HomeMy WebLinkAbout242 CECIL PL - Building Permits(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.c���LDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 242 CECIL PL
Suite:
Vicinity: DUPLEX (242/244 CECIL PL)
Parcel Number: 42607317
Applicant: FAUBERT, TRACI
Address: 8902 SAILPORT DR . � .
HUNTINGTON BEACH, CA �
Owner: LENDEEN, WAYNE J
Address - 242 CECIL PL � -
��
, - � COSTA MESA, CA . .
Convactor: STAR COURSE ROOFING CO.
Address: 8902 SAILPORT DR
HUNTINGTON BEACH, CA
Zip: 92646-2664 , License: 532778
Arch :
Address:
Zoning:
Phone: (800)854-0011
Zip: 92646-2664
Phone:
Zip: 92627
Phone:�(800)854-0011
Eng:
Address:
Status: ISSUED
Applied: 10/22/2003
Issued: 10/22/2003
ISSUED BY:
. / �
� A��,
�, ..A . . � � ,
�
� � • Phone: �. � ,- Phone: "
Zip: ' � License: , License:
- � - SCOPE-OP PERMIT
REROOF DUPLEX (ADDRESSED 242 AND 244 CECIL PL) AND GARAGES: T/O EXISTING COMP ROOF, REPAIR/REPLACE SHGT AS NEEDED,
1 LAYER 15# FELT, APPLY "30-YEAR GAF FIBERGLASS SHINGLES." 34 S�UARES � �
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other.
Inspection:
Total:
$0.00
$97.25
$0.50
$0.00
$0.00
$0.00
$97.75
SETBACKS
MAIN STRUCTURE FrOnt 0-0
ACCESSORY Front ` -0-0.
PARKING Ezi�: o
FEE SUMMARY '
PLANNING & ZONING
Rear � 0- 0 � Ceft 0- 0�
Rear 0- 0 �. Left 0- 0
Re uired: 0 , , Proposed: 0�
Calc Valuation:
Claim Valuation:
Right A- 0� � - ' i �
�i �
Right 0- 0 ,
$3,400.00
$3,400.00
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under Calitornia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abantloned
for a period of 7 BO days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and flnal epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR lNSPECTIONS CALL: (714) 7545626
zane�as 15�00)
WORKERS' COMPENSATION DECLARATION:
I hereby afFirm under penelry of perjury ane of Ihe lollowing tlecleretlons:
❑ I heve end will maimaln e ceniticete of consent to self-Insure lor workers' compensetion, es provitletl for by sectlon 3700 of the Lehar Code,lor Ihe pedortnence of the
work for whiCh thi5 pertnit 15 issued.
�I have antl will maintain workers' compensation insurance, as required by sectlan 3700 of �he LeUor Cade, lor Ne peAortnance ot the work for which Ihis pertnit is I55ueA.
o cers' co�ensation I urance carrier entl pollcy numbar ere: i��������
Carrie � Policy Number:
(!h!s se n need not e mp etetl!! the p i/t!s ve/uetl et one hundretl tlollers ($f00) or less.) - "
❑ I cerlify ihat in the p rt rmance ot the rk for which this pe ' is Issu I shell not employ eny person In eny menner so es to become sublecl �o the workera'
compensation laws i alifomie, entl rea Iha i I s�ou10 be u ject to the workers' compensatlon pmvisions of Sectlon 3700 0l the(� bar Cade, I shell forthwith
Complywit h e r ' �, �^/��'7
ApDliwm Signat e: � Date: —� G i L "' ✓
WARNING:FAILURE SECUREWORKERS' ENSATIONCOVERAGEISUNIAWFULANDSHALLSUfl1ECTANEM%.OYERTOCiLAUNALPENALTIESANDdVILFlNESUPTOONEHUNDREO
hKKISAND DOl1AflE (5100,OW), IN ADDITION TO THE C0.ST OF COMPENSATIIXJ, DAMAGES PS PROVIDED WR IN SECfION 3N80F THE LABOR OODE, IMEREST, AND ATTORNEVS FEES.
LICENSED CONTAACTORS DECLARATION:
1 hereby aflirtn Ihat I em
force antl eHect Lic. # _
Contradofs Sicnature�'
wilh Section 7000) of Divlslan 3 at the Business en�rofBssions CoAe, antl my Ilcense is In tull
� Class M � f.��1 _
Oate: % I 8' � �
CONSTRUCTION LENDING dGENCY:
❑ I hereby atfirtn Ihat there Is e consiruGion lending egency for tha pertortnance of Ihe work tor which t�is pertnit Is issued. (Sec. 3097, Clvil Cotle).
Lenders Name: LenAeYs Atltlress:
Signature:
Date:
OWNER-BUILDER DECLARATIONS: .
