HomeMy WebLinkAbout368 16TH ST - Building Permits(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa•mesa.taU�LDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
C
Job Address: 368 16TH PL
Suite:
Vicinity:
Parcel Number: 42519216
Applicant: CHACON, JOSE
Atldress: 1142 N BOMO KORAL CIR
SANTA ANA, CA
Zoning:
Phone: 714-813-7736
Zip: 92703
owner: VOCHELLI, JULIAN PAUL TR
Address VOCHELLI, JANET lEE �
HUNTINGTON BEACH, CA Phone:
19322 PITCAIRN LN - Zip: 92646 `.
Contractor: CAL STATE ROOFING
Address: 1142 N BOMO KORAL CIR
SANTA ANA, CA
Zip: , 92703 .: .
ArGt :
Address:
Phone: 714-813-7736
License: 801676
Eng:
�' . �Adtlress:
Phone: � � � �
ISSUED BY:
Status: ISSUED
Applied: 10I24I2002
Issued: t012412002
Phone:
2ip: � - License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING COMP AND INSTALL 30 YEAR COMP SHINGLES.
Plan Check: $0.00
Permit: $97.25
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $97.75
SETBACKS ,
MAIN STRUCTURE Fronl -0. 0-. Rear
ACCESSORY Front 0- 0 =� Rear
PARKING Ez(stinq: 0 Re uired:
. �
NOTES: �
0- 0
U3U
0
FEE SUMMARY
Calc Valuation: Sa,000.00
Claim Valuation: Sa,0o0.00
PLANNING & ZONING
Left- 0- 0 Right
Left 0- 0 Right
Proposed: 0 ,
NOTICE: The work authorized by this permit shall compty wi�h all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced wlthin 780 days, or if woAc is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under lhis permit to be consideretl legal, such work must comply with all applicable codes, and all
required Inspeetlona and final epproval must be obtained. Failure to obtein inspectlons and final approval will result in Ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
zasea �sroo�
WORKERS'COMPENSAnON DECLARAnON:
1 hereby eflirtn under penalry o� perjury ane ol the fWlowing declereilons:
I have enA will meintain e cenificate oi consent to selt-Insure br workers' compensation, es provideA lor by sealon 3700 0l the Labor Code, lor the peAormence of Ne
work lar whiCh thls rm�I i5 iss �.
I antl wil in in wo�kers�nsatlon i�is rerke, es requiratl by secUon 3700 0l Ihe LeDor Coda, for Ne perfortnence of Ue work far xTlch thls pertNt I9 is.wetl,
y workers' n or� I�urenc$ Farrier ar�1 ddicy numDer ere: /A � i. � �l \
Certier: `� "
(TTIs section neetl nat be
oaiars �sion� o� iess.�
Poliry NumEec
❑ I certlfy Ihet in Ihe OeAormance at Ihe work lor whic� this pertnit is is5ue0, I shall not employ any person In eny manner so as hecome subject to t�9 workeB'
compensation laws ol Califomia, and egree Ihat It I s�oulE Decome subject to the workers' compensetion proWsions of Set(io 3700 of 1 Lebor Code, I shali forthwith
comply wiM Mese p is�ons. ' l O�
Applicent Signeture: Dele: L�
WARNINO: FAILURE TO SEC E WORKERS' CqdPENSATION COVERAGE IS UNUWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PE ALTES A qVIL FlNES UP TOOME HUNDRED
hIOUSANO WLLARE (5100. �.IN ADORION TO TME COST OF COMPENSATION, DAMAGES AS Pi70VIDE0 FOR IN SECTION 3708 OF TME UBOH DE, IMEREST. AND ATTORNENS FEES.
LICENSED CONTRACTORS DECLARATON:
I hereby eflirtn t�ei l em Iicensed u d r r v i ns
torce entl ettecc Lic. a
ConlractoYn Slgnature:
with Sectian 7000) ol Divlslon 3 ot t�e Bi
_ Cless N
oace:
CONSTRUC710N LENDING AGENCV:
❑ I hereby eMirtn that t�ere is a consiructlon lending epency for t�e pedortnanca ol ihe work lor whlch Ihis Dermit is issued. (Sec. 3097, Civil CoOe).
Lentlefa Nama: Lentleh Adtlress:
Signeture:
OWNER-BUILDER DECLARPnONS:
Dete:
my license is in full
I hereby eHirm thflt under penelry ot perjury t�at I em EXEMPT FROM THE CONTRAC70R5 LICENSE LAW for ihe tollowing reason (Sec. �031.5, Buslness an0 Professions
Code: Any city or counry whict+ �eduires a pertnit to consiruct, elter, improve, demolish, or repeir eny etructure, prlor to its issuance, also requires t�e e0011cant for such permit
to Ille e signed stetemem t�ei he or she is licensed pursuaN to the Drovisions at the Contractors LJcense Lew (Chapter 9(commendnp with Sectlon 7000) ol DMsbn 3 of the
Buslness enA Prafessions Code) or Uat he or she is exempt theretrom and the basis lor the elleged exemption. Any vlolellon of Section 7037.5 Dy eny eppllcant for a permlt
suD�ecis the epplicant to e Gvil penalry ol nm more t�an tWe hundred ddlars (5500).�:
❑ I, es owner of the properry. or my employees wiN wages es Iheir sole compensation, W ILL DO TME WORK, flnd the structure Is not Iniendetl or oNeretl lor sale (Sec.
7044, Business and Professians Cada: Ttie ConiraIXors License Lew does noi aOP�Y �o en owner oi proporty who builds or improves ihereon, end who daes such work
himself or herself or throUgh his or her own empbyees, providetl that such imprwemenis are not intendetl or ottered tor sele. tl, however, Ihe buiitling or imprwement is
soltl wilhin one year of completion, the owner-builtler will heva the burden oi proving that he or she tlitl not build ar improve For purpose oi sale.).
❑ I, as owner of Ihe proparty em EXCLUSIVELY CONTAACTING WITH LICENSED CONTFiALTOR510 consirucl the pro�eq (Sec. 7044, Business end Pmfesstons
Cotle'. The contrnctors U�e�se law does �oi appy to an owner ot property wtw buUds or tmp�wes thereon, and who contracts tor such pro�ecl w{th a conhaccor(s)
license pursuant to the Contrectors License LewsJ.
❑ I em e:empt untler sec. Business and Professions Cade tor t�is reason:
SlgnaNre: Date:
Ownar ID vertlled by tlrivefs IiGense. ❑ Yes ❑ No Drivers License No.
Verlficallan at Ownership Dy (IyDe of document, I.a. � praperty ta�c blll or deed):
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMI7 CERTIFICATON:
❑ I hereby certity ihet no ex�evaHan tNe (5) ar mare feet in depih inro which e person Is requiretl to Cescend, wlll be matle in connectlon with work euthodzeE by thls
pertnit, end Ihat no building siructure, scaNOlEing, felsework, or 4emoliUon or tlismentling thereoi, wlll be mofe ihen Ihirty-six (36) leet high. (Chep. 32, Grp 2, M 2, Sec.
341, Tltle 8, Celifomie Adminlstretive Catle).
❑ As owner�builtler, I will not em0�oy enyone ta do work w�ich would require e pertnit trom t�e Dlvlsion of Industnel Sefery, es noted ebove, unless auch pereon has e
pertnit to do 5uch wark irom Ihe tlivision.
Signature: Date:
Divislon ol Industrial Salety Pefmi� Number:
CEHTIFlCATE OF COMPLUWCE AND AUIHORQATON OF EMAY: I ceRify untler penalry ot perjury Ihel I have read ihis epplicetion end stale that ihe Infortnetion given is
corred. I agree to compty with ell stete laws entl ciry ortlinences releting to builtling construciion, entl authorize representatives ol ihe Ciry ot Coste Mesa to enter upon �he
ebove-dexnbed praperty far inspeMion purposes. I epree not to occupy or allow occupenty ot eny building euthonzed by this permit until finel inspection.
/� Si9�eOtLegalOwner(s) IT �Bpte
� J - —� U U /
AnNOr Au��orizetl Appllcant �
��
1618
1288
Flaod System Flnel Fire Prevention
Pool SOa Flnal
200 Flnal Re-Roof
201 Flnal8lock/Relaining Well
202 Final Feciory Fire PlaGe
203 Finel Sign
204 Final Demalitian
PAg 1[�L@
�� �'
FJ //
COOE 1 INSYECTION TYPE
208 Finel Mechanicel
208 Finel Plumbing
210 Finel Elec�rlGa�
212 Flnal Fire Preventlon
220 Final Planning AODroval
222 Final Si1e
250 Finel Bullding/Occupancy
�.1/11�CIii1/.1F7
PHOJEC1�a��NFSS: 3GS E 16TH �T UNIT: B
OWNEP'SNAME: Z9O 16TH ST ASSOC �, ��
nooREss: 1936 E DEERE tf215
SANTA ANA, CA 92627
263-1920
AHCM/ENGINEEfl: DON FLA I R NEG.NO.: C 1 Z 9 Z O
aoon¢ss: 17875 VOA7 KARMAN uxiT:404
ZRVINE CA 92179
PEFMITTEE: CROSS STATEELECTAIC ( 909 ) 737-8870
aooness: 2445 RAILP.OAD ST
CORONA CA 91720
LICENSEU CONTNACTOB OECL�1flATI0N: I hereDy a�lirm t�at I am Iicense0 unEer Omvision5 0l C�apter 9(commencinp wi�A Sec�ion
7IX10) ol Division 9 of Ihe Busine55 and Pmfessions Cotle. antl my license is in full lorce an0 ellett.
ciTvuc.':-0� 27 7 sTnreuc.:'112061 �cu^ss/:C� ,�1/10� EXP• 8/9S
�. �o SignaWre: � QL6/ \atd, lY� �
WO ENS' COMPEN511710N ECLAHF710N: I �ere�y aifirm tAat I have a certilicate oi consem ta selbinsure or a cenilicare of WOAers'
mpensation In�aqcs. w�certilieA rupy thereoi (Secbon 3800. Lab. L).7 / O S/ 9 S
eoucv xa.: STATE FUND E%P. �RTE: U
OMPPNY:
Ceriified capy is hereby fumis�etl, � Cerli�ietl coDY �5 lea wi�� Ihe ciry Building Division �/'
� AVPiican�: �cf-l�� 1 .Q,Y/J�
E%EMPTION FflOM WOBNEflS' COMPENSATION OECIAPRTION: (ihis sec�ion nee0 not be completetl i� tAe permii is lor one �uMr¢d (5100� or IMS�.
I Cetlity tha� in t�e Oehormante ol lhe work lor w�iCh this permii is issuetl. I Shall noi employ any De«n in any mann¢r 50 as lo beCome
su�le�� �o t�e Workers' Compensation Laws of Califomia.
Uaie: SipnaNre:
NOTICE: II. alter makinp �his Oeclaration, you should become sublect to IAe Workers' Compensation pmvisions af t�e LaDor
CoOe. you mu5i tarihvnth compty vnt� 5uc� O�ovivons ar lhi5 permii shall Ue tleemetl revOkEd. '
CONSTPUCTION LENUING AGENCY: I �er¢by allirm I�at ��ere is a ton5tmciion IenAing aqenty for Ihe pCAOrmante 01 ��e wOrk far
which ihis permil a issue0 �Sedion 3097. Civ. C�. +'
IEN�Efl: .
AODflESS:
OWNEB BUILOEfl DECIANRTION: I �ere0y affirm tha� I am exempt tmm [he Contraciors' State License Law tor �he tollowinp reason
(Section 703t.5 8usine55 an0 Pmles9anal Cotle: Fny ciry ol county whith Bauires a permit to consiruct, alter, improve, aemolisA. or
ieDair any simciwe, prior lo ils issuance, also reQuires t�e applicant for such De�mit to file a sipnetl statement ihat Aels�e is litensetl
pursuam to Ne o�ovisions o1 ine Contracrors' State License Law (Chapter 9(commenunq wii� Section 7000) ol Division 3 0l the Business
anA Professions Coae) or �hal nelshe is evemo� Iherefmm ane ine basis lor ihe allege0 eMemption. Any violation ol Section 7031.5 �y
any applicanl lor a permit Sublecl5 i�e apDlicant lo a civil p¢naliy o� no� more lhan live �undr¢d dollaa (E500�.
I, aS owner al Ihe pmpehy or my employees wi�h wages as their sole compensation, will tlo I�e work, and Ihe
❑ stmcmre is nol imeneea or ollerea lar sale (Section 7044, Business an0 Pmfessional CoOe: T�e Camracmrs' Slale License Law
tloes noi appty to an owner o� a pmperly who builds or impwves ihereon, and w�o Ooes such work hims¢I�/hersell of �AmuOh
y` , CITY OF C6STA P1ESA — BUILDING FERMIT
PERMIT NO: E 0703Z2 FLP.N CHECK NO: N
/
PEP.M NO; E 0703Z2
GOl7T; N SUPP: Al
CONSTRUCTION TYPE; PERMIT TYPE: ELE PURPOSE: NEid
JOB DESCRIPTION : 1119SF 2D1D FL, 8725F 15T FL, 441SF GARAG SQ FT:
CLAZM VALUE: CALC—VALUE; GROUP OCC; R-3 /M-1
COMMENTS; REF; B-69682
+rir+t+r*+�it,t�tr.+r+tit�tia�t***r*�tx�x�iF**�ri�rxx�i�iFit�t*#;r;rit�tirx*at�t�trira�t;t;rtr;r,t+rr*+r*sx**a��-�u+a*�xv�*+6tar�t
Z O N I N G R E Q U I R E M E N T S
sETBn.cxs
----------- MAIN HUILDING ---------- --------- ACCESSORY bUILDING --------
FRNT; FT ZN REAR: FT IN FANT: FT IN REAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
FARKING REQ; PROV: PARCEL: 42519119 ZNE: REF NO:
PLANNING NOTES�
>
iE if if if iE if k iF if iF if iF if if i4 if iF it it iE # it if it # jE if at f! if it jf 9E �)f if iE+: a� iF i: it 1f iE 1t if �k i! it if if i! ih iE it iE ff iE iE iF iP i4 if iE it� it �Y ix iC iF +f ff if if i: iF aP ia iV �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 HY DATE;
BUILDING APPROVED BY : DATE;
APPLICATION ISSUED BY: DATE: '�/ ��/
** i� r* * r ft�lf * i�+r ** ir+r*�r r it*iriFZFiF�+T r�+F�� iF Fs �.� c� ,F�iF � ZTt�Ftt7FiF�* * u�i��c *** r*—•/j�'' . k� iFz!* * I
it+fiEi(�ifiFlEiF�f*�1fiFi4itic+ficitx�iiicjciPifiFiflfitit�lt�lfifjFatiM1*iFacjt�v-raciFx�aFacxr�+caM1ri�lixjciF+fifatafificxrlt-ica�a' ifM {x-i(�+� �f-?f�Fitil-
LEGALIZATION:N F E E 5 U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GP.ADIP]G
PERMIT 69.69
50� ' SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIC'—> PERMIT . ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 69.69 ; 15.00 0.00 84.69 84.69 .00
� �isarherownemployees,proviaetl�hatsuchimprovemen�sarenatimenAeaoroflere0forsale.Il,�oweverlA0bwl0ingor REVENU£ Dll,�j$jON T�T.�LS--> COLI.ECTED• � 84,69 OVER/SHORT• 00
impmvememissal4wilhinoneyearo�compleiion,iheownerwillhavetheGurtlenolpmvinghe/sne0ieno�buildorimD�o�e $LDG FMT PI.(7MBING ELECTRIC MECAANIC FIRE SMIP/TOT Gi2p.DING PL11N—CHECK
lor Ine ouroose of sale�.
84.69
� ' h I' n nV t r t c ns�mct the ro ect Seclion 7044 Business .
I I, as owner ol the pmperty. am e�clusively conlrac�inA �+'ii ice setl co ac o s o o D I ( • '
❑ antlProlessionsCoOe: TheConirac�ors'StateLicenseLawdoesnatapplY�oanownerofpraperty wha�wl0sarimprove5i�erean *******�*************�***************�****x***�*******************�************
� and who conlracls lor suc� pmlecls wi�� a conirac�or(s) license Dursuant �o Ihe Contraclors' State License Law�. I am aware
��at prool ol Nei� Worker's Compensation insurance shoultl he pmvitle0 �o me. I S`7 D 1 V I D�.J A L F E E B ft $ A K D O W N
� I am e�empl untler Section: B. 8 P. C.
� � lor Inis reason: TYP E
oate:L ownec I ELE
I Oo hereDy cently that I am aware ol antl untlerstand Ine repuiremenis ol Calitomia Health ane Safery CaOe Sections 25505. 25533, anU
25534 ana Inat I or any IUWre builaing occupdni will/will not Ici¢le one� neeA to comoly with sai0 slate cotles ana Ine reQuiremenis for a
permit for conslmtlion or motlifiwtion Irom �ne Air Ouali�y Managemem DisMct. flevaential canslmctian aD7liwti0ns are exemp� fmm
Inese prohsions.
