry 7' beige block wall; share of said expense 50/50 between Schell and Cheakea. .s0/SD ,�. G1Ao�rx �' �y 22 7001 PROPOSED STARTING DATE 1. 2. Date received by Management: —,Zulu 28, 2003 r PROPOSED COMPLETION DATE Data submitted to Archkwtural Committee: "V1116~1\Pr40M%W4nW0d= Ojm% rcMMCLMaecav g thrar 601prMu.42m PROJECT ADDRESS: 1141 DANIELLE DR z i I UNIT: OWNER'S NAME: DAIGH, JACQUELINE G D ADDRESS: 1141 ANIELLE DR No C^Tbb COSTA MESA,CA 92626 ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: NOCK PLUMBING (714)895-1246 ADDRESS: 11610 SEABOARD CIR STANTON CA 90680 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in lull force and effect. GITY uc.: O G 0 3 6 STATE uc: 511971 g - CLASS: C •'� Signature: NEflS' COMPENSATION 0 CLARATION: hereby affirmthat I have a certificate of consent to self -insure ers' Compensation Insurance or a certified copy thereof (Section 3800, Lab, C). POLICYNO.: 1167992-94 EXP. DATE: 03/01/95 COMPANY: STATE .❑ Certified copy is hereby furnished. ® Certified copy is file ' h the city Building Division. rte/ -J Applicant: EMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ill or less). I century that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws or California. Date, Signature'. NOTICE: If, after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 701 of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builes or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I. as owner of the property. am exclusivelyy contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractprfs) license pursuant to the Contractors State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said stale codes and the requirements for a permit for construction or modification from the Air Oualily Management District. Residential construction applications are exempt from these provisions. Dale: Applicant I hereby certify that I have read this application and state that the above the above inlm4�correct. l agree to comply with all city and county) agree to comply with all city and county ordinances ldu ung to building construction and her�esen es of this city to enter upon the above-mentioned property for instiller, our aces. ate: Signature: nrmer's I Ii or social Securitv 1641-46 Wbae—Building; Green—Code Enforcement-, Canary—Applicant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 066262 PERMIT NO: P 066262 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH JOB DESCRIPTION DISHWASHER CHANGE—OUT SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING REQ: PROV; PARCEL: 41207166 ZNE: REF NO: PLANNING NOTES> D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: DATE: LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 7.00 25% SMIP/NON—RES PLAN ISSUE FEE 20,00 BUILDING—DIV—> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 7.00 20.00 0.00 27.00 27.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 27,00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 27.00 ############################################################################### I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N= UNIT COST TOTAL COST PLU 1 DISHWASHER 7.00 7.00 END OF FEES 71 00156675-00156675 TOT 27.00 DATE; 03/07/94 TIME: 09:43 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POO' SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding I 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd, 57, APPROVAL TO COVER-GUNITE 7. Footings _ 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, 0 Undrgrnd„ Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, PRTrap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains . r 64, Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16, Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18, Rough Electrical -T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Verttlating 71. Product Piping 0 Gas CI Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank E]Gas 00il 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33, Final Electric -1 Notes:4 + J iJ tie h _ / 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test i- 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40, Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer '. 43. Backflow Irrigation 44. Landscape Irrigation System - 45. Sound Attenuation. 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48, FINAL PLANNING r 49. Electric Release to Edison i 50. Gas Release to Southern California Gas Co _ 51. CERTIFICATE OF OCCUPANCY No. Date s A i 0.t"79139 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 8791 2/2.1/79 293.19 TT 293919CKf IA -- I APPLICATION llW§'1RU OM 9PERMIT. For Applicant to Fill in Completely - Use Ink Only 2701 R EI DAE-RECEIV DATE ISSUED BUILDING ADDRESS Tract 10277, Lot 42 PERMIT NO. 07J-0 OWNER McLain Development Co. A.P. NO. 5�/,i- MAIL 1470 Jamboree Road BUILDING ADDRESS J �J ADDRESS TEL. CITY Newport Beach No. 640-6600 TRACT /0277 LOT z BLOCK NEW ADD ALTER REPAIR MOVING CONSTRUCTION LENDER OWNER C / BRANCH ADDRESS -1 UE n US N $ 1 FIRE ARCHITECT TEL. OR ENGINEER Corbin Yamafu'i TOL ADDRESS 3661 Spruce St., Newport Beach ZONE TYPE GROUP APPROVED CONTRACTOR jv] BY DATE ADDRESS 1470 Jamboree Road TEL. ZONE NO. OF PLAN$ USE OF NEW BUILDING CITY Newport Beach NO. 640-6800 DR-mD RE S STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. 273875 LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF BLDGS. (FROM C/L STREET) OF LOT 45 X 112 NOW ON LOT FRONT FT. 0 FT. USE OF EXISTING BLDG. SI FT. 0 FT. .Separate permits are required for L. SIDE S, FT. 0 FT. electric, plumbing and heating work. REAR O FT. 4 FT. USE OF BUILDING AND WORK TO BE PERFORMED 'DISTANCE BET. BET. MAIN & MAIN SLOGS. ACCESS. SLOGS. Single family residence, VAR.` C.U.P.# Zr- ] -3 DATE '/ APPROVED O New House APPROVED owZJIDATr 411061 HOLD FOR SPE IAL RE UI N I hereby acknowledge that I have read this application and state that the above Information is correct and agree to comply with House 1685 all laws regulating building construction, and 1 shall not employ any person in violation of the workman's compensation laws of 436 the State of California. 1 hereby certify that I am properly licensed as a contractor under SO. FT. Garage THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; am exempt from the provisions of the State of California Business VALUATION PERMIT FEE and Professions Code, Division 3, Chapter 9. $ Signature of (\�� (' /]/[' PLAN CHECK $ Lo. �V ,,t •,, ^ Permittee _Y-i� /1 v C_ �I )✓1 ( /V`-'O� r rJ $ '/�/ 7� `•/`••V// /// TAX $ Authorized nt TOTAL PAID $ 3ey I