1 hereby e�rm that under penalry of perjury thet I am E%EMPT FROM THE CONTiiACTORS LICENSE LAW for the following reason (Sec. 7031.5, Buslness end Professions
Cotle: Any ciry or counry which requires a permit to consiruct, aller, improve, demolish, or repair eny struclure. pnor lo its issuance, elso requires Ihe epplicant for such pertnit
ta tile a signed statement that he or she is Iicensetl pursuant to the proWslons ai Ihe Conireqors lJcense Lew (Chapter e(cammendng with Sectlon 7000) of Divislon 3 of Ne
Business and Professions Code) or that he or she is exempt thereirwn and the basis far the ellegetl exemption. Any violation of Sectlon 7031.5 by any eppllcent for e pertnit
sub)ects the applicant to a civil penalry oi not more than five hundrea Aollars ($500).):
❑ I, as ov.•ner oi the properry, or my employees with wages as their sole compensetion, WILL DO THE WORK, end the structure Is not IntenOetl or oflered for sale (Sec.
70d4, Business and Professlons Code: The Coniractors Llcense Law Coes not epply to an owner of property who builds or improves thereon, antl who tloes such work
himsetl or hersetl ar thmugh his or her own employees, pmvideA that such improvements ere nat intended or oMered for sale. If, however, ��e building or impmvement is
soltl within one year oi completion, the owner-builder will heve the burtlen of proving �he� he or she did no� build or impmve for puryose of sale.). '
❑ I, as owner af ihe properry, am EXCLUSIVELY CONTRAGTING WITH LICENSED CON7AACTORS to construct tha proJect (Sec. 7044, Business end Professions
Cade: The comractors license Lew does not epply to en owner of prapeny who bullds ar improves t�ereon, entl w�o contracis lor such proJect with e contractor(s)
license pursuant to the Coniractors License Lews.).
❑ I am exempt under sec. _
Signeture:
Owner ID verified by driver'Slicen58.
Vedtication of Owners�ip Dy (typa oi
Business end Pmfessions Cade tor Ihis reason:
Ves ❑ No Driver's License No.
it, I.e. - pmper�y t� blll or dead):
Dete:
Eapires:
DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION:
❑ 1 hereby certity that no exwvation five (5) or more leet in depth Into which e person is required ro descend, will be matle in connecllon with work authodzed by this
pertnit, end that no building structure, sceHalding, talsework, or tlemolltion or dismentling ihereof, will ba more than thirty-sl: (36) teet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Califomia Administrative Code).
❑ As ownerbuiltler, I will not employ anyone to do work which would requlre e permit from tha Dlvlsion af Industdal Sefety, es notetl e6ove, unleas such pereon hes e
pertnit ta da such work from the division.
Signature: Data:
Divlsion ot Induslriel Safe�y Permi� Number:
CERfiFlCATE OF COMPLIANCE IWD AUiHOHIZA110N OF ENTRV: I cenity under penalry ot perjury Ihet I heve reed this epplicatian end state that t�a informetlon gNen is
canect. I egree Io comply w%h el te laws end Ciry ordlnances releting ro bulltling construqion, end authodze representetives of the qry of Coste Mese ro enter upon the
ebove-descnbed,p)operty for ins eccipn purposes. I agree not to occupy or ellow occu0ency ot eny building euthonzed by Ihis permil until final inspecti0n.
CQOE t. INSGECfIONTYPE
1616 Fixed System Final Fire Prevention
1266 Paol Spe Final
200 Final Re-Roof
201 Final BIocWRelaining Well
202 Final Fedory Fire Place
203 Flnel Sign
20a Final Demolition
�.1 Clill�
:�m�� �w
�:
� / i ,�
�. .
COOE I INSPECTION TYPE
206 Final Mechanlcal
208 Final Plumbing
210 Finel Eletldcal
212 Finel Flre PrevenUon
220 Finel Plannln8 ApProval
222 Finel Site
250 Finel Builtling�Occupency
PAg Q�l45
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D�ammww d iM wk Iw whidi nre L�1 b e�W (Saaian i�. tiv. CI.
LEN�Efl'9 NAME:
lQl�EX'9 �CONESS:
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(a imPalbn pu0ass.
AON t3QCK
(5151�6.WP1 Wh4e-&1idiq
V'vJc-As�arwn: OaUemed�Asieaoe
, GITY OF COSTA MESA — BUILDING PERMIT
� PERM NO: F 072993
PERMIT NO: p�Q\72993 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE`, V—N pERMIT TYPE: PLU PDRPOSE: OTH
SOB DESCRIPTION ; WATER HEATER SQ FT:
CLASM VALUE: CALC—VALUE: GROUP OCC; R-3 !