Da�e: ADDlicanC
1 her¢Dy C¢itity tha� I have read I�is applicalian ana Slaie Ihal l�e abov¢ informaiion i5 trorrecL I apree l0 ComON �^�� all ti�y anE tounry
ordinan[e5 an0 S�alelaw5relalingio Guilding tOn9Ntlion antl �ereOyaulhorilerepre5enla�iveSOltAiS Ci�ylo en�erupOn�h¢ a�ove�m¢n�ionetl
properly lar inspeclion Ow ei '� r ` � ^ �
D �-( � Signawre: � �%� � ti ��
ive�'s �icense or Socia� Sewriry a:
i6a1-a6 While—Builtling: Green—COEa Enlorcemem: Canary—Appilcanl: Pink—Revenua: Goltlenrotl—Assessor
QTY
1991
D E S C R I P T 2 O N
r]EW RES BLDG FOR 1 OR 2 UNITS/ SQ FT
END QF FEES
ONIT COST TOTAL COST
,03 69,69
01 00173235-00173.:35 T CiT ��.69
Da7E� L�/09/44 TIttE: 11:3b
CONSTRUC710N ANO PLANNWG ' � ��� p'0'
� � ibate Inspector '• Date Inspector
� APPROVALS Permit # f APPROVALS P?rmit ;k^._
��
1. Temporary Electrical Service or Po�e , 52. Pooi & Equfpment LocaUon
2. Soil Pi,ne�Undrgrnd. • . 53. Steel Reinforceme�t
3. Electricei Conduit Utility�Undrgrnd. 54. Forms
4. Electric2l Conduii-Undrqrnd. 55. Electrical Bonding
5. Steel R¢inforcemenc 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE
7. Pootings 58. Electrical ConduirUndrgrnd.
8. Foundation ' 59. Gas P�pe, O U�drgrntl„ Test
9.- Water Pipe-Undr�md. 60. Backwash Lines, RTrap, � Undr�rnd.
70. Struciural Floor SYstem . ' 67. APPROVAL TO DECK
i t. Property Sewer Line & House Connection 62. Backuvash & Receptor�Final
t�. Sewer Cap • _ 63. Heater & VenrFinal
l4. Roof Drains ' 64. Plumbing System - Final
14. Rough Plumbing . 65. Electrical�Final
15. Rough Electrical-Condurt - -, 66. Solar System-Final
76. Rough �lectric Wiring "' �2/�v,/��� 67. Fencin9 & Access ApProval
U. Rou h Wirin Si n � 6-{'
9 9 9 68. APPROVED FOA PLASTERING
18. Rough Electricat-T Bar Celiing 69. POOUSPA SYSTEPMS FINAL
19. Rough Heating & Air Canditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace � � �- APPROVAL$ Permit #
21. Ducts, i� Structure . � = 70. Underg�oun� Hydro
i12. Duccs, Venti4ati�y . . .� I1. Product Piping G` Gas � Oii
23. Gas PipP.-Rough & Test ' �. 72. Undergro�nd Flush
� -
24. Roof Framing � � 73:.Undergrnd.StorageTank OGas ❑Oii
25. floof Sbeathing : �� 74. Overhead Hvdro
26. T�Bar Ceiling �Structurat) &�Monocoat _ 75.: Ory Chemical
27. Frame and Flashing , , 76. Dry StandDrpe
28. La.hing & Siding ' - , 77. FIXED SYSTEh1 FINAL
29. Insulation � 78. FIRE PREV. FINAL
30. Drywall Nailing . HEALTH DEPT. REQUIREMENT
37. Plaster 6rowm Coat /� � 79. FINAL INSPECTION
32. Electrical Power Meter-Finai .�b��' li/�tC 80. F000 CERTIFICATE ISSUED �
P� �-1-
33. Finai Electric .-- Nofes:
34. Final HBating & Air Conditioning �.
35. Final Gas Pipe-Test -/�
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water SCrvice�Final
40. Gas Serv�ce-Pinal
41. Soiar Oomestic-Final
42. Backflow Preventer
43. Backflow Irrigazion
44. LandscaPe Irrigation System
45. Sound Atienuation
46. Handicap Reguiations
47. FINAL STRUCTURE & BUILDING ,
48. FINAL PLANN(NG '
49. Electric Release to Edison �"'
.
� 50. Gas Release to Southern California Gas Co ''
51. CERTI�ICATE OF OGCUPANCY
No. Date
�
�
�
Pfl07ECT POONf35: 3 6 B E 1 6 TH ST
OWMEH'SNAME: Z9O 16Tf? ST ASSOC
aooness: 1936 E DEERE #215
SANTA ANA, CA 92627
�, ►
UNIT: p
263-1920
AflCM/ENGINEEfl.' DON FLAI R HEG.NO.: C 1 2 9 Z O
ADOXESS: S7BiS VON KARMAN uxiT: 404
IRVINE CA 92174
vcnmiTree SANTIAGO AIR CONDITIOA]ING ( 714 ) 998-1600
aooxess: F O HOX 3517
ORANGE CA 92665
LICENSED CONTBACTOB UECLANATION: I �ereCy allirm t�at I am licensed under Dmvisions ol C�apler 9(commencing vnlA Seciion
700�) o� Divison 3 oi �he Busmess antl Pmiessions Code. and my license is in �ull torce ana efleci.
ciTru 01526 sTnTeuc.:26949�6/�� cuss: C 2� E�XP:/ ^OSD�95
oate: �� Signature: —1—� �\ ,[ �� Nb
WOPKENS' COMPENSR710N UEClABR710N: I hereby ailirm I�at I �ave a cemli te I mnsen� to sell-insure or a cenilicate ai Workers'
Compe�safon�i s�ra�ce, a� 3 r�r�e� �� I�ereoi (SecUon 3800. La�.�).7 � 1/ 9 S
roucvxo.:CALIFORNIA COMP EXP.DRTE:
COMPRNY:
❑ Ceniliee capy is nere�y!fumisned G'I Cenilie0 copY is tileA with ��e ci�y Building DiviSion.
aie'. � � l�/ C�y APPlicani'. � �� �-�`��•
E%EMPTION FBOM WOfl6EflS' COMPENSATION OECIABATION: (T�is seNan neetl nol0e complele0 il Ihe permit is lor one �uMreE �5100) of IeA�.
I cerlily Ihat in the pedormance ol Ihe work lor w�ich this permi� is is5ue4. I shall no� employ any person in any mann¢r so as lo hecome
subiect �o t�e WarkerY Compensaiion Laws of Catilomia.
Oate: Signaiure:
NO710E:i1, after making this Oeclaration. you shoWA hecome suble�� �o ��e WOBers' Campensation D�ovisions ol Ihe Labor
Code. you must lohhwith comply wii� such Orovisions or �his De�mit shall G¢ Oeemea �evoketl.
CONSTBIlCTION LENDING pGENCY: I hereGy aifirm that Nere is a consimction lendinp apency lor ihe Dedormance of lhe work for
wAic� ��is permii is Issuetl (Section 3W7. Civ. C�.
LENOEP:
aooRcss:
OWNEB BUIIDEB OEClANR7lON: I hereby aifirm tAa� I am ezemp� Iwm tne Contracmrs' State License Law for ihe followinp reawn
�Seclion 7031.5 9usiness antl Pmfessional CoOe: Fny city ol counry wAich rtquires a permil �o consimcl, al�er, im0�ove, tlemolish, or
repair any stmcture. prior to its issuance, also reQuires Ihe aDDlicant for such permit to lile a signeA statemenl thal he/she 4licensee
pursuant to I�e pmvisions ol tne Contraclors' State License Law (Chapler 9(commencing wilh $ettion 7000) o� Oivision 3 0l IAe Business
antl Professions Cotle) or ��al �e/s�e is exemOt ��erelrom an0 ��e basis lor t�e allegeE exemD��on. Any violaiion of SeciiOn 7031.5 Ey
any aDPlicant lor a permit sublec�s the apDlicantlo a civil penalty ol nol more t�an �ive hunAreU tloliars (5500).
I. as owner oi ihe propeny ar my employees witn wages as ineir sole comDensation, will tlo ine work. ana IAe
❑ stmcmre is nol imenEea or oiferea tar sale (Section 7044. Business antl Pmlessional Code: The Caniractars' State License Law
doe5 nol apply fo an owner o� a pmperiy w�o builAs or impmves Ih¢reon, ana who does Suth wOrk him5ell/h¢f5e11 of l�roUg�
�is or her own em0loyees. provitletl that such impmvemems are not intenOetl or ofiereG for ule. Ii, Aowever ihe builainp or
imo�ovement is soltl within one year of completion. Ine owner will have �ne burtlen oi pmvinq ne/she dia not huilE or improve
for I�e Durpose ol Sale�.
I, as owner ol Ihe D�operty. am exclusively contractinq wiih licensed conVac�ors �a wns�mcl t�e prole�� (Section 70ad, Business
❑ and Pmlessions Coae: The Contactors' State License Law Uoes not aDPN �o an owner of Dmcerry wrro o�aes or �morares mereon
antl who conirazts lor such pmjecls with a contractor(s�license pur5uani lo the Canlrac�ors' S�a�e License Law�. I am aware
t�al prool af t�eir Worker's Campen5ation insurance s�oul0 be OrOviEeG Ia me.
� I am exempi unaer Section: 8. 8 P. C.
�or ihis reason:
�aie: Ov+nec
I tlo hereby cenily inat I am aware of antl unders�an0 the repuiremenis oi Calilomia HeatlA anA Salery Coae Sections 25505, 25533, an0
2553d antl �hal I or any Wlure buil�ing occu0ant wilUwill noi (drUe one� ne¢O lo camply with uiG 5�ai¢ coAes and ��e repuiremenfs lor a
permii (or conslmction or motlihtalion Imm t�e Air Oualiry Management Oisirict. HeSieential consimction aDPlications are eMempi imm
I�ese pmvisions.
Oa�e: FpplicanL
I hete0y Cer�ity I�a� I have rea0 Ihis aOD�italion antl Sia�e iha� Ihe aGOve intormati0n is tarret�. I agree �o tomply with all Ciry anE wuniy
ardinance5 a�b 51a1elaw5relaiing�o buil0ing Consimc�ion and hereby aultqrizerepreSenlalive5a�i�i5 utyto ¢nter uponihe a0ove-menGaned
' O�openY �or insDetlion purposes
oa�e:1�—/�/�y Signamre: / � � /���
od�er's �icense or Sociai Secu�i�y a: �
i64La6 �"/hl�e—BwlEing: Green—Co�e Enlorcement: Canary—AOOlican�; Pink—Revenue; Goltlenroa—Assessor
CITY UF COSTA MESA — BUILDING PERAIIT EP,M D70: M 0%U3'l5
PERP9IT D70: M 070325 PLAN CHECK NO; N GOVT; N SUPP; N
CONSTRUCTION TYPE; PERMIT TYPE: MEC PURPOSE: NEW
JOH DESCRIPTION
CLAIM VALUE:
; 1119SF 2ND FL, 872SF iST FL, 4915F GARAG SQ FT:
CALC—VALUE: GROUP OCC; R-3 /M-1
COMMENTS: 41SF 2ND FL DECK, 93SF FRONT PORCH, RE:NB69682
11'iF iE if M iE if M'?i'iE iflf 1F iF'IM 1f #'kif'N'1Fif'N'if iE'If iE if'Ififif 1I'# lfih if'1f ih ?f 1E�1f Y-'fi 1f iF if'N")f if i! M'1f'1�'If'N'if 1k # Mif if �f'I�'iF iE Mal'# d! !�'if jffM1it�lflf iF X� 1i
Z O N I PI G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR; FT IN
LEFT; FT IN P.GHT; FT IN LEFT: FT IN P,GHT: FT IN
PARKING REQ; PROV: PARCEL: 42519119 2NE: REF NO:
PLANNING NOTES>
i
it��r�ti�+tit#+r�it*itit�tr***it�-l�x-**r*�lt*r***�E**it��k?E*ir*ic�tir#u�r**.r*r�ic�s*�i�******ur**#*,ric�it-�*�lr*r�+r
D E V E L O P M E N T S E R V I C E S P, E Q U I R E M E N T S
ZONZNG APPROVED BY ,
DATE:
BUILDING APPROVED BY ; DATE:
APPLICATION ISSUED BY: �—� DATE: ��- �1 �1
�*�*.,�**�.**,�**,�**,�.,�.*�* .,. ��**�**��*�*�y.*�
1Eif 1F if iE 1f if iF'lfif �f if if if if iFifif-14 iFi4 i4if�IfiM1 iEif if �f iF i4 1E af iR�)f �f if iEifiE if iF Y Y. 1R if iF �fiF'1E iF iFiEiE M if if 1F if iF 1R iR if 4 if if if�lf if i(�iF iF ±E ifiF IMaF1f iF
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIAE SMIP/RES GRADIP7G
PERMIT 9,00
25E SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PEP,MZT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 9,00 15.00 ,: 0.00 24.00 24.00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 24.00 OVER/SHOFiT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
ZQ,O�
i!M M ff if ifitik if fEif +! if 1E�lf if iF '4 1(�tf k ff if 1E if if if V iF1f � 1f 1f '�E if if if ifM 1f 1t iE M it iF 7liFif iE1Fas It�iF ! 1fiE i' if Y 1Fit 1E iF il�1f iEia iE M iE i! if aF 1F atil�if if aE
I N D I V I D U A L F E E B R E A K D O W N
TYFE QTY
MEC 1
D E S C R I P T 2 O N',
INST FORC—AIR/GRAV FUEtN <= 100 K BTU
END OF FEES
UNIT COST TOTAL COST
9.00 4,OQ
Os nOft;240-0017324p T C�Y y;,pp
OATE� 12fQ?/gq TIME� 12:39
r CONSTRUCTION ANDPLANNtNG P�Q� A I
� y qPPROVALS Permii# `Date Inspector APPRpVALS Permit?k ! Date Inspector 4
1. Temporary Electrical Service or Poie 52. Pool & Equipment location �
2. $oil PiGa�Undrgrnd. -• 53. Steel Reinforcement E
3. Electrical Conduit Ut�lity-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steei Reinforcemenc 56. Rough Plumbing & Pressure Test
" 6. E�ectrical UFER Grnd. � 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Condui[�Undrgrnd.
8. Fpundation 59. Gas Pipe, L� Undrgrnd., Test
9. Water Pipe-Undr9rnd. 60. Backwash Lines, P�Trap, O Undryrnd.
10. Sttuctural Ftoor System 67. APPROVAL TO QECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor�Einal
12. Sewer Cap • 63. Heater & Vent-Final
73. Raof Dreins 64, plumbing System - Final
.
14, flpugh P4umbing 65. Electrical-Fina1
15. Rough Electrica6Conduit 66. Solar System-Pinal
16. ROugh Electric Wiring 67. Fencing & Access Approval
17. Ao�gh WiringSign 68. APPROVED FOR PLASTERING � I
79. Rough Electrical-T Bar Ce�ling 69. POOL/SPA SYSTE�AS FINAL �
19. Rough Heating & Air Conditioning /L re - FIRE DEPT. REQUIREMENT I
20. Rough Factory Fireplace APPROVALS Permit # i �
21. Ducts, in Strutture 70. Underyround HYdro
22. Ducts, Ventilating 71. Product Piping'JGas ❑Oi1 j
23. Gas Pipe�Rough & Test 72. Underground Fiush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil �
25. Roof Sheathin9 74. Overhead Hydro
0
26. T�Bar Ceiling {Structural) & Monocoat 75. Dry Chemical i
27. Freme and Flashing 76. Dry Standpipe '
28. Lathing & Siding 77. FIXED SYSTEh9 FINAL
29. Insulation 78. FIRE PREV. FINAI
30. DrYLvall Nailing HEALTH DEPT. REQUIREMENT !
31. P18ster Brown Coat 79. Ff(VAL ffVSPECTtON
32. Electrical Pow2r Meter�Final 80, FOOD CERTIFICATE ISSUED j
33. Final Eiec:ric Notes: '
34. Final Heating & Air Conditioning �
-�= !2- (s�--�- -
35. Final Gas Pipe�Test
? � �i ^ � �t 2m1_s.tc� '___�
36. Hood or Canopy
2=z��5:� �uc, _" I
37. Final Factory Fireplace �� �
38. Final Plumbing �
39. WBter Service-Final
40. Gas Service-Final
41. So�ar pomesticFinal
42. Backflow Preventer '
---1
43. Backflow Irrigation i
44. Lendscape Irri4ation System
45. Sound Attenuation �
46. Handicap Reguiations
47. F�NAL STRUCTURE & BUILDING �
48. FINAI PLANNING
49. Electric Release to Edison •-
50. Gas Release to Southern California Gas Co -
51. CERTiFiCATE OF OCCUPANCY
No. Date
�
PflOJECTADUflESS: 3(B E 16TH ST UNIT: B
owatesx$fE: zg0 16TH ST ASSOC
` noonEss: 1936 E DEERE tt215 �
SANTA ANA, CA 92627 _
263-1920 .
ANCNIENGINEEN.` DON FLA I R flEC.NO.: C I Z 9 Z O
RDOflESS: S% B% S VON KARMAN uxiT: q p q
IRVINE CA 92174
PEflMITTEE: 29O 16Tx ST ASSOC LP (714)833-5047
nooncss: 1936 E DEAR AV 215
S.A, CA 92715
❑LENSEO CONiBRCTOB oECUM710N: I nereoy aHirm tlat I am ticeiae0 unEer orwitim5 of Ctupter 9lwmmencinp with Section
7000) ol Division 3 0l Ine Business an0 Prolessions COGe. anE my litense is in lull force anU ellect.
LITY LIC.: STRTE UC.: ClAS3: EXP :
Dale: Signature:
wONKFflS'COMVENSRTIONDECLAflAT10N: Iher¢Oyanirmthatlhaveacenififateolconsenitosel4insureoracenilicateofWorker5' �'�.
Compensation Insurance. or a arlilie0 copy I�ereol (SecGon 3800. LaE. q.
POLICY NO.: • EXP. DATE:
COMPPNY:
❑ Cenilied copy is nert�y lumisnetl. ❑ Cenifie0 copy is filed with ihe uty Buil�in0 Division.
ate: ADplicanC
EXEMPTION FAOM WONRFfl3' COMPENSATION OECUMTION: TNs sec�on n l not Ee mmDleteO it iM perml is tor one �uMrM (5100� or less�.
I[ertily IM1ai in l�e petl man[e Oi Ihe work �or whith Ihis p it is issu¢0 �all nu� employ any persan in any mannef 5o as lo become
sublecl /la IA WOB¢r Co ¢nsati0n LavS ot Calibmu. .