COMMENTS: NO OTHER WORK AUTFiORI2ED BY THIS PERMIT
****+�x�*********���*�*�r********�*+r�r�+c�+�***�**����+��r�r��*�r���*+��*�*�t�*�******��+��+�
Z O N I N GS ERTEBQAUCIKRSE M E N T S
------ ----- MAIN HUILDING ---------- --------- ACCESSORY BUSLDING ---------
�RNT: FT IN REAR: FT IN FRNT; rT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 412112Q6 ZNE: REF NO:
PLANNZNG NOTES>
>
iE if aE if iE 1f 1E iE if 1E 3f f61f fE if 1E if 1f if if iF �E if if iE ff !E if iE1f if af 1f 1f 1F1E fE 1Elf iF iF if �E if 1f%!f iFlP �ElflF iE i6 iE N� iF iE 1F iF iE iE IE iF iP iF fF #F iE 3F iE 3E �f iF 3E iE iE iE iE
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: 2 ` 1
iFlFikiFlEiElklFftiElFfF�ElfiFkiFiElfiEiFi! ��F�Q'i�'�iF1EiE1FiEffiEfElffEdE 1E�E
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL EGMENT:N
BLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIPIRES GRADING
PERMIT
PLAN
ISSUE FEE
gU2LDTN�3—nIV—r
TOTALS---->
7.00
?y�
20.00
pE7M00 20500
SMIP/NON—RES
PLAN—CHECK TOTAL PAID DUE
0.00 27.00 27.00 ,QO
REVENUE QISIISION TOTALS--> COLLECTED: 27,00 OVER/SHpRT; 00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
27,��
iF if iE aE 1F if iE 1E iE if 1E k iE iE if 1E 1f 1f iE 1t if !k 1f fE if if �E iE �E iE if fE if iE �F iE if iElf if 1P iE 1E k 1E 1E ff if 1F fE 1kiE �f iF if iElF 1E IE IklElF 4 f(� 1! #f 1E 1f 1E Ik f! #t iE #(-it If if iF iF
I N D I V I D[J 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 i WATER HEATER AND��ENDEOF FEES 7.00 7.00
EX��DATE � � �� �'' "
!
1.. . :'�.
` ,_ : _ �
�._ C _. . .. ...
-�-
'ECQNSTRUCTION AND PLANNING PO S SPA ��
APPROVALS Permit # Date Inspector APpROVALS Permit # Date Inspector
1. Temporary Eiectrical Service or Pole 52. Pool & Equipment Location : •
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement 7
. i
3. E�ectrical Conduit Utility-Undrgrrid. 54. Forms "�
4. Electrical Co�duit-Undrgrnd. ' 55. Electrical Bonding
5. Steel Reinforcement � 56. Rough Plumbing & 7ressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
� 7. Pootings �- 58. Electrical ConduirUndrgrnd.
8. Foundation 59. Gas Pipe, O Undr9rnd., Test � �
9. Water Pipe�Undrgrnd. i 60. Backwash Lines, P�Trep, � Undrgrnd.
10. Structural Floor SY:tem � 67. APPROVALTO DECK , '
11. Property Sewer Line & HouseCorinection r' 62. Backwash & Receptor•Finai �
r 12. Sewer Cap ' 63. Heater & Vent�Final �
13. Roof Drains 64. Piumbing Sys[em � Final�
14, Rough Plumbing 65. Electrical-Final
15. Rough Eiectrical-Conduic . 66. Solar System-Final �
16. Rough Electric Wiring � 67. Fencing & Access ApProval ,
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Electricai-T Bar Ceiling ' ' 69. POOI/SPA SYSTEMS FINAL �
19. Rough Neating & Air Conditioning FIRE DEPT, REQUIREMEN�
20. Rough Factory Fireplace _ APPROVAIS Permit #�
21. Ducts, in Structure _ 70. Underground Hydro
22. Duccs, Ventilating - 71. Product Pipinc� O Gas ❑ Oil
23. Gas Pipe•Rough & Test - 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil �'
25. Roof Sheathing 74. Overhead Hydro r
�^�� .
26. T�Bar Celiing (Structural) & Monocoat 75. Dry Chemical F�--!
27. Frame and Flashing 76. Dry Siandpipe `-^ '
,�
28. Lathing & Siding � 77. FIXED SYSTEM FINAL
29. Insulation 76. FIRE PREV. FINAL �
30. Drywall Nailing HEALTH DEPT. RE�UIREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION • �
32. Electriral Power Meter•Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: �Li_��-C� N� ����T�_ __
34. Final Heating & Air Conditioning '
35. Final Gas Pipe�Test
36. Hood or Canopy . . �
37. Final Factory Fireplace - �
38. Final P�umbing
39. 4Nater Service�Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation SYstem '
45. Sound Attenuation �
46. Handicap Reg�lations
47. FINAL STRUCTURE & BUILDING .
48. fINAL PLANNING �
49.'Elec[ric Release to Edison
50. Gas fielease to Southern California Gas Co
57. CERTIFICATE OF OCCUPANCY
N0. Date
AOOlicant to fill in all spaces except those wit�in �eavy Do�Eer lines anO si9n all approoriate Ceclarations.