Dale: (��� � Signaturt:
NOT E: II. ler rya mg INs aeUaraiidl, yau shWla etome suUjett Io tne Work¢rs' CompenSaGon provivons of �he lahor
fAOe. you usl lort wi�� ComD�Y ��� Suth proviti0n5 Or Ihis Dermit Stull EC E¢eme0 revOkeG. ' `
CONSTBUCTION LENOING RGENCY: I �ereEy aflirm ttui t�ere 5 a w`sinrctlon IeMinp agenry fm the pertormance of the work lor
wnicn �nis permn a@iuetl I�tion 3097. Gv. CI. '
LENDEX:
nooaess:
OWNEB BUII�FB DECUB�710N: I �ertEy atlum ilut 1 am exempt Irom itre Coniractors' Sute lkensa Law lor tM lollowinp reason
(Section 7G11.5 Busineu an0 Pmfessional CoOe: My city of wunry wNc� reduires a permil Io conswct, altei, impmve, demalisA, or
reoair any strucWre. O��or lo its iuuance, also repuites ine appliWnt lor su[� permit to lile a 90�� statemMt inat 11Nshe is licensetl
pwsuam io t�e Dmdvons ol tM1e Coniractors' State Licenu law (Ctupter 9lcommencinp wilh Section 7000) al Diuiswn 3 0l i�e Business
ana Pmlessions Caael or inat ne/sne is exempt tnereimm ana tne Uasis lar the allepeE eeemD��on. My violation ot Section 7031.5 oy
any apDlicant for a Oumit suGlects t�e apD�iWnt to a civJ Denalty ol not mOR tAan live �unOreO OWlars (5500�.
I. as owner al Ihe pw0eny or my empbyees wt� wa0es as t�eir sole campensation, vAll Eo t�e work, anE tAe
❑ stmcWre is no� imenUetl or olferea for sale �Seclion 70aa. Busineu an0 Professional Cade: The Comractors' Stale License Law
Uoes nol ap01y to an owner ol a DmOeny wM OuilCs or impmves thereon, an0 w�o Eoes such wark �imsell/herull ar Ihmup�
his or �Cr own ¢mployeei, pwviGetl Ihal Sut� improvemenl5 are noi in�entled oi OflEreC lOf Sale. II, hOwever IAB buil0inp or
improv¢men� is SOIG vnlhm One ylar 01 cample�i0q l�¢ OwnOr vnll tuv¢ Ihe EurOen 01 D�adnO ��She OiE n0i EuilA al imD�ove
for ine puroose ol salel.
,.t I, as owner ot ihe propert . am e�clusively contractinq vn�� IicenseE conirattors to conslrucl I�e pmject (Section 7044, Business
L•] an0 Pmfessions CaOe: iXe Cantractars Sute Licenu Law Ooes nol appty �a an avmer al praperry wAo OutlEs ar Improves thereon
and w�a CONratls lor SutA O�olet�5 wilh a Conirattor�5� liCenie Oursuant Ia llle Conirat�ars' S�ate Licensa Law�. I am aware
I�al prool ol tAcir Workcr's Comp¢nSa�ion insuraME 51bu10 Ue prOvipEE to m0. �
I� I am eRempt wGer Sec�ian: B. 8 P. C.
lot Ihis te sOn:
Oaie: Y < P+mer.
I Uo �ertGy c Oly ItWI I am awafe al an0 unCerS�aM l�! repwemen6 0� ifNNd HWih antl Sal¢Iy COtl! Set�ion5 2 ,�
2553< antl t�at I or any Imwe Ouildinq occupam wiNwill noi (cirGe one) need Ia comON ��h uiA sine coEes anE t�e requiremenls for a
peimi lor cansVuctiOn or muEditation Irom 1tre !u� OuaLry Manaqemeni OiSirid. fle5beniial ConSlNction applicdlkns aa exem0� �mm
t�ese provisions.
�a1e: AppGcant:
I here�y ceility IIWI I tWve Rae iNs aOD�%�Gon ane state t tne aDOve inlo atqn ¢ WrretL I aprze ta fAmpry wiltl au city and wunty
oi0inancesanOstateiwsrela�ingloEuilEinpconsimaiona erebyauttrori� DresematNeSOlt�isdrytoenterupont�eaEwe�mentione0
pmpetly la� .nSDeci� n pur SeS.
�
Dale/O $ignature:
oriver's icense � Social Securiry x:
i64na6 Whne—Bmlaing: Green—GOEe EnlorcemenL Canary—AOPlicam; Pmk—Rovenue; GOIEenrotl—Assessor
CITY OF COSTA MESA — BUILDING PEP,MIT PERM NO; P 069683
PERMIT NO: P 069663 PLAN CHECK NO; N GOVT; N SUPP: N
CONSTRUCTION TYPE; PERMIT TYPE: PLU PURPOSE; DIEW
JOB DESCRIPTION ; 1119SF 2ND FL, 872SF iST FL, 441SF GARAG SQ FT:
CLAIM VALUE: CALC—VALUE; GROUP OCC: R-3 /M-1
COMMENTS: REF: B-69682
******�r**�*�w�r�r***�**��t+t�*�t*�t�r�r**rit�trr*r*�r�t*«****r«r*****r**�t*x�***r+r«+�«***r***ra[�
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 6UILDING ---------
FRNT; FT IN AEAR; FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ• PROV; PARCEL: 42519119 ZNE; REF NO:
PLANNING N6TES>
% � �
if if iM i! M�f if i! iE 1k 1f if M k if %1F iF 1f 1f if 1F ik if if iE 1f ff ik if if if it if 1f iE 1f 1F 1f �1f if if if iF %af #! if #� if �f k 1E ih ff if if ff iF iE ff it iE it if if i! af iF iF it aE 1f f if M if 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 HY; /iYlti �'.'i DATE: �o l.
ik if k ifM if i! 1f iFif if if iE if it xi! i! i! ifif �f if k if tf iE iF �f if R# if if 4 if iF if 4 tt k M+rit if M iFk 1f�rlkif lfif tE1F4 KilM1f iflf 1! 1f 1f 4 Y if +t M tE if it
1t 1f ff itlt ifif if i1�Y k V if 1f�lf %i' !f if iflf 1f if 1f M�Y ff if if i' 7f if ff if af if �f #f 1f M i! 1tilifif it if it �f 4 41t 1t if 1t M illFif if i1�M i! M i! if4if 11�1f it 1f if if if 1fM 1f Y
LEGALIZATION;N F E E S•U'M—M A R Y STRUCTURAL SEGMENT:N
� ,
HLDG PMT PLUMBING ELECTRIC- MECHANIC' FIRE SMIP/RES GRADING
PERMIT 147,00 - '
25t , " ', SMIP/NON—RES
PLAN . - �
ISSUE FEE 20,00 •
BUILDING—DIV—> PERMIT ISSUE PLAN=CiiECiC TOTAL PAID DUE
TOTALS=---> 147,00 20,00 - 0,00 167.00 167.00 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 167.00 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIAE SMIP/TOT GRADING PLAN—CHECR
167, 00 ,��
M if M it ih if it it 1! if M M if it if it if 1f ih if 1! 1f i! ff i! if if if it it iF 1f jf if iF if 1f� 1h if if it M iE M iF r i! M'it M iF M M if r if if if M if it iE iF if if iF it 4 M it iF if iF 1f it �f if if iE
Z N•D I V I D U A L F'E �,. B R E A K D O W N
TYPE (,�TY D E S C R I P T I O N .�� UNIT COST TOTAL COST
PLU 2 BATHTUB . , 7,00 14.00
PLU 1 DISHWASHER t 7,00 7,00
PLU 2 LAUNDRY TUB OR WASHER 7.00 14,00
PLU 1 SHOWER � 7,00 7,00
PLU 1 SINK, KITCHEN • 7,00 7,00
PLU 1 WASH BASIN r ��•. 7,00 7,00
PLU 2 WASH BASIN (SET) � '. 7,00 14.00
PLU 3 WATEA CLOSET (TOILET),�. " 7.00 21,00
PLU 1 WATER HEATER AND/OR.VENT , 7.00 7,00
PLU 1 WATER SERVICE '' �.' �. ��t��S0,0_Q�IiG8Q6 7Ci7 �•�P7.�7C�
PLU 1 GAS PIPING SYS OFA,h � 1 .TO 4 OUTLETS ����� 5��9���� rjq�; 7,1�15 5.00
� %i A
�CONS7RUCTION AND PLANNWG POOL : A '
..,�4PPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspee;or
��1 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location � •
E1. Sofl PiFv-Undrgmd. I�--� 53. $teel Reinforcement �
L
3. Electrical Conduit Utility-Undrgrnd. � 54. Forms
4. Electrical Conduit•Undrgrnd. 55. Electrical Bonding -
5. Steel Reinforcemem 56. Rough Plumhing & Pressure Test
CI• Electrical UFER Grnd. 57. APPROVAL TO COVER•GUNiTE
: 7. Footings 58. Electrical Conduit�UnUrgrnd.
� Q. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe�Undrgmd, r/J �� 60. Backwash Lines, P�Trap, O Undrgrod. �
{ �. L
70• Strucwral Floor System -� 67. APPROVAL TO DECK _.� _
i t. Prooerty Sewer Line & House Connection Z./ Q,/'� � g2, gackwash & Recep[or�Final •
'd ca
12. Sewer Gap 63. Heater & Vent�Final --' ��, ;
�
13. Ra�f Drains 64. Plumbing System � Final '
14. Fiough Ptumbing 65. Electrical�Finat �
i2._� 4 �4`_�- �
15. Rough ElectricabCondurt 66. Solar System•Final ' . __.
16- Rough Eiectsic Wiring 67. Fencing & Access Approvaf '. �
17. Rough Wiring Sign 68. APPROVED FOR PLASTEFING"
78. Rough Electrical-T 8ar Cei�ing 69. POOIlSPA SYSTE�AS FtNA�
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
2�. Rough Factory Fireplace . APPROVALS� � .Permit # , , �
21. Ducts, in Structure .. . 70. U�derground Hydro �
22� Dutts, Ventilating • � :71. ProducPPiping �-Gas OOiI
23. Gas Pipe�Rough & Test � 72. Underground Flush
24. Roof Framing �• � -73.�'Undergrnd. Stora9eTank O Gas ❑ Oii
25. poof Sheathing � , 74. Overhead Hydro �
26, T�Bar Ceiling (Structurall & Monocoat ' 75. Dry Chemical ' ' ' �
27, Frame and Plashing 76. Dry Standpipe - . �
28, Lathing & Siding • • . 77. FIXED SYSTEM� FINAL ''
29, Insulation ' ' 78. FIRE PREV. FINAL
.30, Dryevall Nailing HEALTH.DEPT. REQUIREMENT �
31. P�aster Brown Coat 79. FINAL INSPECTIQN - ,�
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Finai E)ectrlc � Noxes: W
' , �°�.�_$-�� � -.
�34. Finil Heating & Air Conditioning /��� ,
tt
35_'Finat Gas Pipe-Tese � Z� .
Z- '�1'r` - c,BZ�ZTt s
36. Hood or.Canopy
!��_�-`_ _
�37. Finat Factory Fireplace �_' _c� � C.,yt r..�.� �� . i � .?11F_j
` .t
38. Final Plumbing �.C�j� Z.�, Q.�. � wXr� S v
39, WaterService�Final �`�S y+r_�r_(]-- ' � �
d
40. Gas Service-Final �
2 � ' f.t
A7. Solar pomescic-Final �
42. Backflow Preventer , � � � ,
43. Backflow Irrigation ' . ,
�44. Landscape Irrigation System � - � �� � � ' �
45. Sound Attenuation � . ' � �
46. Handicap Regulations .
47. FINAL STRUCTURE & BUI�DING , '
46. FINAL PIANNING '
49. Electric Release to Edison �
50. Gas Release to Southern Caiifo�nia Gas Co � •
5L CERTIFICATE OP OCCUPANCY
No. Date
�
�
PPBJEtT RDOflESS:
ON,WEP'S �AF:
� � AUONESS:
pAGN/ENGINEEfl:
aooness:
PEHMIREE:
nooeess:
XEG.NO.:
UNIT:
PERMIT NO: P 069683 PLAN CHECK NO: 04299-94 N PAGE: 2
*xrr*r*r�r*r**rrx�irr*r�r*rr****rr�*r****�t*+**�r*�r**r**r*r***r�r**+rr�rr*r****�r********
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
uNiT:
IILENSEU CONTBFCTOH OECLAPPTION: I �em0y aHirm tlut I am IicenseU unEer pmvisions al ChaD�er 91�ommencinA wilh Seclion
7000� ol Oirsion J o� Ue Buvness antl Proleswra COEe. ann rtry Ikenu is in IM fo¢e an0 eflect.
CITY IIC.: 5T1TE IIC.: CIASS:
Da�e: Sigwture:
WONNEN$' COMPENSRTION OECIABATION: I �¢rCGy aflirm inai I tyve a cerii�iwle ol toniem m Sell�nsure or a Cenifica�e Of WOM1¢rs'
Comoensalion Insurance. or a ceniliM copy tnereol (Seclion 3800. LaO. q.
POLICY NO.: EXP. ORiE:
COMPANV:
❑ CendieG copy is here6y IumisheG. ❑ Certilietl copy is /ile0 vnt� tAe ciry BuilNnp Oivision.
Jaie: ApDlicam:
E%EMPfION FXOM WOPI(ENS' COMPENS1710N OFQAMTION: (iltis secpon neW mt Oe wmpinM ii Ne perml b la ane �unErM (5700) or less�.
I cenity that in ihe oeAormdnce ol the wOrk lor wNtli thit perrttit is i5;ye0. I Shall not emDloy arry person in any manner 5o as lo become
subject to t�e WorkerY Compen5ati0n LaxS af Calilomia.
Oate: Sipnalure:
NOTICE: II, ailer maWng t�is Oedaratwn. you shouM Eecame SVOjtt� to the Workers' Comperisation Dmvisrons ol t�e Labor
Code, you musl loh�vn�� compty vn10 such provisions or IAiS permil s�all be OeemeG revOked.
CONSTBUCiION LENDING RGENCY: I �ereGy allirm tlut t�ere'a a cpnstructian Imdinp a0emy for t�e pedormance ol t�e woM1 br
w�ich �his permit is issuetl (Section 3097. Gv. C).
LENOEN:
ADOflE55:
OWNEfl BOIWEP OECIABAT10N: I �¢r¢Gy altirm Ihal I am eK¢mp� ��Om tll¢ fAnitador5' Slate lic¢nse Law Im lhe lollowinp reason
�Section 70.31,5 9usines5 anG Pmfessional CaOe: Any ciry ot county which reavires a Dermit ia consWc6 alter, impmve, d¢molish, or
repaii any slruCWre, prior Io ils issuan[¢. also rt0uir¢5 I�e applican� �Or Suth Oefmi� Io file a Siqn¢E 5tat¢meni IAa� �e/Sh0 is litensed
pursuam m ihe provisions oi tAe Comractors' State License Law (ChaDter 9(commencinp vnt� Sectian 7000) ol 0ivision 3 of the Business
anE Pmlessions COAe� ar that he/s�e is erem0� ��erelmm anE t�a GaSis lor tAe alleqeU eKemption. Any violalion ol Section 7031.5 6y
any applitanl far a permi� SuOjeCtS I�0 apPlitant IO a tiWl penally 0� noi mofe Itwn INe �unOr¢E GOIIaR (SSIXI).
I, d5 OwOCf 01 IhC plOpCtly Of Illy CIIIpIOytES VA�II M'd0E5 i5 IAEIf SOIE campen5aii0n, will Ao Ih0 WOfk, 0fltl lhB
❑ s�mc�ureis notinten0etl orollereC Iorsa�e�Seclion 70C4, Business anE ProfessionalCotle: The Contractors' State License Law
eoes not apOry �o an awner al a Oroperty xTo GuilEe or imD�wes l�ereon, anE w�o Eoes such waM himself/Aersell or tAroup�
his or her own employees, DmviAetl t�at suc� impmvemen�s are not inlmGeG or ollere0 lor sale. II, however tha huildlnq or
imO�Ovemen� i5 SOIG vAlAin One year ol COmpIAtiOn. IAB owqer will �ave ��e EurC¢n 01 O�Ovinp IINih¢ tli0 noi OuiIG Or improv0
lor ihe ourpose ol sale�.
I, as owner 0� the prop¢riy. am extlusively contraclinp wil� Ii�ense0 coniractors to conslmct Iha Dmlect (Sec�ion 7007, Business
L� anU Pmfessions CaOe: The Comractori State Lice�ae Law Oces rrot aOdY �o an owner ot pmperrywtw 6uAE5 or im0�oves IAereon
antl wno comrac�s lar suc� Orol��s wit� a comractoqs) lic¢nse Oursuant ia ihe Coniractors' State License Law�. I am aware
I�at pmol ol ��eir Workei s Compenuli0n in5ufant0 5iwula 0¢ prOviGlE Io me.
� � am ecemp� untler Section: B. 8 P. C.
lor I�is reason:
Oate: Owner.
I ao hereGy c¢nity Ihai I am aware aI an0 unG¢r5lan0 l�t reQuirements 01 Cali�omia Heal�h antl Sal¢ty COEe SeC�i0n5 25505, 25593, ana
25534 ana that I ar any lulute GuilOing acupant wilVwill not (drele ane) nee0 lo COmD�/ ��� ��tl state co0es anG Ihe Rquiamenis for a
permit lOr tOnSlrutiion ar motlili[alion Imm I�e Ai� uahty Manaqement Disirkt. HevEentul consimctian applications are exem0� Imm
Ihese provisions.
Date: ADPlicam:
I nereby certity t�al I �ave 2a0 t�is applicati0n anG state IMI I�e a0pve infarmdtiUn 5 fArrCtt. I apree to cOmON m�h all city anU counry
orGinances an0 s�ate Wxzrelatingto�uilUing consimction arb �ertEyautMrin rep2untatives afitus dtyto enter upon��e a0ove�mentlmed
pmoeny lor inspeclion Duroases.