C NSTRUCT PERMIT PES,[v11SN0.,� ��,�n TRACTNO. LOTNO. UNITNO.
CITY OF COSTA MESA
, Project Address
Applicant's Mailin Address O
Owner's Name n Phone � l3 r
Addreu ,4f�,�y��%
Arch/Eng. License No.
Address '
Contractor's Nam Phone � .
Address (mailing) � �
City License No � �
LICENSEO CONTRACTOR DECLARATION
I hereby aHirm [hat I am Iicensetl untler provislons of Charter 9(commencing
wlth section ]000) ot Division 3 of the Business'antl Professlons Caae, antl
my Itcense is in ful fo and eHect.
Licens Cla s ic nse No
Dale - Si9na[ure
vpRKERS'COMPENSATION OECLARATION
iereby a(firm that 1 have a certificale of consent to selt-insure or a certiticate
r Wo�ke�s' Compensation Inw�ance, o� a ce�tifletl copy tnereof (Se[ti n
3800, lab. C ,I y _ �7 /� ��A � O�
Polic No. �Q����� "O � Compan�a� ��.�
ertifietl copy is lte�eby fumishetl.
Cer i le op i tiletl with the tity "Itli ' i' n.
Date.�fL-�� APplicant
EXEMPTION FROM WORKERS' COM SATION TI N
(This sectiOn nee0 nat be completetl it the permit is for one huntlretl (§300) or
less�.
I certity ihat in [be Oe�fo�mance of th¢ work (Or which,this permk is issuetl, I
sM1all not employ any person In any manner so as to become subject to the
Workers' Compensation laws of Calitornia. '
Date Signature
NOTICE: If, af[er making this tleclaration, you shoultl become subjec[ [o the
Workers' ComOensalion provi5ion5 of N¢ LAbo� Cotle, you must brthwitn
com0ly with Such 0/ovlsions o� this' pe�mit shall be deem¢tl revokotl.
CONSTRUCTION IENDING AGENCV
I hereby afBrm that tnere is a construction lentling a9ency for the performance
o/ the work for which [hi5 permit is issuetl ($ection 309] Clv. C.)
lPntler's Name
Lender's AtltlreSs
OWNER BUILOEN OECLARFTION
1 hereby aftirm that I am exempt trom the Contractor's License Law for the
following reason (Section �031.5 Business antl Professional Cotle: Any ciry or
county wnich r¢quires a Oe�mit lo Construc[, al�e�, imprave, tlemolish or repair
any structure, prlor to Its issuance, also requires the applicant tor such permlt
to file a signetl statement ihat he/sne is licensetl pu�suant to th¢ provi5ion5 of
'he Contractor's License Law (Chapt¢r 9_(commencing wlt� Section ]000) of
ivision 3 of the Business antl Pro(essions Code) or that he/she i5 ¢xempt
ierefrom antl the basis for the allegetl exemp[ion. Any violation ot $ecHon
i031.5 by any applicant for a pe�mit subjects [he applicant to a civil
�enalty of not more than tive huntlretl tlollars ($500�.
I, as owner of ihe O�oOerTy or my employees with wagez as tneir sole
compensation, will tlo che work, antl the structure is not intentleG or ofie.etl
fot sale (Section ]044, Business antl Protessional Cotle: The Contracto�'s
License Law tloes not apply to an owne� of a property wbo builtls or impmves
t�creon, and who does such work� himzelf/herself or tnrou9h nis or her own
em0�oyees, provitletl [nat such improvements are not intentletl or offa�etl for
�sdle. H, howeve�,-tite builtling or improvement i5 Soltl witM1in one year Of com-
pletion, tne owner will have tne burtlen of provinq he/she tlitl no[ bui10 or im-
prova for (he purpose of sale).
❑ I, as owner ol tbe O�operty, am exctusivaly contractln9 with Iicense0 con-
lractor5 to consVuct th¢ profecl (Settion ]044, Business antl P�ofesslons Cotle:
The Contra<tor's Licanse Law doez not apply to dn owne� ot property who
builtls or improves thereon, antl who con(rac(s for such projects with a con-
bactor(sl ucense pursuant to tM1e Contrac[or's License Law�. I am aware that
proof Of tnei� Wo�ke�'s ComPensatlon insuranc¢ shoultl be provitletl lo me.
❑ I am exempt unaer Section B. & P. C. for Ihis reason
Oate Owner
1 heretiy certity that I have rea
information a<orrecL I agree to
antl state laws relating to bulitlir
sentatives of this city to ente
inspectlon p s .
Siqnature
oriverz' License or 55 �
_� MF 0865�46, �ev. 30/84 W�ite - E
][his appliCation antl State.that the abOve
comO�Y `�`/ith all city antl county ortlinances
y Const�uctlon, antl hereby au[horiza repre-
�� pon t�e above�men[ionatl pro/perty pfor
Daie_�l��U �.
"- �
TYPE OPCONSTRUCTION NEW AOD ALTERATION REPAIR
,� ❑ CONVERSION ❑ DEMOlISH ❑ OTHER A p #
- DESCRIPTION OF WORK/USE OF BLDG.
.. S Main Building:
E
TVVE�OFPERMIT GRADING FOVNDATION '$TRVCTVRAL T F�Ont
.O TENANT ❑ ELECTl31CAL �LUMBING ❑ MECHANICAL A Reef
•� ❑ OTHER C RlcPub
PROJECT DESCRIPTION SQ. FT. OCCVPANCV K
CONSTRUCTION TVPE VALUATION $ S Left
:+
ZONE GRAOING CU.vDS. ACRES Ping. Ref. #
Remarkz; ' Planning Notes:
Sink
Preventer
Irriqation
Drinking Fountains
Floor Drains '
Floor $inks
Gas Service OuUets
Interceptors
Ki[chen Sink
Lavatories
P—Trap
Roof Drains
Reinspection Fee ! $75
Duct� Under Ground
Duct - Svuctural
Duct � Ventilating
Exhaust System � Mul[iple ❑
Firepl/Fact Blc ICBO #
Heating System & Ducting
❑4700,000 BTU 0100,000 BT
Reinspection Fee � S75
Itlinq; Canary - Applicanp Pink - Accounting; Goltlenrotl - A55e55or
Showers
Servite Sink
Sewer Cap
Sewer Conriection
Solar Collecrors.
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Warer Heater
Warer Service
Auto�Wesh
Issue Fee
Hood or Type I ❑
Canopy Type I I ❑
Refrigeration System
❑aioo,000aru ❑ioo,000eTu
System Repair/Alteration
fire Dampers
Registers
laue Fee
FEES
$ 3
$ 3
Auromatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers �Gas ❑Electric
Fan
F.A.U.
Pixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generamr �0-5 KW C
088� 12/04/97
. i
5000 TL
Zone
Accessory Building: .
2
O
N
1
N
; . G
R
Parking Req./ProviCed • E
Q
- M
T
$
ELECTRICAL , .
Transformer ❑ 15-50 KW
O 50+KW
Meter ❑up to 100 amps
Meter ❑over 100 amps
Sub Panel
Motors D O-1 HP � 1 Yh - 8
Inc.Solar �9�15 HP �16�75+
Microwave �
Pole Light �
Sign
Standing Sections
15 KW Trash Compactor
I Reinspection Fee �$75 ' I luue Fee
DEVELOPMENTSERVICESREQUIREMENTS:
Zoning Approved By
Building Approved By
Appliwtion IssUad By
FEES
$ 3
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ �— PERMIT
PLUMBING $ -� • �/� ISSUANCE $ �
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRAOING � $ '
PLAN CHECK � 50°� $ MICROFI LM $ �+
MECHANICAL S TOTAL FEE $ v�%
PLAN CHECK 25% $
CONSTRUCTION AND�PLANNING , POOL &'SPA - .
APPROVALS Permit�# Date Inspector qPPROVALS Permit# Dace Inspec[or
i. Temporary Electrical.Service or Pole � 52. Pool & Equipment Location ' , i
�•
2. Soil Pipe-Undrgrnd.'� 53. Steel Reinforcement ' �
3. Electrical Conduit U[ility�Undrgrnd. 54. Forms ,� � , .
��z ,
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding !�> �
5. Steel Reinforcement � 56. Rough Plumbing & Pressure•74st �
6. Electrical UFER Grnd. 57. APPROVALTO COVER�GU�NITE �
7. Footings 58. Electrical Conduit-Undrgrnd-�
�
8. FoundatiQn �L . 59. Gas Pipe, O Undrgrnd., Test;, r
9. Water Pipe-Undrgrriil-'� 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK L•`
i t. Property Sewer Line & House Connection 62. Backwash & Receptor-Final �,� ,
12. Sewer Cap 63. Heater & Vent-Final '
13. Roof Drains 64. Plumbing SYstem - Final
14. Rough Plumbing 65. Electrical-Final �
15. Rough Electrical-Conduit 66. Solar System-Final '
16. Rouc�h Electric Wiring 67. Fencin9 & Access Approval
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING �
18. Rough Electrical-T Bar Ceiling -�' 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ,
20. Rough Factory Fireplace APPROVALS Permit # _
21. Ducts, in Structure 70. Underground Hydro �
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil -
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 PREV. 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 � � Notes: �Z��.� (��- � _