Date: Signamre:
Driver's License or Socul Securi�y +:
i64i�afi White—BuilCing: G�een—CaOe Enlorcemunl; Canary.-qpp�icanl Pink—Revpnue; GdEenroE—Asseswr
PLU 1 GAS SERVICE
PLU 1 SEWER, BUILDING / TRAILER
PLU 1 SEWER, CONNECTION TO HUILDZNG
END OF FEES
7.00
15.00
EACH 15,00
7.00
15.00
15.00
#QUFLYCATE FCEGEIPT#
D1 0O170f05-00170s�b T 4 T le7.Q�
DATE: !D/3ilS'4 T.IIi'c: 11�i5
� �CONSTRUCTION AND PLANNING POpI 2 >
� APPROVkIS Permit # Date Inspector qppROVALS Permit # Date Inspecror
`'�1. Temvorary Electriwl Service or Po�e 52. Pool & Equipmenc �ocation
�
2. Soil Pipe�Undrgrnd, 53. Steel Reiniorcement
3. Eleczrical Conduit Utiliry-Undrgrnd. 54. Forms
4. Eledrical Conduit�Untlrgrnd. 55. Electrical Bonding
5. Steel Reinforcemenc 56. Rough Plumbing & Pressure Test
6. Eleccrfcal UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Pooungs 58. Electncal Conduit•Undrgrnd.
8. Foundation 59. Gas Pipc, O Undr9rnd., Test
9. Water Pipe•Und�grnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
70. Structural Floor Svs[em 61. APPROVAL TO DECK
71. Pro'�erty Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent�Final
73. Roo( Drains � 64. Plumbing System � Final
14. Reugh Plumbing 65. Etectrical-Finai
15. Rough Electrical-Condu�t 66. Solar SYstem-Final
76. Rough Eleccric Wiring 67. Fencin� & Access ApProval
77. Rough V�(irin9 Sign 68. APPROVED FOR PLASTERING
78. Rough Electricai�T Bar Ceiling o9. POOLlSPA SYSTEMS F�NAL �
19. Rough Heating & Air Conditioning FIRE DEPT, REQUIREMENT
20. �Rough Factory �Firepiace APPROVALS Permit # I
2}. p��s, in Siructure 70. Underground Hydro
22. Dutts, Ventilating 77. Product PiPing � Gas � Oi!
23. Gas PiPe-Rough & Test 72. Undcrground Flush
24. -Roof Framing 73. Undergrnd. Storaye Tank � Gas � Oil �
25. RooY Sheathing 74. Overhead Hydro I
26. T�Bar Ce�ling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding ". 77. F�XED SYSTEM FINAL
29. Insulation �. 78. FIRE PREV. FINAL
30. Drywall Nailing - HEALTH DEPT. REQUIREN7ENT
31. Plaster Brown COac 79. FINAL INSPECTION
32. Electrical Po�ver Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Eiectric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe�Test �
36. Hood or Canopy �
37. Finai Factory Firepl�ee I
38. Final P�umbing
39. Water Service�Final
40. Gas 5ervice-Final .
41. Solar pomestic-Final
42. Backfiow Preventer
43. Backflow Irrigation
44. Landscape Irrigation Syscem
45. Sound Attenuation
46. Hand�cap Regulations
47. FINAL STRUCTURE & BUILDING
46. FINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OP OCCUPANCY
No. Date
PNOJECT PODNESS: j 6 B E 1 6 TH JrT
OWNEN'SNRME: 29O 16TH ST p.ssOC
naoeess:1936 E DEERE N215
SANTA ANA, CA
. •263-1920
RPCMIENGINEEfl: DON FLAI R
nooness:17875 VON KARMAN
IRVINE
PEPMITTEE: CROSS STATEELECTRIC
AOOflE55: z44S RAILROAD ST
UNIT: p,
92627
�
BFG.NO.: C 1 2 9 L O
uxiT: 9 0 9
CA 92174
(909)737-8870
CORONA CA 91720
IILENSEO CONTflRLTOfl OEGUIIATION: I hereCy allirm tlut I am Iice�tteG uMer provisions a� CAaD�e� 9(commenpnp wii� Sttiion
7000� ol �rvisi n 3 � � Business an0 Pw�essions Coae. ana my license a in lull fo¢e an0 eflect.
ciTv uc.: � g 1��� STRTE LIC.:4 1 Z O 6� -1/�� � �cwQ�ss: �C%� 10 ��/pyy� P• 0 8/ 9 5
�Date ��'—�_ SOnaWre:1,J��.X//./ w` �^� '✓ t�
NEHS' COmPENSRTION DECU1f1AilON: I nereW aflirm tna� I luve a ceriilrcate ol consm� ta sel4insure or a certiliwte of Workers'
Comoensation�ns�yi f�.qr� �rJili� �opy Inereot (Section 3800, Lao.�Cll � 0 1/ 9 S
eoucr wo.: STATE FUND ExP. o�re:
COMPANV: y,
7 Cenifi¢tl topy i5 �ere0y IumiSheE. C7 Cenitie0 mpy�e0 wit� tt�e Gry euil0in '' ion� • ��'
Da I ApD�icam: JC��..i�i%l . �J
EXEMPIION FPOM WOflKEflS' COMPENSIITION OFCL�IflNTION: (ilut secuon neeC mI Ee compeleG il Ne pdml'a fa oire hunEreO (5100) or le5s�.
I t¢tlity �hat in th¢ OeAOrmante ai I�e vrork tw wNCO lltis Dermil'u i55ue0. I Slull nol emD�%' any person in any manner s0 a5I0 DeCOm¢
subl¢Ct lo Ille Wor4er5' fAmpenSation LawS ol Calitomia. -
Oa�e: Sipnature:
NOTICE: II, alier maMing I�iS Eetlaralion. you S�w10 Ottrom! SuOiBCi lOIAe WOtkeR' Compensation Omvisions al ihe LaCor
Cade. yrou mus� �orthwil� comON �^�h suc� prw6ion5 Or ItiS Oemril stull be tl¢eme0 revOk¢G.
CONST80LTION LENUINC RGENCY: I �ereGy allirm tlwt I�ere rs a construction Ien0in0 a0emy lor t�e peAormance ol the xrork lar
whicn ihis oermi� is issue0 (Section 9097. Gv. CI. i
LENOEfl:
aooeess:
OwNEB BUILOEH oEClAfU710N: I hereoy allirm tlw1 I am e�empi Irom tne CanVacmri State License Law br ine lallavrinp reason
ISeclion 7Q71.5 BusineSt an0 Pwlessional CoOe: Any Gry ol tqunty wnich roauires a permil to tansimct, alter, impmve, Oemolisn, or
repair any simclure. priar to M1s i55uance, als0 repuues Ine appliCant lor wc11 Oermit to lile a si0ne0 statemeni inat nPlsneis Iicense0
pursuant lo ��e O�ovisions al Ihe Conlraclor5' S�aie License Law (C�aD�er 9(cammencinq witn Section 7W0� ol Division 3 al the Business
ana Pmles9ons Coeel or Ilul hNshe is ecemD� ��erzlrom an0 tne OaSis lor tne aneOeE eeemo��on. Any violation ol $Ktion 7031.5 Oy
any a001ican� �or a permii SuUleclS I�e ap0liWn� lo a civil penalry ol not maa Ihan live �untlre0 Oollars �5500).
I. as owner of I�e OroOeny or my employees with wapes as Iheir sole comDensation, will Go tlle work, an0 t�e
❑ slmcWreis notintenEetl orofkreE lorsate(Secuon 70aa, Buvness anE ProlesslonalCoOe: The Coniractor5' Staia License Law
tloes not avPN �a an owner ol a propeny wM EuilUs or improves ihereon, ana wlio aoes such woM himself/herself or inmuph
his or ner own emoioyees, eroviaea ma� sucn impmvemen�s are noi iniGnCeG o� 011ereE lor sale. 11, however Ne builtlinp or
imD�a�emenl is 501G vnt�in One y¢ar 01 com0leiion, t�e owner vnll �ave t�e GurG¢n 0� pmvin0 �e/she Oi0 no� Ouiltl or impmve
tor me ouroose of salel.
I, as owner al ihe pmDert9, am evclusively comraciin9 wiiA Iicense0 contractors to constmct i�e O�olect (Sectlan 7004, Business
❑ anA Pwtessians COUe: The Contractars' Slate License Law Ooes noi apDN �a an owner af pmpe�ty who Ewlds or impmves therean
antl w�o comracts lar suc� D�oleca wii� a conUactoqs�license pursuam to ihe Contractors' State License Law),I am aware
�na� pmol ol Ihcir worker's ComDensatian insurance snoWa �e pmviEEE lo me.
� I am exempi unAer Section: B. 8 P. C.
lor mis reason:
�aie'. Ownec
I tlo nereoV �enily Inal l am awarc ol antl untlerstanG I�e requiremenis of Califomia Healih anC Sately CAOa Sections 25505, 25533, antl
2553a antl I�at 1 or any iWure GuilEinA acupam vnlVvnll not (circle one) n¢eG io comply with said state ca0es an0 t�e repuirements for a
permil �or conslmction ar motlilicalian IrOm I�e An ualily ManaOemeni OiSirici. fleSiG¢ntiat CanSimclian apDlica�ions are exempt Irom
I�ese pmvisions.
�ate: ADOliwnl:
I herehy certitythal I nave reatl Ihis application antl statethal Ine a�oveinlormation is torrect.laqreeto comply wilh all city anU county
o�rtlPinances ane slate Wws reiaung io buibing crosvunim an0 �ere0y autlar¢e representatives ol iks dry m enter upan I�e above-mentioneE
V IY lor ins0ecl n V ooses. ^� /� /� �f � (��
Oat � Signalure: �bL.Y�/Cil �• �JCif�%UV��
onver's �icense ar Soca� Securi�y +:
16<La6 Whne—Bunding: Green—Co�e En�orcemam: Canary—Applicam: Pink—Revenue; GoiOanroC—Assesmr
^ .^.ITY OF COSTA MESA — BUILDINC PEAMIT
PERMIT NO:_,E. „070318 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYFE: ELE
PERH D10; E 070318
GOVT: N SUPP: N
PUAPOSE: NEW
JOH DESCRIFTION ; 1119SF 2ND FL, 872SF 15T FL, 441SF GARAG SQ FT:
CLAIM VALUE: CALC—CTALUE: GROUP OCC; R-3 /M—i
COMMENTS: REF; B-69684
***+t*�t�r***r#nr«*�c*ft�**�r*+t****r*rr****+ti:�*+�u�rr*�:+f+�ic+t*s�x+t*�r*�+c�*s*ur.*i�**a�*xac+e
Z O N I N G R E Q U I R E M E T] T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT ZN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN P,GAT; FT I2J
PARKSNG REQ; PROV; PARCEL: 42519119 2NE: RE� NO;
PLANNING NOTES>
if'1E'lE'IF ih �1F �IE if )f 1E �f if iF 1E if i� if 1f k 1! Y 1f 1f 1E i! 1f'lf if ik 1k if i if'� ih'1E if k 1f if ik M# ff if iM1'Y tF AF iF i tF 1f �F iE #:{ 1E if it if Y?f'Y 1f # iM M- iE iF iF L�'K iF jf ih iE iF iF
D E V E L O P M E N T S:E R V I C E S A E Q U Z P. E M E N T S
20NIA]G APPROVED BY ,
DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY; � ��� DATE: � �
if !fi! if ff iE if it 1f�Fif if iFif 1F 1f if if iF # iF ikit if +f if if ktf if sf iP-1(�R if i�if ifiF# t+.iF if it ib lftf M r iFlFifif 9f ih# iF if iFY if i! it V it if � r x.� k4 i f F 1f .f
'If 1k iEif if 1l1F1f iE 1E M lhif 1f1f ifiFifif ih il'if if if'7F ifif 4 Y tk 1fiFif if�k 1L ifiFif ifif % it rt M�if if ?rY #` if'V+F Y Y 1f if 1F1f�f iF{f if 4 1��If if 1E 1F if if !+E �Fif ifif�lF �
LEGALIZP.TION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
PERMIT
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/AES GRADING
69.69
SQt
PLAN
ISSUE FEE 15,00
FtUILDING—DIV—> F�ERMIT ISSUE PLAN—CHECK
TbTALS----> 69.69 15.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED;
HLDG PMT PLUMBING ELECTRIC MECHAD]IC
64.69
SMIP/NON—RES
TOTAL PAID DUE
8A,69 84,69 .00
89,69 OVER/SHORT: 00
FIRE SMIP/TOT GRADING PLAN—CHECY.
.'If if if� if if M i41f if if if if iF 1E if af if 1f if iF M iF if if if 1E i41f iE if if iF iE J4 i! if if iF ih if iF ft iF dF'IF if iF'M' i4 i4 M if'�f if'If i�- ii iE if if 1F 1�' M if ih Y�E iF 1F ii it ii� if i: Y i4 iF aF a!
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 UNZT COST TOTAL COST
ELE 1991 NEW RES BLDG FOR 1 OR 2 UNITS/ SQ FT ,03 69.69
END OF FEES
Of DU1�32B7-00173237 T OT 84.b9
DATE= 12/09/94 TIf9E: II:37
COSVS7RUCTION ANO PLANN WG � POO 3PA
APPROVALS Permit # Date Inspector APpRpVALS Permit # Date Inspeccor
1'Tempo�ary Electricat Sesvice or Pola 52. Pooi & Equipment Location
2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement
3. Electrical Condui; Utdity-Undrgrnd. 54. Forms
4. E(ectricat Conduii-Untlrgrnd. 55. Electrical Bonding
5. Stee Ae�nSorcemenc 56. Rough PVumbing & Preswre Test
fi. Etectr�cal UFER Grnd. 57. APPROVAL TO COVER•GUNITE
7. FOotings 58. Efectrical Condutt�Undrgmd.
8. Foundation 59. Gas PiPe, I� Undrgmd., Test
9. Water P�pe�Undrgmd, 60. 8ackwash Lines, P�Trap, � Undrgmd.
10. St�uct��al Floor System 61. APPROVAL TO DECK
71. Property Se�ver Line & Hous.e Connect�on 62. Backwash & Recepmr�Final
12. Sewer Cap 63. Heater & Vent�Final
13. Roof Drains • g4. Pfumbiny System • Finaf
14. Rough Plumbing 65. Electrica�•Final
75. Rough Electrical-Conduit � 66. Solar System-Final
76. Rough� IectritN�iring J J� �� 67. Fencing & Access A�proval
l7. ftough Wiring Sign 7 gg, ppppOVED FOR PLqSTER1NG
78. Foug�'Elearical-T Bar Ceiling 69. POOUSPA $YSTEDAS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT (
20. Rough Factory Firepiace APPROVALS _, Permit #
21. Duccs, in Structuse . 70. Underground Hydro
22. DuCts, Ventilating - 71. Product Piping O Gas 0 Oil
23: Gas Pipe�Rough & Test � 72. Underground Flusb
24. Roof Framing 73. Undergrnd. Stor�ge Tank � Gas ❑ Oil
� 25. Roo4 Sheathing � _ 74. Overhead Hydro
26. T�Bar Ceiling (Structurall & Monocoat � 75. Dry Chemical
27, Frame and Flashing - 76. Dry Standpipe
28. Laihing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailinq HEALTH DEPT. RE�UIREMENT
37. Plasrer Brown Coat _ n ,- 79, FINAL INSPECTION
32. Electncal Power Meter�Final �6�s 90..L� 80. FOOD CERTIFICATE ISSUED
�'� TMl•./Y'K
33. Finat Electric Notes:
34. Final Neating & Rir Conditioning � •
35. Final Gas Pipe-Test �
36. Hood or Canopy � �
37. FinaV Factory Fireplace !
38. Final Plumbing
39. Water 5ervice�Final �
40. Gas Service•Final
41. Solar pomes[ic-Fi�al
42, Backflow Preventer
43. BackfloW irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. HandicaP Regulations
47, FINAL STRUCTURE & BUILDING /'
48. FINAL PLANNING ��
49. E{ectric Release to Edison �
50. Gas Release to Southern California Gas Co ���
51. CERTIFICATE OF OCCUPANCY ' �•�
No. Date '
�
�
PFOJECTAOUflE55: jEB E ZF-'TH ST UNIT:�.1,
OWNEfl'SNAME: 29Q 16TH :�T l::�s(7C •
•aooRess: 1936 E DEERE �k215
' SANTA ANA, CA �92627�
. • 263-1920
FflCMIENGINEEH: DON £LA I R pEG.NO.: C 1 Z 9 2 O
noosess: 1% 8 � 5 C'ON KAP.MAN uxiT: 4 0 4
IRVINE CA 92174
rexminee: SANTIAGO AIR CONDITZONING ( 714 ) 998-1600
aooA[ss: P O HOX 3 5 1 7
ORANGE CA 92665
LICENSED LONTBACTOH DECIANATION: I �ereby allirm that I am IicenseE wCer O�ovisions ol C�apter 9(commencing vnih Seclian
7000� of Oi 'sion 0� he Busine55 anE Professions CoOe. ana my license is in fulllorce an0 eflec�.
cinuc1.:�l�l�'4 s�nTeuc.:269496 �l��B3 �_C) 20 E;{P• 08/45
Da�e: /��C�Cjy _ Signawre`� \ �P �
WOBKENS'COMPENSRilONOECLAflATION: �herebyanirmlha�ItuveaceniliWteoftonsenitoself-insureoratetlificateofWorkers'
Camoensa6on��r�ce.�9r1 �vr�iep o�V �hereo� ISedion 3800. lao.�7 / O 1/ 9 5
aoucrno.:CALIFORNIA COMP E%P.DRTE:
COMPRNY: ,y,
❑ Cenifietl coDY is �ereDy Wmis�ea. C� Ceni�ietl copy is filed wiih IAe ciry[�u�(p\inp Division.
Date: � C _ AP7licant �� � / �— �"
E%EMP710NfBOMWOflKEflS'COMPENSATION�EClAPR710N: (ThissecUonneeGirotGecompletedilthepemu�i5toronehunOreA�8100�orless�.
1 tetlily I�ai in Ih¢ Dedormante ol �he wOrk ior whith ��is p¢rmit is issuetl, I Shall not employ any person in any manner 50 as �o become
subleci lo Ihe Workers' Compensation LaWs o� Califomia.
Oale: SipnaWre:
NOTICE: II, alter makinq IAis tleclaraiion. you stloultl �ecome sublecl �o Ihe WOBers' Compen5ation provisions o� Ihe Labor
Cotle, you must lonhwith comply with such pmvisions or ihis oermit snali be aeemee revoked.
CONSTflUCTION 1EN01NG RGENCY: I �efeGy aflirm �hat IAere is a ConStmc�ion IenUinp a0enty Ia� ��e Dertormante o� �he work tor
w�ich �his permil is i55ueE ($eclion 3097. Civ. C�.
LENOEfl:
aooeess:
OWNEB BUILOEH �ECNNPTION: I herebY affirm t�at I am exempl imm t�e Contractors' Slaie license law for l�e following reazOn
�Sec�ion 7Q31.5 Business an0 Prolessional Cotle: Any city ol counry w�ic� r¢quires a Dermii to con5imc�, alier, im0�m'e. Oemolish. or
reoai� any simcWre, o�ior to its issuance. 9lso reQuires ihe aDolicanl lor such permit Io lile a sipned statement tnat he/sne is licensetl
pursuam lo the pwvisions ol the Comracbra State License Law �Chapter 9(commencinA ��� Section 7000) af Division 3 of the eusiness
ann PrO�essions CoOe� ar Ihai he/she is ex¢mpt I�erelwm and the basis for Ihe alleq¢O exemption. My violaiion al Seciion 7031.5 6y
any apDlicanlior a permii wOiec�s �he aD0lican� lo a ciWl penalry u� n0I more ihan �iv2 hunGreO GOIlarS (55f10�.
I, as owner ol ine proDerty or my emyloyees witn vrdpes as their wle tampensation, Hill ao ihe work, anA the
❑ stmcWre is nol inten0etl or olfereA lor sale (Section 7044, 9usiness antl Pmlessional Cotle: The Contractors' State License Law
aoes not appty Io an owner af a proDe�y who bui105 o� improves l�¢reon, an0 who �ces su[h work himsetl/li¢rself or �hmugh
his or �er Own em0loyees. pmvitlea that such improvemen�s are not in�ende0 ot atferetl f0� sale. I�, �owever the builtlinq or
imOmvemen� is SOIE wi�hin ane ye8r of comDletion, �he owner will �ave I�e 6urtlen ol provinA �e�s�e tli0 nol builtl or improve
lor I�e pur0ose af sale).
i, as owner of I�e D�operty, am exclusively contracting wi�� licensea comracrors m constmct tAe Omlect (Sectian 704a. Business
❑ antl Pmlessions Coae: Tne ContraG�ors' state License Law aoes not appty to an owner ol O�opeM wlw hml0s ar impmves thexon
and who contrac�s for such D�ojects wiih a conirac�oqs�license pursuan�lo Ihe ConVactors' State License Law�.l am aware
Nal D�uul ul their Worker's Compensalion insurance should be pmvi4eG to me.
� I am exempl under Section: B. d P. C.
lor Ihis reason'.
Oa�e: Owner.
I tlo here0y certity ihal I am aware ol antl untlerstantl ihe repuiremenis oi Califomia Healih and Safery Code Sections 25505, 25533, antl
25594 and Ihal I ar any �uWre builaing occuoan� willlwill nol (circle one) need lo comply wilh said Slale codes anE �he requiremenis �or a
oermit lor consimction or matlihcation imm t�e Nir �uabry Management Oislnct. FesiOential consimction aOVlications are e�empt from
Inese O�ovisions.
Oale: Applicant:
I here�y cetlily Ihal I �ave reaa ihis applica�ion and 9a�e Iha� ��e a0ove inlormalion i5 [Orrec�. I agree to compry vnt� all ciry anE counry
oramances anU siale IawS relaiing Io Uuilaing cons�mQion an0 �ereUy auihorae re0resenialives ol IAR dry Ia enier upOn th¢ abOVEmen�i0n¢E
proDetly lorinspeclron putposes.
Dale: SignaWre: ' 1`� f Q�
Uriver's License oi Saia� Securiry a:
�60b06 W�ne—Bmbing; Green—CoOe Eniarcemem: Canary—Applicanl: Pink—qevenue; Gdtlenrotl—Assessor
CITY OF CU�'TA MESA — BUILDINC PEP.FiIT ''P.P4 NO: M 07Q324
FEP.MIT NO; M 07U324 PLAN CHECK NO; N GOVT; N SUPP: N
CONSTRUCTION TYFE: PERMIT TYPE: MEC FURPOSE; NEW
JOB DESCRIPTION : 11195F 2A]D FL, 872SF 15T FL, 4415F GAP.AG SQ FT:
CLAIM L'ALUE; CALC—VALUE: GROUP OCC: R-3 /M-1
COMMENTS: 41SF 2ND FL DECK, 93SF FRONT PORCH, RE:JtB696B4
if'N'-1f if i4 ifif'IE 14'lE-1F 1LaI'iFi4 M'iR 3E iF iGi4�iF'If if if if iFif % �fif if if')F Y 3f'N'II'1E 1!iF'N'if'K�1F {E'lf iR iRif 1E iFif;�f iE iE'Y'Y �F-1F�('�'iFih if M'iF IF i("K if YiF iF IF iF iE �f iF
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 HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAP.; FT IN
LEFT; FT IN RGf?T: FT IN LEFT: FT IN P.GAT; FT IN
PARKING REQ; PROV: PARCEL: 42519129 ZNE: REF NO:
PLANNING NOTES>
i
��1f�f 1f ffiF i! if afif if 1f ifif 1f 1f iFif iti! iF ar Y-k�!tiEiE 1t+f M# iF Y-if iF k 4 iF iFtt iE if il�iF 'rtifiM1 if1F it iF ift(�it # fl�if iti(-iF # ifiE if # iF+f ifia v�il�# if iE V�)fitat-1f
. D E C� E L O P M E N T S E P. V I C E S R E Q U I R E M E N T S
ZONING AFFROVED BY DATE;
BUILDING APPROVED BY : DATE; /,./
APPLICATION ISSUED BY; DATE:�LI �� _
�ifif�tifM#ifiEifiFifiFiF�1F�lEif�iFlfriFif�lEiEifififif�iFiRiflE±M1ififiF �FiFiFif�tiiFai if�lEicir-+tici�-+4�IE�RiF�1PiM1ititY.if#iEif�iFic�ritw�rf�ifl4aF
iF iF �f it if if +F # ic iF+f iF iF+f it iE iE iE it if iE �)f jk jf 14 iF iE 3E r M iR ft iE iF u iF if +F M�t r it �t it iF IE iF �Y 3f if+f it iF if jF iF iF aE iF iF jF iF iE *+E �` iF i! * iF iF iF iE if i�� �If x ic iF
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTP.IC MECHANIC FIRE SMIP/RES GRP.DIPIG
PERMIT 9,00
25R SMIF/NON—RES
PLAN i
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PI.AN—CHECK TOTAL PAID DUE
TOTALS----> 9,00 15,00 0.00 24.00 24,00 ,00
REVENUE DIVISIOP] TOTALS--> COLLECTED; 24,00 OVER/SHC�RT; ,00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
24.0�
iE �%iF r ic ic+f if it if �7f r iF 9E at �i ic i{ i� if if +f jf iE 3F �F+E 1f * ii il jE #'- if iF N� at M it iF+t �E ic it iF 1E iE+F ii if +c it if it #`++� ie �F �E iF r jc 3t ic iF iF �11� �IF r iF if iE iF s if iF af �Y iF
I N D I L' I D U A L F E E b P, E A K D O W N
TYPE QTY U E S C R I F T 2 O N UNIT COST TOTAL COST
MEC 1 INST FORC—P.IP.; GRAV £UR,D] := 100 K BTU 9.00 9. 00
EP7D' OF FEES
,
� Uf u�;73239—OD173139 T�=sT 24.t�D
� DaiE: 72/09/94 TIflEr 11:3E
�QNSTRUCTION ANDPIANNING POOL,.SPA
qPpRO'VALS Permit# �ate Inspector qppROVAIS PermR# Date Inspector
t, T�mporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Etectricat Conduit Ur.tity-Undrgmd. 5A. Forms
4. ElBctrical Conduit-Undrgrnd. 55. E�ectrical Bonding
5. Stee! Reinforcement 56. Rough Plum6ing & Pressure Test
6. Electrical UFER Gmd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit-Ur.drgrnd.
8. Four.dation 59. Gas Pipe, O Undrgrnd., 7esc
9. WOter P�Qe�Undrgrnd. 60. Backwash lines, P-Trap, C] Undrgrnd.
10. Structural Floor Systam � 61. APPROVAL TO DECK
r
11. ProPerty Sewer Line & Nouse Connection 62. Backwash & Receptor-Final
�2• Se'Ne' CaP 63. Heater & Ve�bFt�at
73. Rnof Drains 64. Plumbing System • Finai
14. Rough Plumbing 65. Electrical�Final
15. Rough Electrical�Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Anprovai
77. Rough Wiring Sign 68. APPROVED FOR P�ASTERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEh4S FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
r _��4-- _
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 Praming 73. Undergmd.Stora9eTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�6ar Ceiling (Structuraq & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINraL
29. InSulation 78. FIRE PREV. FINAL
30. Drywall Nailin9 NEALTN DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Elactrical Power Meter�'rinai 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:•,
2-(4=Sf� c�avzN.,-z:.�a_
34. Finai Heating & Air Conditioning _ ZY ,�+,� _
/2'�'i��i-- 'vZtrl��
35. Final Gas PiDe•Tesi �,�� �� �
36. Hood or Canopy
37. Final Factory Fireplace �
38. Final Plumbing .
39. Water Service�Finai �
40. Gas Service�Finai
47, Solar Oomestic-Final �
42. 8ackflow Preventer
43. BaCkflow Irrigation
44. Landscape Irriqation System
45. Sound Atienuation
46. Handicap Regulations -_
47. FINAL STFiUC7URE & BUILDING
48. FINAL P�ANNING �..
49. Electric Release to Edison -
50. Gas Release to Southern Caiifornia Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
�
�
PflOJECTp00PE5S: 3[j$ E 16TH ST uxir: p
OWNEN'SNRME: ,ti9O 16TH JrT p.Jr'Jr�C �
•n9oness:. 1936 E DEERE ii215
� SANTA ANA, CA , 92627
• ' 263-1920
PflCH/ENGINEEN: DON FLA I R PEG.NO.: C i 2 9 Z O
aoosess: 17875 VON KARMAN �N�T 404
IRVINE CA 92174
PFflMITTEE: 29O 16TH ST ASSOC LP ( 714 ) 833-5047
nouxess: 1936 E DEAR AV 215
S.A. CA 92715
tICENSEO CONTPRCtaP oEeIANFTION: 1 nereEy allirm that 1 am licensee under o�ov¢ions at Chapter 9(commencinA with Section
7000) 01 Div��sion 3 0l t�e Business ana Pmiessions Code. anA my license is in �ull lorce anE etleci.
cirv uc.: sTare uc.: cuss: EXP :
Date'. Signaiure:
WONBENS' COMPENSR7lON OECLAPa710N: I nereGy affirm that I have a cenificate of consent to self-insure or a cenificate o1 Worker5'
Compen5aiion Insurance. or a[enilietl coDY ��e�eot (Sec6on 3800. La�. C).
POLICY NO.: E%P. OATE:
COMPRNY:
� 0 Certdied copy is �ere�y lumishetl. O Cenitied copY is IileU vnth the ciry Building Oivisian.
Date' APPlitani: / �
E%EMVfION FNOM WOHKEflS' LOMPENSA770N OECIAPATION: (iN5 seciwn n irot 6e compietetl il Ne perrtot is lar one huMreE �31 W) or iess�.
I certity that in tne pedor ance ot �ne woB lor wnich this mit is iuue shall not emo�oy any verson in any manner so as to Uecome
subiec� �o ih WOBers' omv ation Laws af Califomia
�at� Signalure�
NO CE: I. ter ma ng inis aeclara�ian. you snoua ¢tOme SubjeCtJo t�e WOrkerS' COmpen5ali0n pmvisions ol fhe Labar
Cotle. you mustJo K+IO Comply vn�h Suth O�ovi5iUn5 ar �Ns�p¢rmi��SAall �e 7eeme0 revoketl.
CONSTNUCTION LENOING RGENCY: I hereby aHirm tha� ihere is a wnstruction IenOinq agenry lor the-petlormance of ��e work lor
whic0 I�is permit i5�i55ue� �5¢ciion 3097. Civ. C�. ;��
LENOEfl:
A�ONESS:
' OwNEB BUILOEP OECUMTION: I here�y aifirm ihat I am eKempt tmm tne Contracmrs' State License Law tor ihe fallovnng reason
I(Sec�ion 7037.5 Business anU Pwiessional Cotle: pny city ol county which repuires a Oermil �o canstmct, alter, improve, Oemolish, or
� r¢pair any slmcWre, prior Io iis i55uante, al5o rtpuireSlhe applitant lor Sut� permii IO lile a SiA�ed 5talemen� lha� he/She is licensetl
pursuant to tAe pmvisions ol Ihe Contractors' State Littnse Law (CAapter 9(commencinq with Section 7000) of Division 3 ai IAe Business �,
an0 Prolessions Catle) or IOat ne/s�e is e�empl I�erefrom anOlhe basis lor I�e allepeA exemp�ion. Any viola�ion o� Section 7031.5 by �
any applicani for a permil suUjeds ihe apD�icant lo a civil penalry ol not moa t�an live �untlre0 dollars (E500�. �i
I, as owner ol I�e pmpeny or my employees vnt� wages a5 t�eir Sole comDensa�ion, will Oo I�e work, and I�e �'
❑ simc�ure is noi intenAeU ar atiere0 for sale Isedron 7044, Buvness an0 Profeuional CaEe: T�e Contractors' Slale License law
DoeS noi applY to an owner o� a OmOe�y who Ouiltls or im0�oves lhereon, antl w�o GOeS SutA wark him5eli/hefself of ��mu0�
�is or her own emplayees. provideG IAai such im0�ovemems am not intenOeA or offereG for sale. If, Aowever the 6uiltlinA or
impmvemenl is SOIE wi��in on¢ year Oi ComDie(ion, (�e awner will �av¢ Ihe burOen 01 prOvinp he/She Eia n0� Euiltl or imDfOve
lor I�e Ourpose o� sale).
,tt I. as owner ol ihe pmperty. am eKtlusively comractinq wim licensed comractors m consimct ine oroie�� (Section 76oa, Business
L'T antl Vmiessions COEe: TAe Coniractors' State license �aw Aoes noi appty �o an awner of D�oDeM � bml0s or improves Iher¢on
antl who coniracts lar such pmjects witn a conlractorls) license vur anl to ihe Conirac r5' State L�cense Law�. I am aware
Ihal proof of Iheir Worker'S ComOensation insurante ShoulC be prOn E Io me.
� I am exempi un0er SecY n: 8. 8 P. C.
for Ihis �e on: � r
�ale: / Owner' �
I tlo hereU cenily tha� i am aware I and unaers�antl ��e reQuiremenl5 0l alifomia Heal�� antl Safery Cotle Sections 2550.5, 25533, and
2553a and t�a� I or any lu�ure Guiltling occupani will/vAll not (circle one� neetl to compty xii� sai0 slale cades and �he requirements �or a
permil lor consimction or rtwEi6cation imm tM1e Air Oualiry Managemem Disirid, flesi0entul consimction apD�ications are evempt imm
Ihese O�ovisions,
�ale: Applitant:
I here�y Cetlity Iha� I Ilave r¢atl Ihis aD0litaiian antl Slaie ��ai e above imarmati n is correcL I agree to mmply vnlh atl city antl counry
ortlinance5antl51telawsrela�;,globui�tlmgconstmClionanG re6yauitaraer r emativuatt�¢cirytoemeruDontheabove�mentioned
o�ooeny ro� ��s cuon ou�v es.
p� �
Daie: ` Signa�ure:
oriver s �mense or Saia� Seanty c:
164ha6 WNte—Buileing: Green—Cotla Enlo¢emem: Canary—ApplicanC Pink—Revenue; GolOenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 069686
PERMIT NO: P 069686 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE; PERMIT TYPE; PLU PURPOSE: NEW
JOB DESCRIPTION : 11195F 2ND FL, 872SF 1ST FL, 441SF GARAG SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1
COMMENTS: AEF; B-69684
****�c-+r�***r****�r+r�r****«****�*r********rr�r*�************x�**+�*�**r**r+r****�-******
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUZLDING ---------- --------- ACCESSORY HUILDING -----=---
FRNT; FT IN REAR: FT IN FRNT; FT ZN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REp • PROV; PARCEL; 42519119 ZNE; REF NO;
PLANNING NbTES>
i
*+e*�t�r�rx��r�r��r*+�r*�*****x�******�r**�e***�r******�rr**�x-�*'ifi��r+r�r*r*�rr***�rr**x�*�r�*�i�*�r****
D E V E L O P M E N T S E R V I C E 5 R E Q U I R E M E N T S
ZONING APPROC�ED BY � . DATE;
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY; /'iJ2. .�%-� DATE: 0 �`1
*******ar**�rrx�*�r**�r■*�r**�r***x�******** `' **��rr***********�r***�******.�a� ** �r .* **
ik it ff 7f i! ifit if if if it M%4 if klfff ff if if IE iE iF iEif 1f kMif fFif 1Fitatjfif 1f lfif M if iflf if if itihiF Mif lfif ififif if iF if ilif M1E if ifit 1f if jfif if iE iE ifk M iFif iF
LEGALIZATION;N F E E �•U M.M A'R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC 'MECHANIC FIRE SMIP/RES GRADING
PERMIT 132,00 i"
25R , , , . SMIP/NON—RES
PLAN ' .