C4�2o, L. �_D ,F �
34. Final Heating & Air Conditioning ��� N
G-- �
35. Final Gas Pipe-Test 3_io-�a� lanc.F.(., Rs aee 2a3 �� . L. E•D
36. Hood or Canopy ,; ,
37. Final Factory Fireplace � - ' �
38. Final Plumbing - � " �
39. Water Service�Final • . �
40. Gas Service-Final - ,. � �,
, 41. Solar pomesticFinal . � . -
42. Backflow Preventer � . . � . � ,
43. Backflow Irrigation , , � . � , , .'
�
-44. Landscape Irrigation System ' ' . ..�- � •"''
45. Sound Attenuation � . ' ' . ' "
46. Handicap Regulations - � � , � .
47. FINAL STRUCTURE & BUILDING �• � -
i -
48. Special Requirements Completed .. , �'� � "
49. Electric Release to Edison '
50. Gas Release to Southern Califomia Gas Co � . " " � :
�
51. CERTIFICATE OF OCCUPANCY , '
No. Date � � ' �
' .r,,
„j. . �� ADP���ant to lill In all s0aees exceD� tnase wlt�in �eavY Oortler Iines anE sign all apD�opriate 0eelantions.
IT PERMIT NO. TRACT NO. LOT NO. UNIT NO.
CP
CiTY o TA MESA11 1C.ONSTR/UCTION'�ERM
Prolect�d��I � M M b Q G t
Applicant'sN�ingAddreu S4�-7 _Ol1ar S
Owner'�NOme —�r'N �Jr""rJl Phone
Address
Arch/Eng. License No.
Address
Contractor's Nam y,. Phone.�Z1 —4 i/,7
Addresslmailingl nn�� I
Ciry �icense No. � 4U � �
LICENSED CONTRACTOR DECLARATION •
1 hereUy aHirm that I am Iicentetl untler provislons oi Charter 9(commencing
with 5ection ]000) ot Division 3 of tha Business antl Protezzion��cQ �
Ty IiC¢n5¢ i51n fUll /O�Ce deltl BHeCL ,SZ `
Ucense Class r—' � Lice se No.
oate � � � `1�%�T Siqnature
'VORKERS'COMPENSATION DECLAR T N
hereUy aftirm Nat I �ave a certHicate ot unt selNnsure or a certiflcate
,f Worker5' CompenuNOn InSurance, Or a certifietl cOOY thereot (SectiOn
3800, Lab. C.)
Policy No. Company
eCertified copy is hereby lurnishetl.
Certltietl coDY Is tiletl wilh the city Builtlin9 Division.
Da[e Applicdnt
EXEMPTION FROM WORKERS' GOMPENSATION DECLARATION
(This sectian neetl not De completed if tna permit is for one �untlretl (S100) or
le5s).
I certify that in the pertormance Ot Ine wo�k to� wl Ich tbis ¢�m4 I5 Issuetl I
Shall nOt employ any pe�son In any manne� So a5 to bec e 5 bjeGt [o t�e
Workets' Co�n"pens�t IQ0 LawS of CalifOmla.
oate �-I• /q- (•�( Signa[ura
Workers' Compensatlon �provisions oi the �La r otle, y8u� must (orthwith
wmply with sucn' provisions o� thii perm all be tleemGtl revoketl.
CONSTRUCTION LENDING HGENCV
I he�eby affirm lhat thero IS a<onstru<tion Ientling agency to� the perto�mance
of tna work /or wnlch t�is permlt is Issuetl (Section 309] Civ. C.)
LPntler's Name
Lentler's Atltlrezs
OWNER BUILDEIi UECLARATION
I hereby aftirm that I am axampt lrom the Contractor's �icense Law for the
lollowing reason (Soclion 7031.5 Busine55 antl Professlonal Cotle: Any dty or
county which roquires a permil lo construct, alter, improve, tlemolish or rapalr
any s(ructure, prlor ta il5 issuan<e, also reqWrei Ihe applicant for 5uth perml[
to fiie a signetl slatament that ho/s�e is Iicensetl pursuant to [he provislons of
the ConlractoYS Llcens0 Law (Chapter 9(commencin9 wilh SettiOn 7000) of
�IvlSion 3 of thC Bu5ine55 antl ProfeSslonS Cotle) or that he/She is exempt
.ber¢trom antl tha basis for thc allegetl examptiOn. Any vlolatlon of SetHon
7031.5 Dy any apPlitant tor a Oa�mit subjects lha applicant [o a civil
�enalty of not more tnan five nuntlretl tlonars (E500).
I, as ownar o1 lhe property O/ my am0�0y¢C5 with wages as thoir sole
compensatfon, will Co tho work, antl tho structure Is not intentleC or ofteretl
for sale (Saction ]044, Business ane Protessional COEe: TM1e Conbactor's
LicenSe Law tloM not app�v to an owner o1 a properry who Duiltls or improves
thereon, antl wlto tloes Such wO�k nlm5¢tl/hurselt o� throu9h hi5 or her own
employ ees, p�ovlCetl Ihat zuc� ImprOVOmenIS are not IntenOetl o� offeretl 10r
sale. II, however, tne bulltling or Improvament is soitl within one year of com-
plotion, tne owner will hava the burtlen ot provin9 he/sh¢ ala not builtl or im-
�rove for tho purpose o1 sala).