ISSUE FEE 20.00 �
BUILDING—DIV—> PERMIT ISSUE PLAN—CI-IECK TOTAL PAID DUE
TOTALS----> i32,00 20.00 0.00 � 152.00 152.00 ,00
AEVENUE DIVISION TOTALS--> COLLECTED; `�152,00 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
152,00
. .. :,� '
iEiE4i4ifiFififieifitlfiFkiFM4ifMMffifkif�tiflfiEifMkiFiflfifififlllfihitlfMiflfififififlfiEififitif3fiEMiFriF�fif%iFiEiflflfi!%{EiF11iFiFjEifdf
I N D 2 V I D U A I: '_ F�.E E' H'.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 2 BATHTOB "� 7,00 14,00
PLU 1 DISHWASHER "� � 7,00 7,Q0
PLU 2 LAUNDRY TUB OR 4IASHER_ 7,00 14.00
PLU 1 SHOWER , ;�, 7,00 7,00
PLU 1 SINK, KITCHEN - � 7,00 7,00
PLU 1 WASH BASIN � � • 7,00 7,00
PLU 2 WASH HASIN (SET) -. 7,00 14,00
PLU 3 WATER CLOSET (TOILET), ` 7,00 21,00
PLU 1 WATER HEATER AND/OR,VENT r' 7.OQ 7,00
PLU 1 WATER SERC'ICE � s�� �'' OZ 001��3�•Q-0017Q£Q4 TOT �•��+ QO
PLU 1 GAS PIPING SYS OP",( 1; TO 4 OUTLETS D„7E: 5:�a0�q4 TII'±E: 11'?; 5.00"
CONSTRUCTION AND PLANNING POOL !L SPA
APPROVAlS Permit # Oate Inspector APpROVALS Permit # Date Inspector
i. R-mporary Electr�wl Service or Poie 52. Pooi & Equipmen[ Location �
2. �Soil Pipe-Undrgrnd. �0 2�„ 53. Steel Reintorcement -
R
3. Electrical Conduii Utility-Undrgrnd. 54. Forms ��
4. Electrical Conduii-Undrgrnd. 55. Electrical Bonding . �
5. Steel Reinforcement 56. Rough P�umbing & Pressure Test �
i.
. 6.� E@ctrical UFER Grnd. 57. APPROVA� TO COVER�GUNITE
' 7.•Footings 58. Electrical Cqnduit�Undrgrnd.
'" 8. Foundati0n , 59. Gas Pipe. O Undrgmd., Test '
9. Water Pipe�Undrgrnd. )/_ /_ G_ ? 60. Backwash Lines, P•Trap, Cl Undrgrnd. �
!C L (i J
10. Structura� Floo� SYstem i 67. APPROVAL TO DECK `.t --�l ��
17. Property Sewer Line & House Connection ?� S � 62. Backwash & Recepta��Final �'
6
72. Sewer Cap 63. Heater & Vent�Final .
13. Root Drains � 64. Plumbing System • Final -- '� 1
14. Rough Plumbing 65. Electrical�Final 1 i
rz_��-
55. Rough EfectricabConduit 66. Solar System-Final ,
76. Rough Electric Wiring �• � 67. Fencing & Access Approval • '�
17. flough Wiring Sign 68. APPROVED FOR PLASTERING!. �
�.
78. Rough Electrica6T Bar Ceiling 69. POOL/SPA SYSTEPAS FINAL _,
19. Rough HBating & Air Conditioning FIRE DEPT. REQUIREMENT
20..Rough Factory Fireplace • ; , � APPROVAtS . .Permit #
�
21. Dutis, in Structure '„ - ' � 70. Underground, Hyclro
22. Dutts, Ventilatirlg� . " 77. Product.Piping C3Gp5 �Oil
23. Gas Pipe-Rough & Tes: ' . . 72. Undergroun4 Flush
24. Roof Pram�n9 73.' Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing 74.- Overhead Hydro -
26.;T-Bar Ceflinq fStructurall & Monocoat � 75. 'Dry Chemical �
27. Freme and Flashing . J. . 76. Dry Stand'pipe • �
29. Lathing,& Siding . i • 77..'FIXED SYSTEM PINAL
29. Insulation 78. FIRE PREV. F�NAL �
30. Drywall Nailing � . HEAL7H DEPT. REQUIREMENT
31. Piaster Brown Coat , 79. FINAL iNSPECTiON
32. Electrical Power Meter-Final � 80. FOOD CERTIFICATE ISSUED
33. Fina� Eietiric � Notes:� �I 1?t�OW�/ ��5�_
L_!`_
34. Final Heating & Air Condi[ioning �
^ �U" _�--_� -4
35. Final Gas Pipe-Test ' -�L �-' _�,.��5 4 C�-�ldriCS
36. Hood or,Canopy '- '
2.i.��c�M-���
37. Fina� Factory Firepiace ' . 2_ S- 4,��_ �
38. Final Plumbing � � , s� _ �
� !d�'Z��S}.:i�Sd�
39. Water Service-Final �/ OS - �
Z"> 6 �- r' 'G' � ' GY-�'/=' s
40. Gas Service-Final . 2 Z4 �.-- � ��
47. Solar pomesticFinal � ' _.z�� r- - ,
�42. Backf�ow_Preventer , '
43. Backfiow Irrigation ;
44. Landscape Irripation System; , _ �
45. Sound Attenuation • , ;
46. Ha�dicap Regulations � _ ,
47. FINALSTRUCTURE&BUILDING
48. FINAL PLANNING �� �
49. Electric Re�ease to Edison � '
50. Gas Release to Souchern Califomia Gas Co � •
51. CERTIFICATE OF OCCUPANCY .
No. Dace
>..
PflOJECT AOOflESS:
OWNEP'S NRME:
ADONESS: '�
APCN/ENCINEEP:
FODNE55:
PFflMITTEE:
aoosEss:
UNIT:
flE0.N0.:
UNIT:
LICENSEo cOxiHRCTafl oECUNRTION: 1 nereoy allirm inat 1 am IicenSCE unaer pmvi9ons of Chapter 91�ammencinp witn Section
7000) 01 Division 3 0� ��e Busineu antl Proh55ions COGe. anG my Ilcenu is in lull lorco anE e��ecl.
CITY Ut.: SiRTE LIC.: CIASS:
Date: Signatur¢:
WOflNENS' COMPENSATION DECIAflATION: I �ea0y atlirm �ha� I �ave a Clrlilitat0 0� tOnSent b Seii-insure or a Certititaie of Workers'
Campensation Insurance, or a certilie0 copy tnertal (SeCtian 3800. LaO. CI.
POLICY NO.: E%P. ORTE:
COMPFNV:
❑ Ceni�ie0 copy is trereEy furnis�eE. ❑ Certilie0 wpy is IdeG vrith the dry BuJEinq Divition.
02�e: ApDticant:
E%EMP�ION FHOM WONIENS' COMPENS�TION OECUPATION: (Tlus secUon neM not De campete0 il Ne pcmi 6 fa ane AunAreO (5700� ar kss�.
I cenify tlut in Ille Dedormance ol t�e work lor whiU this permit is iSSUCd. I 51u11 not employ any p¢rSOn in any mdnner 5o as to become
subletl lo t�e Workers' CAmpenSalion LaxS ol CaObmia.
Date: Siqnawre:
NOTICE: I�, afl¢r makinq I�is AeCWra�qn. y0u S�WId G¢tomt wEjtti Io I�e Wark¢R' fAmDen5dli0n O�ovi9on5 al l�e La60r
CoC¢. yrou muil farl�vnN CamDly wil� Sut� provitiortt ar Ihis perrttii Slull Gp OG¢meE rewketl.
LONSTBUCTION LENOING RGENCY: I hereby affirm tlut t�ere 5 a consVuctian IenOinq apeMy lor Ine Oetlormance af t�e work for
wnic� Nis p¢rmit i5 i55uM (SKIiOn 3097. Civ. C�.
LENDEN:
ADOHE$$:
OWNEB BUILOFfl DECLAflRTION: I �et¢Oy a��irm Oui I am ¢eBmO� ��om I�8 fAnVaCtars' $Iaie Li[¢nSe Law �ar Ihe �ollowinp r¢aSOn
($ECIIOfI 7I1�1.5 BOSi02S5 d110 Pf0�25510f1d1�l: My GIY OICOUIII'/ NTICIIf�QNflS d pGflllll �0 COIISIIUCi, d1I!!, II110«E. ECIIIOIISh, Of
repai� any strucWre. pnor lo its iuuance. aW repuires itM aD06�a�� �or SUN permt lo lile a SipnM statement thdt �elslrc is IicenSeE
pursuam m ine provisians al t�e Comracmri Slale License Law �Gupter 9(commencinq wi�� Seclion 7000� o� Oivisi0n 3 0� IAe Buvness
an0 Pmlesvons fAde) ar IM1dt �PJslie is eKempl t�etelmm antl tlle Oa9s fot t�e allepe0 eKemD��on. Any violation ol Section 7031.5 hy
any applicantlor a Oermit suCjecis ��e aDClicantlo a citil penalty of not mora t�an IivE �unGreE Uollars (5500�.
I. a5 owner ol IIM D�Op¢M1y ar rtry Bmpbytl5 vnitl wdpEs az lheir 5010 COmpenu�ion, vrill 0o Ihe wOd, anA IAB
❑ simcwre is not intenae0 ar allere0lor ule (Secuon 70aa, Buvness antl Pralessional COEe: The Cantractors' State license law
daes not appry to an ovmer of a Oropeny wtn OuilEs or imD« tAerron, an0 wlw Eoes wU work MmselU�erself or I�mupA
his or �e� own emDloyees. D«ded tlut suU imp�wemenis are noi intmEetl or allere0 lor ule. II, Aawever IAe �uiltlinp ar
impmv¢meni is 5o1G within one year ol completion, I�e awner vrill luve tAe EurUen ol pmvinp �¢/s�e Eitl nol huilA or imD�ave
lor I�e Outpase o� Sale).
I, ai awner Ot l�e pmpeM1y, am ¢xtluvvelp coniqtlinp wiih lit¢nSeO ContraClOrs l0 COn5imtl lA0 D�ojeCl ($BCiiOn 7041, Busine55
❑ anG Pmteuions CaUe: TAe ComrattOrs State Lkeme Law Eces noi appy to an owner ol Droperty wAo WilUs w improves IAerean
antl w�o contracts lor suc� projttls wit� a contracmr�s) licaae W?�nt to t�e Contracrors' State Licensa Law�. I am awara
t�a� prooi al ��¢ir Worker'S Campensa�ion insuranc0 5tqu10 Oe D�ontl¢0 Ia m0.
� I am erem0� untle� Seclion: 8. 8 P. C.
�or ItliS rea50n:
Daie: Prmer.
I Go �erety cenily iAat I am aware ol an0 un0erstan0 tAe reQuirements ol Califomu HealtA anU Satety CoOe Seclions 25505. 25533, and
2553a an0 t�at I or any lulure GuilCing occupant wilVwill not �circle one) neeG to compN ��� sai0 state fAUes an0 ihe requiremenis br a
permit lor conslruction or mOdJication iromt�e Air Whty Manaqemeni Usiricl. NeSiCential COnsimction apDlications are eeempt irom
I�ese prOvision5.
�alel Ap0licanl:
I hereby certdy Ihal l have reaU ihis apv�ication an0 slate tlut ine a�Ove inlormation is fArrttl. I a0ree to comply vnih all city an0 county
ottlinances antl stale laws relatiny lo �uil0inp conslNcliOn an0 �ereby autlqri�e re0resenUtiveS ol thiT uty to enter upon the ahove�mentionetl
pmoeny mr inspec�ion o�rooses.
Oate: Signaiure:
Oriver's License or Social Security w:
�6at�A6 wnne—Builaing: Green—Coae Emorcemeni: Canary—nOP���am: Pink—Revenoe: GdOenraE—nssessor
PERMIT NO; P 069686 PLAN CHECK NO: 04301-94 N PAGE: 2
****r*r**rit**�r**rr***�r�r�r*�r*�r***r*�r�t*i�*****+rr*x��r�rr�r********�**r****r*r*r*r****�rr
TYP.E QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 GAS SERVICE 7.00
PLU 1 SEWER, CONNECTION TO BUZLDZNG EACH 15.00
END OF FEES
7.00
15.00
o! 00 )08�0�0 1�708p4 T�T�S�1 2.1�p
DATc': 10/31/44 ill4E: 11:f4
CONSTRUCTION AN6 P�ANNING POOI ,. oPA �
qPPROVALS Permit # Date Inspec[or AppROVALS Permit � Date Inspector
1. Ternporary Electrical Service or Pole 52. Pooi & Equipment Location
2. ;�qil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit U(ifty-Undsgrnd. 54. FormS
4. Electrical Conduit�Undrgrnd. 55. Electrical Bondi�g
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electcical UFER Grnd. 57. APPflQVAL TO COVER�GUNITE
7. Footinqs 58. Elnctrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water PIpe�Undrgmd. 60. Backwash Lines, P�T�ap, L7 Undrgmd. �
70. Structural Floor SYstem 61. APPFOVAL TO DECK
i t. ProPerty Sewer Line & House Connectio� 62. Backwash & Receptor�Final
12. Sewer Cap 63. Hearer & Vent�Final
13. RoOf Drains 64. Plumbing System � Final
14. flough Plumbing 65. Electrical�Final
75. flough Electriwl-Condu�t 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencing & Access Approval .
17. RoUgh Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Electrical-T Bar Ceiling 69. POOl;SPA SYSTEPriS FINAI
19. Rough Heating & Air Condiiioning FIRE DEPT. REQUIREMENT �
20. Rough Factory Fireplace APPROVALS Permit �t
21. OuGts, in Structure 70. Underground Hydro I
22. Ducts, Ventilating �7. Product Piping f>Gas ❑Oil
23. Gas PiPe-Rough & Test 72, UndergrounU Flush
24. �Roof Framing 73. Undergrnd.StorayeTank QGas ❑Oil �
25. Roof Sheathing 74. Overhead Hydro
26. 7�Bar Ce�ling (Structural) & Monocoac 75. Dry Chemical
27. Frame and Fl�shing 76. Dry Standpipe
28. 'Laching & Siding 77. FIXED SYSTEM FINAL
29. Ins�lation � 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. PINAL INSPECTION
32. EleCtrical Power Meter�Final 80. FOOD CER7IFICATE ISSUED
33. Fina� Electric Notes:
34. FinBi Heating & Air Conditioning
35. Fina� Gas Pipe-Test
36. Hood or Canopy .
37. Fina� Factory Fireplace `
38. Final Piumbing ,
39. Water Service�Final
40. Gas Service•Final
47, Soiar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape IrriQation Sysiem
45. Sound Attenuation
46. Hand�cap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Elettric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No, Date
Pfl0.1ECT RODRE55: 3 G 8 16 TH P L �
OWNEN'SNFME: VOCHELLI, JULIAN PAUL TR
nooaEss: 19322 PITCAIRN LN
HUNTINGTON BEACH,CA 92646
963-3193
AflCH/ENGINEEX:
noosess:
NEG.NO.:
ux�T: GARAG
uxiT:
PEflMITTEE: JULIAN VOCAELLI (714)963-3143
aooxess: 368 16TH PL
C,M. CA 92626
LICENSED CONtBRLTOP OECLAPATION: I hereGy atlirm ihat I am IicBnsed un0er pmdsions ol Chapler 9(cammencing wiN $eciion
7000) o� OiNsion 3 of Ihe Business an0 PrO�essions Code. an0 my license is in Iu0 �orce antl effect.
CITY Ut.: STpTE LIC.: ClASS:
�ate: SignaWre:
WOflNEflS' COMPENSATION UECIAflATION: I �ereby aHirm ihat I �ave a[¢riificate ol conun� to sell-insure or a certitica�e of Workers'
Compe�5dtion Insurance. ar a certilied copy inereof (Section 3800. Lab. C�.
PULICY NO.: E%P. UATE:
COMPANY:
❑ Cenilie0 copY is �ereCy tumis�etl. ❑ CenilieG copy is fileA vrilh tAe city Builtling DiviSion.
� .
Oa�e: Applicanl:
FYFMVTION FNOM WOPIIENS' COMGENS1ilON OELIANRTIO�Rh¢ seciion neetl noi be camWeleA il Ih�mitiS fOr On¢ huntliPE IS100) or lessl.
I cetlily Itwl In I�e petlarmance oi ��e work ior wnicn Ims ei
SuUI ��o ��e WorNers' Compensalion Laws ol Ca6fomia.
aie' � SignaWre:
NOTICE: II. alter king Ihi� declaration, you shoula e
Cotle. you mu5� �a �Ih comply wilh suc�-0�Ovi5ion5
LONSTRUC710N LENOING AGENLY: I �ereUy allirm t�at I
w�icA I�is Oermil is issued �Seciion 3W7, Civ. C).�,
LENDFfl: �
nooeess:
emDloy any �erson��T�ny manner
to I�e �WorA4G5' Compensation pmv6ions al.�he La�or
snall ee aeemea revokea. , jr
mction lentling a9ency for the pedormance�ol l�e work for
{
k'
i
OWNFH BWLOEB OECLAHptION: I nereUy aftirm ihat I am eKempt Imm Poe Comractors' State License Law tor ihe foliowing reamn
�Seclion 703L5 Business and Prolessional Code: Any cily ol county whic� repuires a permit to consimct. alter. impmve. Oemolish, or
repair any 9mcture. O�ior to its issuance. also repuires the applicant tor such permit to file a signetl statement ihat he/s�e is licensetl
Dursuant lo Ihe provisians of I�e Conlractors' S�a�e License Law (Chap�er 9 �commencing wiih Sec�ion 7000) o� Division 3 0l ��e 9usiness
antl Pmlessions COAe) or Ihat he/she is exemp� I�erelwm ana ihe basis for ��e allege0 exemption. Any violation o� Section 7031.5 Oy
any aDPlicanlior a permil 5u6jeci5 Ihe apDlican� Io a civil penalry oi no� more than live huntlretl dollars ($500�.
I, as ownei of Ine propeny ar my emyloyees with wages as iheir sole compensation, will do ihe work, an0 the
❑ simc�ure is no� in�enGetl or oifered �or sale �Sec�ion 7044, Business and Pmfessional Cotle'. T�e Coniracmrs' S[ate License Law
tloes nol apply to an owner of a ompeny who builOs or improves thereon, anJ who tloes wch work himself/hersetl or through
hi5 or Aer Own emDloyees, pwvitleG Iha� 5uth impmvemenis are n0� in�¢nd¢tl or o�lere0 tOr Sale. II, however ��e �uilding or
impwvemeni is 5010 wilhin one year oI completion, Ihe owner wi0 have Ihe burden o� pmvinA he/she Oid no� bui10 or im0�ove
lor Ihe purpose ot Sale�.
I, as owner ol �he pmperly. am exclusively comracling wilh Iicense0 comrac�ors �o constmct �he prole�� (Seclion 70ad, Business
� anA Pmlessions Code: The Coniracmrs' State License Law tloes not appty to an owner of property who builtls or impmves ihereon
d04 Wh0 COO�fdC�S IOf SUCII pfOjCLIS Wl�h d COfli�dtl0f�5) IICCII p11f5112t11 �0 �h¢ COO�f2CfOf5' $Id1E LiCEfISC LdW). I 2fll dWdIC
Ihat proof ol �heir Worker's Compensaiion insurance shoultl b mvitletl to me.
� I am exempl untler Seclion: B. 8 P. C.
Ior mis reason:
p'yty, � ` �— Owne , _
i
I ao Aere�y [enily Iha� I a ware ol anE under51an01he reQuirements of li�a ia Heal�h antl Sa�e� Cotle Seciions 25505, 25533, and
25534 antl �Aat I or any IWu building occupant willlwill na1 (circle one) nee o mply with said siale coaes an0 �he reQuiremen�s for a
permil lor consuuction or modilicalion Imm Ihe Au Ouaiily Managemeni Disi t. sitlential cons�mciion apDliw�ions are exem0� «om
Inese provisions. '
Oale'. ApPI¢anP.
I hereby cetlify Ihat I have reatl ��is applica�ion antl Slalf
ordinances ana Stale laws relaling �o OuilOing consiruclion
pi�riy lorinspeclion Ourposes.
Da Signamre:
Driver's License oi :ial Security a:
—Appl¢am; Pink—Revenue; Goltlenrod—Assessor
CITY OF COSTA MESA — BUILDZNG PERMIT PEP.M NO: E 06736"i
PERMIT NO: E 067367 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: NEW
JOH DESCRIPTION : CONSTRUCT 462SF 2—GARAGES W/PATIO IN HET SQ FT:
CLAIM VALUE: CALC—C'ALUE: GROUP OCC: M—i /
COMMENTS: REF: H-67356
-�t�x-�t*+t***+t�t*�+t�**�-*�t**r-���t-*��-�t**x�*�t*�t�*�r+t�r�x-�t**�,r�-*-�t�r x�*�t�t+t�r�--�t����r#�t*�t*�t�x *-�-*��-�t�*�*�t��t���t��-#
Z O N I N GS ERTEH�AUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGI-IT; FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 92519216 2NE: AEF NO:
PLANNING NOTES>
>
if aE 9E iF ff iE �E iE jE iE iE if iE �%iE 1E iF �f iE iF iE iE if 1f 1f �F 1E iE iF iF �E iE if �if � iE 1E aF iE af 3F if if if iF iE �f * iF ic iR iR iF iF ii iF iF �E jf if 1f iF af if iE �F iF iE � aE if af if aE 1E iF iE jf iE
D E V E L O P M E N T S E ii V I C E S R E Q U 2 R E M E N T S
ZONING APPROVED HY � � DATE:
BUILDING APPROVED BY : — DATE:
APPLICATION ISSUED BY: i S/���'�� DATE• ������
ifiF{c{E3f3EafiFiEiEiRifiFiFiF3F1EKiFiEiEiFififiF�F'i7F3F7F7F�F�fiF3F�FiefiY�"x :F'RT'7F7FiFiiFl�xfiF�#iFiFiFiEafitiElEiE3EifiFiR iEiF
iE iE iF iE 9F iF i6 iE iE if iE #} 3f iE iF iF iF 9f iF iP iE iF if if if iF if iF iE K iR 1E if if +f iE iF i4 iE if IF iE i�-if iE iE 3F if if if if if 1t if if iE iF If iE if if if iF i@ IE �F i! iE iE K af R ic iF �lf if jE * 9E
LEGALIZATZON:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADZNG
PERMIT 32,00
, 50� SMIP/NON—RES
PLAN �
ISS[]E FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE
TOTALS----> 32.00 15.00 ` U.00 47,00 47.00 .00
/
REVENUE DIVISION TOTALS--> COLLECTED: 47.00 Ot,'ER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
97.00 '•,�,
if if iE if ic iF iE iE iE iE �E �E �f if iE iF if if iE iE iF iE iF it if if jf it if iE if if if iE iE iF iF iY iF if if if jf 1f jF if i(� iF iE if iE iF iE if 1f iE iF K 1R iF if iE j! iE aF iE �f jF iE iE aE iF jElf iF iE iE � iF
2 N D I V I D U A L, F E E B R E A K D O W N
i-
TYPE QTY D E S C R I P T I O N'; UNIT COST TOTAL COST
ELE 4 FIXTURES, LIGHTING�,�'1. ST 20 EA. ,75 3,00
ELE 2 RECEPT/OUTLET i' i ST 20 EA. ,75 1.50
ELE 9 RECEPT/SWITCH �-'1' ST 20 EA. .75 3.00
ELE 1 SERVICES HELOW 600 V E BELOW 201 AMP 18.50 18.50
ELE 2 MOTOR/POWR APPARATUS 0,0 — 1.0 HP 3.00 6.00
END OF FEES
�Ji Q�161294—D016±294 T U T 47.OD
6HiE= OS!'al/94 TIME= 1b:17
I CONSTRUCT�ON AND PLANNING
APPROVALS Permit �
I t. Temporary E�ecvical Service or Poie
���--- ---- - -
2. So�l Pipe�U�drgrnd.
3. E!�ctrical Contluit Ut�hty�Undrgrnd.
� 4. E�� ctncJ Co�d�it�Undrgrr.d�L�
� 5. S!�z-R.��n�o�cerie^t
6. E'�:�clrcal UFCR Grnd.
7. Footings
8. Fo���rJ,�tion
i 9. U,bte� P�qe-Undrgmd.
r---
�, lU. Structw�l Ftpor System
71, Prapt-;y SFr:=r Line & Ho�se Cpnnection
, 72. Se��.er C�p
f-- - ---
73. Ro�* Or„�ns
I----
' '4. Aoup� Pi�m�,ng
' �5 Ro�gli E'ectr'cal•Cond�:t
, 7 R qh Elec;�ic Wiring
� 17. Rough'::�ringSign
i
r18. Ro�yh Eiec!rica!�T Bar Cedinq
79 Rovgh i+c,c;ng & A�r Cor.d;tionfnp
ZC. • F..c;orti F�replace
2L Du� , -.5'rvcwre
22. Due!s, Venti!at;ng
23. Gz� Pip��Rough & Test
Ir24. 7oa! Fra�ning
25. Root SFt..thing
� 26. T B;:� Ce�ling (5!�ucturall & f.'o^ocoat
� 2� /. 1'rdmP e':i FldShing
� ?8. L:.th�ny;„ S�d��.g ---
29. Insu'at.cn
30. Dryr.ail �:a�tin9
37. P�aster 6�own Coat
?2 CleclriW Po�ver PY,eter-F�r�al
33. FIreI Electrie
34. F�nel Ncdting % A�r Cond�tiOrmq
35. Fin_! Gas Pipe�Test
3G. Hnc�' or Cn�OPY
i 37. F�,^al Factory Fireplaw
38. Final Plumbing
39. �Vater S�ruita�Pfnal
� 4C. Gas Sare�ao-Fi�=1
'�11. Solar pon•esdo-Final
� 42. Back�ic:: Preventer
43. Bacl:flcc� Irrigation
44. Landsc�Ge Irn9ation SYs;em
45. Sound Attenuetion
46 Handicap Regulations
47. FINAL S7RUCTURE & BUILDING
48. FINAL PLANNING
49. Etectric Ralease to Edison .
�
50. Gas Releasa to Southero Ca6fomia Gas Co
51. CEFTIFICA7E OF OCCUPANCY �
No._ Date ;
Date
X.
POOL PA
Inspector qppROVALS Permit #
52. Pooi & Equipment Location � �
53. Steef Reinforcement �
54. Foims ' �•
' 55. E�ectrical8ondmg _
56. Rough Plumbing & Pressure Tett
��57. APPRCVAL TO COVER�GU\ITE
58. Electrical Cooduit�Undrgmd.
59. Gas Pipe, � Undrgrnd., Test
. �
' ! 60. BaCkevaSh Lines, P-Trap, O Undrgrnd.
61. APPROVALTODECK
.�
62. Beckwash � Receptor-Pma!
63. Heator & Vent-Final
I 64. Plumbing System � F�nal �
65. Electrical�Final . �
��66. Solar System�Fina� -,
-<-•---�-
��67. Fencing & Access Approval
68. APPROVED FOR PLASTERING�
69. POOL/SPASYSTEf;1SFItVAL
FIRE DEPT. REQUIREiNEN i
i
A?PROVA�S Permit �
'0. Underg�0und Hydro
71. Product Pipin9 O Gas u Oit
72. Underground Fiush
73. Undergmd. Storage Tank ^ Gas C C�;
74 Overhead HVdro
1
r•
Date In�pector
`.
� _
75. Dry Chemical I
-- -f --
76. Dry Star.d:ipe ;
77. FIXED SYSTE\". FI':AL �
-J--
78. fIRE PREV. FINAL �
F(EALTH DEPT. R'cQUIflE:ai[idT
79. FINAL INSPECTION _ _;
�'_
SD. POODCERTIFICATE ISSUED
n--- -I--
/
/
�
�
PNOJECTAOUNE55: 368 16TH PL '
OWNEfl'SNFME: VOCEIELLI JULIAN PAUL TR
aooness: 19322 PI�'CAIRN LN
HUNTINGTON BEACH,CA 92646
963-3193
ANCN/ENGINEEfl: XEG.NO.:
aooness:
u"�' A 6 B
uxir:
PENMITTEE: SULZAN VOCHELLI ( 714 ) 963-314 3
aooeess: 368 16TH PL
C.M, CA 92626
LICENSEU CONiflRLTOB DELNNATION: I hereGy allirm t�ai I am IitenseA unGer D��sions ol CAapter 9(commencinq wilA Section
7000� ol Division 3 of t�e 8usiness antl Pmlessions COtle, anG my license is in Iu0 torce an0 eflecl.
cirr uc.: sTae uc.: cuss: EXP ;
�ate: Sipnature:
WORREPs' COMPENSA71aN oECIABAT10N: I hereby aflirm Ihat I nave a cenificale ai Consent to sell-insure or a cenificale ot worker5'
Compensalion Inm�ance. or a Certilie0 cooY ��ertol �Senion 3800. lao. q.
POLICY NO.: E%P. DATE:
COMPANY:
� Cenilietl copy is here0y Iumisne0. ❑ Cenilietl coDY is filetl with ine ciry BuilAinA Oivision.
Date: Applicant:
EMEMPTION FPOM WOBNEBS' COMPFNSATION OfCIANATI :(This section nee0 not be completeG ii thr per �(is lor one hunOretl (5100) or less�.
I[etlify IM1ai in Ihe Oehormance o� IM1e work for which Ih ermii is iss e0. I 5 II no� employ an� p�n6o A an manner��y _ �co as �o become
su�leqp Io I�e Worker5' Compen5aiion Laws o� CalilOmi � A" V
Oate: �.\u61 . � ' �QQ � Sipnamre ;il\74
NOTICE: I1. al�er making I�is aeclaralion, you s�oultl � ie SuUject �o the W !ers' ComDenSaiion pmvisions o� t�e Labor
Cotle. you must Ionhwilh comD�Y wit� such pmvisions is Oermit shall be dee e0 revoked.
CONSTBUC710N LENOING AGENCY: I �ereEy ailirm ihai the i a consimction lentling agency tor the periormance o� the work for
whicn I�is permil is issued (Seclion 3097. Civ. C).
LENOEN:
AUOflESS:
OWNEfl BIIILDEfl DECLANATION: I �ereby a�lirm Ihai I am exempl Irom I�e Contraciors' State license Law for the followinp reason
�Section 7031,5 Business antl Prolessional Code: Any ci�y ol county whic� requires a permit m constmct, alter, improve, tlemolish, or
repai� any stmcwre, prior io i�s issuance. also requires Ne aDPlicant for such permit to file a signe0 s�atement that he/sAe ¢ licensetl
pursuam �o t�e pmvisions ol the Contracmrs' State License Law (Chapter 9(cammencing wi�h Section 7000) of Division 3 0l t�e Business
antl Pmlessions Coae) or t�at he/she is e�emD� �herelmm an0 the basis lor t�e allege0 ecemption. Any violation of Section 7031.5 by
any apPlican� �or a Dermii su01ec�5 ihe applicani lo a civil penal�y ol not more �han live hunOretl Gollars (E5110�.
i, as owner af ihe pmpeny or my employees with waqes as their sole compensation, will Eo ihe work. antl ��e
❑ simcm2 is nol inlenEetl or olieree for sale (Sec�ion 7044, Business anA Pmfessional Cotle: The Cantracmrs' State License law
Does not apDly m an owner oi a propeny who UuilOs or imOmves ihereon, an0 wha aces such work himself/herself ar thmup0
nis or ner own emo�oyees, o�oviaea inat sucA impmvements are not intenAetl ar attered tor sale. If, however the huJding ar
impmvemeni is solU wilhin one year ol complelion, Ihe owner wili �ave t�e Uurden oi D�oving he/s�e tlitl not huiltl or impmve
lor tne ourpose ol Salel.
I. as owner ol Ihe DmDeny. am evclusively coniractine wiih licensed contractors to cons�mm the Dmlec� (Sec�ion 7044, Business
� anE Pmiessiws CaJe: T�e Caniracrors Slaie liten5e Law Ooes nol aDDh to an owner o� pmperty who �utlOs or impmvu thereon
antl w�o wmratls �or sucA D�olecis wiih a conVactoqs�license Oursuanuo I�e ConVactors' State License Law�. I am aware
Ihal pr001 al Ihei� Warker'S ComOe�iion insUrante ShaulC mvi�ea �o me.
� I am exempl un er Section: B. d P. C.
�or Ihis r¢ason: +\
v
Oa�e:
I tlo nereUy cenity t I I am aware o an0 un0erslantl the requiremems oi C i nia Heaun ane Safet De Sections 25505, 25533. antl
2553a anU i�at I or any imure builOmp occuDam wilVxill nm �circle one) nee 0 i110N v^Ih 53itl S�a�2 tro�¢5 and �hP �¢qNRm¢nI5 �0� d
permil lor consimtlion or m00ilication Irom i�e Fir Oualiiy Managemenl Oisir . esiUeniial cons�Nction applicaiions are exempi from
tnese O�ovisians.
Oale: pDu�icam:(�_�
I �ere�y certifythatl �ave rea�l�is aD0licalion and stat�
orNnancesantlslaie awsrelalingloEwlCingcwstmc�ion �
pr eny �or ins0ec n purposes.