1, as owner O/ lhe property, am exclu5lv¢ly conl�acting with litensetl con-
tlactorS�U COnitfuct tha projOct ($ECtiOn 7044, Busine55 an0 PrOtessioni Cotle:
The ConVactor's License Law does not apply to an owner of property wno
builtlz or Improvas lherean, antl wh0 cOnVactS tOr Su<h prqecls with a con-
tractor(s1 ucense oursuant ro tne ContrattOr'S License Law�. I am aware that
proo( o( their WOrkor'S COmp¢nSatlon Insu�ance Shoultl be provltleE lo me.
❑ I am exempt untl¢r Settion B. & P. C. tor thls reazon
Date
I hereby certi/y th
iniormatlon Is wrre
dOtl SLdIC IdWS IC�dI
sentatives Of this t
inspectlon Ourposes.
Si9ndture
Drivers' LicenSe or
IF OB65-46, rev. 10/B�
_ Owner
hav! rea
ro
f tM1is application an0 state that tlte above
comD�Y '�'��h all city antl cOunty Ortlinances
9 consVuction, antl her¢by auNorize repre-
upon the above-mentione0� pro�pqerty qf�o�r
Date r���o_g
� f
E - 33 /S/
TVPE OFCONSTRUCTION NEW ADo ALTERATION REaAIR
❑ CONVE0.51pN ❑ DEMOLISH ❑ OTHER A p.�6
DESCRIPTION OF WORK/USE OF BLDG.
S Main Building:
TVPE OF PERMIT�.�/ GRADING FOUNDATION STRUCTURAL T FfOnt
❑ TENANT IJ ELECTRICAL ❑ VLUMBING ❑ MECHANICAL B Reef
❑ OTHER %�
PROJECT DESCRIPTION Sp. FT. OCCUPANCV C Right
K Left
CONSTRVCTIONTVPE VALUATIONS S
ZONE GRADING CU.YDS. ACRES ping. Ref. #
Remarks: Planning NoteS:
3ar Sink
3ackflow Preventer
3ackflow Irri9ation
3athtubs
Clarifiers
Jishwasher
�rinking Fountains
Floor Drains
Floor Sinks
uasService Outlets
Interceptors
Kirehen Sink
Lavatories
P—TPap
Roof Drains
Reinspection Fao $15
Boiler
Duct - Under Ground
Duct - 5« ucturel
Duct - Ventilating
Exhaust System ❑ MWtiple
Firepl/Fact.8lt. ICBO #
Heating System & Ducting
❑ ai oo,aoo eru O i ao,000
Reinspection Fea � $15
-�-- - -
White - Builtlin9: Canary - Appllcant; Pink - Accountin9: Goltlenrotl - Assessor
NG
Service Sink
Sewer Cap
Sewer Conneccion
Solar Collecmrs
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater /
Water Service
Auto�Wash _
lauo Fae
Hood or Type I ❑
Canopy Type I I ❑
Refrigeration System
04100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
laue Fee
FEES
5 3
FEES
S 3
9038 4/19/8�1
Zone
Accessory Building:
Parkin9 Req./Provided
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW .
Construction Pole Sub. � 50 + KW
Cooking Unit , Meter �up to 100 amps
Dishwasher Meter �ove�t00amps
Dryers ❑Gas ❑Electric SubPanel
Fan Motors �0.1 HP � l Yh � 8
F.A.U. Inc. Solar �9-15 HP �iG15*
Fiztures Miuowave
Device BOxes Pole Light
Outlets
Switches
Garbage Disposal �
Generator �65 KW �5�15 KW
7a'�e LoYs`�1 O
Sign
Standing Sections
Trash Compnc�or
� Reinspection Fae � 315 � � luue Fee
DEVELOPMENT SEHVICES REQUIREMENTS:
Zoning Appraved By
Building Approved By
Application Issued By
IQ2,75 fL
FEES
Z
O
N
I
N
G
R
E
Q
M
T
S
SUMMARV OF FEES
BUILDING PERMIT $ � SMIP $
P�P.N CHECK � $ PERMIT
PLUMBING $ ISSUANCE S
PLAN CHECK 25% $ ENERGV P.C. 5
ELECTRICAL $ %.p3.5� GRADING S
PLAN CHECK 50% $ 2/•ZS MICROFILM 5
MECHANICAL $ TOTAL FEE S /�2 7`�
PLAN CHECK 25% $
CONSTRUCTION AND PLANNING POOL & SPA ���
APPfiOVALS Permit# Date Inspector qppROVALS 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
5. Steel Reinforcement• 56. Rough P�umbing &�Pressure Test
6. Electrical UFER Grnd.• .' 57. APPROVAL TO COVER-GUNITE
7. Footings ` � 58. Electrical Conduit-Undrgrnd.
8. Foundation , 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. �1 � � 60. Backwa�.Lines, P-Trep, O Undrgrnd.
10. Structurel Floor System . 61. APPRO�VAI TO DECK
11. Property Sewer Line & House Connection 62. Back h& Receptor-Final
12. Sewer Cap - �' � 63. Heat r& Vent-Final
� �
13. Roof Drains , , 64. Plumbing SVstem - Final
14. Rough Plumbing •, 65. Electrical;Final
75. Rough Elec[rical-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. POO VSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning , FIRE DEPT. RE�UIREMENT
20. Rough Factory Fireplace " APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe•Rough & Test 72. Underground Flush
24. Roof Framing r: �. � 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing '�' 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry S[andpipe '
26. Lathing & Siding -' 77. FIXED SYSTEM FINAL
29. Insulation ', 78. FIRE PREV. 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 ' � Notes: .
34. Final Heating & Air Conditioning
35. Final Gds Pipe-Test
36. Hood or Canopy ��
37. Final Factory Fireplace +�,. �
38. Final Plumbing � ��
39. Water Service-Final - ��
40. Gas Service-Final � '
� I
41. Solar pomestic-Final � , , _ ,
' 42. Backffow Preventer ' � '
' � .i
• 43. Backflow Irrigation � ,. .
: 44. Landscape Irrigation System
� 45. Sound Attenuation � ' � .
' 46. Handicap Regulations � ' � • �
i �
�47. FINAL STRUCTURE & BUILDING i �' j
48. Special Requirements Completed � ' �
1
49. Electric Release to Edison • �
•'
50. Gas Release to Southern California Gas Co '✓
51. CERTIFICATE OF OCCUPANCY • �
No. Date
• ��� ���i�� tl ��
�.i'�SS ('� fEB 6 iool
COSTA MESA BUILDING-SAFETY DEPARTMENT %,/� \r FINANCE DEPT.
P. O. BOX 917 COHTA MEBA. CALIFORNIA 'p� CITY OF COSTA MESA
For Applitant fo Fill In Complefely �� APPLICATION FOR PERMIT
YYPE OR PRINT BUILDING
BUILDING �=,� e�'G/� �
A�DRESS
COSTA MESA CALIFORNIA For Offite Use Onl y
�•t+ �_/� � AECEIPT NO. pHyMIT N_d�
OWNER h W � 3 0'
%iAIL /� ♦ ^ �./}� HHC81V6/U OY DATH REC61VlD J DAT! 186U[D
AO�RFf.A i_� 1� �. EQ�//�R �/ 1 /� . I fil .� r �L.A -� —�{��� �
TEL.
r�J
FIRE
ZONE
� APPROVED
CASTA MESA. CALIFORNIA
LIrC.TNO. ! �7 JY NO. ��1 � ��Q�, osxrtiv iorv
$IZE I NO. OF BLDOB. /�
OF LOT O � HOW oN �oi `� A p NIj
U8E OF YARDS
E%ISTING�BLDG APPROVED
BHTBACK LINB FROM / �S` � ICeNTHR LIN6
CHMER OP BiPeeT REAR YARD oC �� FRONT
r / �
SIDE YARD I LEFf J RIGHT S R. SIDE
DESCRIPTION OF WORK . _.__
O NO. OF
ROOM6
� C I ROOF
1� � anvwo
APPROVED
— BY
/
` �•�i,L 1d6�L fr
� .ES
1 H6R8BY ACKNOWLEDPB TMAT I MAVB R8A0 THI6 APPIJGTION
ANO BTATB THAT TN8 ABOV6 19 COPRBR AND AGIieB TO COM-
PLY WITN ALL CIT' ON��NANCBj� BTAtH LAWB 1166LILATINO
BU1lDiN0 CONBTfiURIPM.�
'AUTHORIZED AGEN7
`�ONING
NO. OF'l �� uee or n
PL.hNB �� BUILDINO
�Jn�
r!�-/y�
FT
TN8 �MOUM BHOWN UNDEH VALUATION IB POP TH8
PURPOSC OP EBTABLIBHING � PEqMIT P88 ONLY.
VALUATION
/-9 � PERMIT FEE S '�
S / // • "�`' /` PLAN GNECK $ / �/S "
OWNER W�;.
JOB ADDIiESS
INSPECTIONS
DATE
DATE 2-15-(�1
FIRE ZONE DESCRIPTION OF
GAOUP 1 3 J TYPE V
SUBCONTRACTOR I __.._ �
��
oCCUPANCY � � � I �
Form ZIO—SM-11-59 S-B P _ . � ],3788