�al Signaiure
Oriver's License � soc�ai se ��nv •: !
t6<L46 WM1ne—BuilEing: Green— oEu Enlmceman�:
I�e aDove inlormati0p is correcL 1 agr¢9.Ie.qQrypty wilh all ciiy an0
Pink—Revenue; GOldenro0—Assessor
J
CITY OF COSTA MESA — HUILDING PERMIT PERM NO; B 06831
PERMIT NO: B 068319 PLAN CHECK NO; N GOVT: N SUPP; N
CONSTRUCTION TYPE; PERMIT TYPE: STH PURPOSE: NEW
JOB DESCRIPTION ; T/OFF SIDING, STUCCO 2 SIDES OF RESIDENC SQ FT: 3,000
CLAIM VALUE; 3,000.00 CALC—VALUE: 3,000.00 GROUP OCC: R-3 /
COMMENTS: STUCCO 2 SIDES OF A DOPLEX
.,���*���*****��*���*�����������*��**.���Q� � � �x,����*,�*,��*�x*S`i��'E'�'i'�1C'i'pR
Z O N I N G R E U I R E M E N T S
SETHA�KS REQUIRED
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDZNG ---------
FRNT: FT ZN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: ET IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 42519216 ZNE: REF NO:
PLANNING N6TES> , �
i �
if 1f !E 1F 1tlk 1k it 1! fE tf 1tlElF tt M if M 1f 1E if 1! 1k 1ElElf !E!t 1F 1k 1F 1f 1t 1F 1E iFlF 1E iF 1Elt M M k 1F 1E 1t if 1!!F M MM 1t 1tlF 1F 1f ft iF k iE if iE fE 1k 1tlk 1E'iE ii 1FlFlFlF fE M iE ik
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
ZONZNG APPROVED BY DATE: "
BUILDING APPROVED BY .:'
APPLICATION ISSUED BY:
iE 1f fE iE 1E if M iE iE ff 1f K iE 7f 1E 1k 1E ik M ik 181F7F�iF
1f iE iE iF ii 1k M it M iF it iF iF it iF iF if iF iE iE if iE 1F iP i! M%if
LEGALIZATION;N
BLDG PMT PLUMBIN
PERMIT 54.00
PLAN
ISSUE FEE
DATE: �'
iE if M it iE1f 1E itlFlE M M iF 1E 1E if 1F iF if 1E M 1E %iF M 1f M iE iE 1Elk 1E 7t 1E fE 1f 7E iP iFlE 1E 1E iF if 1f k iF if iE iF
F E E S U M M A R Y STRUCTURAL SEGMENT:Y
ELECTRIC _MECHANIC FIRE SMIP/RES GRADING
5�
SMIP/NON—RES
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 54,50 0.00 0.00 54.50 54.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 54,50 OVER/SHORT: 00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
54,00 ,SO
if M it k 7f /f if 1f 1f k ik M if M fk fF it k ff iF 1k iF it if 1F 1F 1F 1F fk if if iF it if if it iF M ik /f if iF ik 1t M ik iF M 1F it M iF 1t M k if k 1f M if 1f iE 41f ik 1E 1f 1F iF it 1f k 4!f fF if if if iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE
63aT:1
{JTY D E S. C R I P T. I O N
3000 ALTER BY VALUE RESIDENTIAL N020NE
END OF FEES
,y r���.
_,bi�! 6� . ..
UNIT COST TOTAL COST
1,00 3,000.00
�D �� D
AUG 1994 �
� 2
CITY, 8F 60STA M�A �
/ �
� i � . --- `
POOL .PA
CONSTRUCTION AND PLANNING � - �
APPROVAIS Permit� Date Inspector qppROVALS Permit# � Date Irispestor (
1. Temporary Electrical Service or Pole 52. Pool & Epuipment LocaUon � .
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ,~' �•
. �'�.[ectrieal CondvJttl�iility-Und�gmd. 54. Forms � ` _
_, � �: -
z?�i��ut�i�� Cond�t,.�lndrgmd. - 55. Electrical Bonding -
'-'S'vSka'el RcinforcemEnc 56. Fough Plumbing & Pressure Test •` ��
r}uy�� 7l,
i6:�ctrical UFE ��nd. 57. APPflOVALTO COVER�GUfdiTE . ��
c�7a� dOtings �:T ' S8. ElectricalConduit•Undrgmd.
��
.
`�,'�o�ndation �� �;�� 59. Gas Pipe, O UnUrgrntl., Tes[ ��,
�ater Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd. ,�
1b` StfLctural Floor System � 61. APPROVAL TO DECK `^ •_ '.
17. Prqperty Sewer Ling�& House Connection .�: � 62. Backwash & Receptor�Final ���
L
1� Se,"_sver Cap � _ 63. Heater & Vent-Final _F, � ,
13. Roof Drains �p - , 64. Plumbing System - Final .',� �.
tA. Rough Plumbing �� r `� 65. Electrica6Final � �
::� i
15. Rough EVectrica -Conduit .`� 66. Solar SYstem-Final '� �
._
16. Rough Electricp�iring 67. Fencin� & Access ApP�oval �-� �
`t7. Rough Wiring S`gn 68. APPROVED FOR PLASTERING�:� -� �
18. Rough Electrica�-T Bar Ceilir,g 69. POOL;SPA SYST6b15 FINAL ' ;
19. flough Heating & Air Corditioning FIRE DEPT. REQUIREMENT I
�. � � -. �... :'] C T-� :U i� O:, k i-� nI i
20.,�ti.o�qh Factoi� FiLeplace i c:m S'7 *. �, z: 73PPRQ+lAtS:���'er�t # + �+ ^
� c z +-. -: x �� C'vy�- •-
� � � F+F y� Y. ... - '7�c t: r� "�'7 (n 4 '+• '
21.�uC.'�.in.�Str�tuC�.�,� .... .S �� S � ,-•k� � `i0. �der9�€3?C7�YrEo >. '
22. Ducb. �$iitil�ting . .7S � 5 �.."* �� t�l. Product�F �r�g ;=PQ�� COii
23.�as�"i e�tou &' st � `� � ^"'t:F' i' ''y�J x �.;5 u
...,P .. � �',t ;:y ; ,. ;h „+ � ,� � `�2. Undergro�irjdiFlu:;vJ � > c., o
24.�F?o�Frkming. F.. -. ; ;-.F. '' �• � �j a+ �x � s3.r-yFJndergrnd?StoraT� ,k OGa �
25, Roo'f'Sh'e�S3thing ^ r Q v �',.'' � 7 t; �-74.,,`�}u�rhead Ffydra C`�� .�'`�
�
26. �;�Ba'ryCelling (Struccural)' &�oaocoat > v e+ c,v x 75.1'Jry Chemical �"� a' � �� '�:
27.�Frameand Flashin � * ^ � ` � 76."b`v� Stand�� ��� +'' � �
i-. 4 "9 R � T, � N ^_7.[ 'F c+Q� R1
,7�S.�Lathing&Sic}jng,J,� �-fe,� :Z�l�.rglf�q,�[.'x 77.cfIXEDSI`S'CEM;FWAL*
._, .- -� ,. _
=29. Insulatio'n � N# -' � ' " ' a " �C �� 78.�IRE PREV. FIN:4� ; � � �
� 0. Orywall �ailios,� +i �� � ,r' '-; li&ALTH�EP•a��_T,A�6QW}RE7IENT
� . > � t.
r.
��1. Plaster B'tbwn,Co�i� �y ,� � .,,�, 8� Z. 'W' �9. �'hINAL IN�'�ECTIOJ91 � d �
� � . i ;. - �--F.:-. F
�2. _6lectrica5"PowQr Mytar,final � � cu � •!$0, t600D CE IFIG7�'ISE IS9UED
��3.'�'+�,inaTEle."etric,� '=� � i c^ � �T, t' t" -� x '%
�;� Plot�e.�: � �a� c h J�v.*7
1. �IH �� � . ' �F �1 l"� 4 .�ll 3
:34. :Fina( He�i�ng`-& Ai� �otr di[ionin9S t'� _' s. i�.� x s CO
I �
35. iiinatGa£Pip2aTest K ..� "' <� � � �� �� ";� '� c� SO
i: � S C C: ti a. F.^•
36.'FIoOd�or�CanOPY � pC i r"'7 a i. f1 � , S � f�o �� a. �� �C T
- n
'37. 'E�inaFfaciory Firepl�ce' ^ : � �'" �' ,:� .`k � � b,�.. ~ =� �
, . : �- �-+ -, i
T �: ,z � .. .. a: x . � : : 4. s. -;--- �� -. ;
3,8. Final�Alu�bing i y i �, , ". ,.: .� '�; Q J
-39. Water;Sec'vice-Finat = � � '� i �+ - T n 'L'�:: x � �
ti� i � 2 ��{ i+ a S
4�0. Gas Servic^,e-Fi al . � ` � `" • v .. .
q � r..;.��,. K r � p" ",1' x�..,
:4:7. Solar portiestio-Finat• � L' � � �• ' :� I •� " `f'� ^'+ #
:r n: r ! m -7 7 C M:C a
'42. �ackflowiPreventer � -` ��� �'� � �.� � ;,F • �. C� � 1
43. Backflow�irrigation �� ' : =•`+ x � y z�'-c x � - :
a•• s ;d i s .l
d�4. LandscaPelrcl�ationSystemro,���+.ii *?l C�: 0= � JJ P; ._:J � ^+ -•
. . �: �. r ... . . . _ .. _ . . ..
?}5. $ound Atten�tion.� ;`f�i"T�' �" f E � M m�a� � F c+' ~ SS F�7 Z
_ . .. .. . , = -'
f.. lir � - Y .. � i' / l V •
G6. HandicaP.Regyllatior��'; �..y �, k :' .. S;� •� p;� � k:
47. �INi,j1 STRUCTUR� �YJ'�L"DING :iO,(�t/ ��.�: "? n%oS ~ a
J � , i c� x t�
48. EIN/Y�L PLANNING�;� " j�,c�'_,r �� _ ,�"- r .r� v, (-'. w
,.
J9. �lectric Fielease to �? i n I S � .� � � p -. _
c
50. �ias �elease to Sout n tiforpj��ias Co �; � � � �, �; . `�;;; * ;j • -. -
� _ -. -
��, . CER�:IFICATE OF �UPANCY' _ � y i7 ,n;� ;� ,� �. �
No. ace __
,��1
�
` �
. 7� .N
36� 15TH PLACE A,B
COSTA i�1E�A.CA
G82. G �q. rT
�ecr aooness: �' _.� 6 8 E 16 TH ST uxir: B
OWNEq'SNRM'� yg0 16TH ST ASSOC
PDOflES� 1936 E DEERE Ii215
SANTA ANA, CA 92627
�263-1920
PflCHIENGINEEP: DON FLAI R flEC.NO.: C 1 2 9 2 O
nooness: 17875 VON KARMAN uNiT: qpq
' IRVINE CA 92174
PEPMITTEE: z90 16TH ST ASSOC LP ( 714 ) 833-5097
noon¢ss: 19 3 6 E D EAR AV' 215
S,A, - CA 92715
LILENSED CONTNACTOP OECLAflFTION: I �ereby allirm mat I am Iicense0 un0er provisions ol C�aO�er 9(commencinq wit� SeciiOn
7000) ol Division 3 ol ihe 9usiness antl Professions Code. and my litense i5 in �ull �orce an0 eHecl.
CITY LIt.: STATE LIC.: CLRSS: EXP ;
oate: Sipnamre:
WOflNENS' COMPENSR710N OELLAPATION: 1 heROy affirm ihat 1 have a cenilicate ol tansent to sell-insure or a cenilicate of Wofkefs'
Compensa�ion Insurance. or a cenifiea copy ihereol �Section 3800, Lab. C).
POLICY NO.: F%P. ORTE:
COMPRNY:
� Cenifietl copY is here6y Nmishetl. ❑ CenilieC caOY �s IileU vrit� l�e ciry BuilEinA Oivlsbn.
„ate: ApPlicant
EYEMPTION PBOM WONNENS' COMPENSATION oECIAB�TION: RAis seciion ne A not Ue mmplete7 if tle permt is Im ane huMrM (St W) ai less).
I ceNty ��at in ��e pedormance ol lhe work �or which I�a rmii is iss . SAall no� employ any per50n in any manner so as �o become
su m lhe Work s' Comp sation aws 01 Calilami �
a�e: y � Signa�ur
NOTItE: If. alter king thi aeci,�aua�. ro� sn ulA �erome su0lect ta the Workers' ComOensation pmvisions ol I�e laGor
Cotle. you musl Iorihailh wmpty wii� SutA provi5ion5 or WS permil S�all b2 OeemeO r¢wkeA.
CONSTHUCTION LENDING AGENCY: I hereby ailirm tha� tnere is a wnstmciion lentlinp apency lor tAe OeAormance af ihe work lor
whic� I�is permil is issueA (Section 3097. Civ. C�.
lENOEN: '
AOUflESS:
OWNEfl BUILOEfl OEQABRTION: 1 hereCy allirm I�ai I am exempt Imm I�e ConVactOrS' State Licenu Law for Ihe followinp reason
�5¢ai0n 7031.5 BUsiness antl Pmfessional Coae: Any tiry ol Counry w�ith reqNrts a pefmil Io canSlNCi, alt¢r, impmvE, Aem01i5A, ot
repair any simcture. prior lo its issuance. also reauires the aDDlicant for wch permillo lile a ApneE statement Itut h¢/sne is licensea
Dursuant to Ihe pmvisions oi I�e Contraclars' Slate License Law (C�api¢r 9(commencinp with Section 7000) of Oivision 3 0l the Business
anG Pmlessiun5 COAe) or I�al he/s�e i5 ¢K¢mpi IAert�mm an0 ihe basi5 br Ih¢ all¢p¢C e�¢m0�i0n. Any Nola�ion al SeCtion 7031.5 by
any applicanl for a Oermit suElecls ihe aDPliWnt lo a tivil penatty ol noi more ihan five IlunErtO tlollars (5500).
I, as owner of ine vmpeny or rtty employees with waAes as Iheir sote compensation. will Uo ihe work, anE ihe
❑ s�mciure is no� imenEeG or O��ereG br 5ale (Section 7W4. Buvness an0 Professional Coae: The Cantractors' State License Law
aoes not aDON �o an owner ol a pmpeny who OuilUs or impmves thereon, an0 who Coes such work Aimsell/hersetf ar ihmuAh
�is Or her awn emD�oyees, pmvitl¢E Ihai Sut� impmvemeni5 are noi inlen0etl or ofl¢red IOr SaIE. 1�. �owever �Oe �uibinp or
improvemenl is sol0 within one year of complelion. Ine owner vnll have �he 6urtlen of provinp nC/she Ei0 not Uui10 ur improve
lor the vurpose al sale).
I. as owner of t�e D�openy, am exclusive1y contractinq xit0license0 coniraclors ta construct I�e pmlect (Section 70Ea, Business
� and Pmlessians Caae: The Contractors' State License Law does noi a00ty to an owner al Omperry w�o CmICs or im0��es Iherean
antl wno comracis lor such pmjecis witn a wntractorls) license pursuant m �he Comraclors' State License Lawl. I am aware
Ihdi D�00� 0� IApir Warker'S Comp¢nSdtiOn in5u(dntC ShONd 0¢ pfOVIG¢G IO 111¢.
� i am exempt under Sec�ion: B. 8 P. C.
lor I�is r ason:
at 9 Owner �
tlo nereby cenily ih I am a are ol an0 understantl Ihe requiremems of Calilomia Healih antl Salety CoUe Secvons 25505, 25533, anA
25534 and t�a� I or any Iwure huilding acupant willlwill not (circle ane) neetl to comply wi�h sai0 state coJes an0 IAe requimmenis lor a
permil far constmction or modilication Imm t�e Air Oualny Management Oisirict. ResiUential consimction applications are eKempt imm
Ihese pmvisions.
Daie: Appli[anl:
I hereby certily Na� Ihave rea0 this apPl¢auon antl s�atet�ati�e above inlor tion is wrrec�.lapree m comply with all city antl county
or0inancesantlsatelaw rela�inglobuil4ingconsimc�iona herebyaulAoni resen�ativeSal�AiSciry�oen�eruponlhfabove�men�ione0
pmpetly lor irt eclion urposes. �
' Signalure:
nv¢r' Li ense o Social Security a:
164La6 W�ne—Builaing; Green—Cotle Enbrcemenl; Canary—Applicanl; Pink—Revenuo: Goltlenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06968
PERMIT NO; B 069682 PLAN CHECK NO: 03576-94 A GOVT; N SUPP: N
CONSTRUCTION TYPE; PERMIT TYPE; STR PURPOSE: NEW
JOB DESCRIPTION ; 1119SF 2ND FL, 872SF 1ST FL, 441SF GARAG SQ FT; 2,566
CLAIM VALUE; 150,000.00 CALC—VALUE; 157,519.80 GROUP OCC; R-3 /M-1
COMMENTS; 41SF 2ND FL DECK 93S£ FRONT PORCH
�r*�t+t+rx�r�rr*�r�e�r�r*�r�r�r*ie�t+f�r;�**��r*�r�r**�r**x��r�r*�r�r�r�er*r*+r+r+r*�r*�r�rr**ir*�r***r�r�rr*****+r�rx**
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 BUZLDING ---------
FRNT; 22 FT IN REAR; 20 FT IN FRNT; FT IN REAR; FT IN
LEFT; 18 FT 4 IN RGHT: 8 FT 8 IN LEFT; FT IN RGHT; FT IN
PARKING REQ • 6 PROV; 6 PARCEL; 42519119 ZNE: R2—M REF NO; DR-92-13
PLANNING N6T'ES> 1 UU OF 2 CONDO PROJ. FAONT SETBACK IS SEPARATION, VESTING
> MAP EXISTS EOR THIS PAOJECT, PKING ABOVE IS PROJ TOTAL. P/E
r�r�r**r***�rr�r�r�r�rr�r+r�r.**i�*�r.**irr******�t*****r�rx*�rx��r+�*******�r**�rr*r****rr*********r*
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
20NING APPROVED BY--. •' ' i/(/�� DATE: �0-31—��I
BUILDING APPROVED &Y •:; • ' //Y�2 DATE: �� —Z I - f`+
APPLICATION ISSUED,BY:. � ` DATE:/�— 31• �
1EiEMlfiEiFiEififififftifMlfM�fifiElEifiE. IEiflfitif�ElFi:iFif jflk
if if if �f if ft jF if if ff 9F if %if if 1f if M iE if if jf if if iE iE if iE if iE ff 1E iF iE i! 1E 3f iF if !f M M it �f it fP iF if 1F %if if if if if 1f if i: iE if K iE fF iF it M M if aE iF ii if iF if M Y jf M�E
LEGALIZATION;N F E E .S U M M A R Y STROCTURAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC �MECHANZC FIRE SMIP/RES GRADING
PERMIT 842,50 15,75
PLAN 136.91 ' SMIP/NON—RES
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLA3d=CHECK TOTAL PAID DUE
TOTALS----> 858.25 0.00 1'36.91 995,16 995,16 .00
REVENUE DZVISION TOTALS--> COLLECTED: 858.25 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECFIANIC FIRE SMIP/TOT GRADING PLAN—CHECK
842.50 15.75
if 1f iE i! iE if if 1f k iF it M iE if it iF 1t iF if it ff if 1f it it i! it if ih 1E 1f i! iE if iE if 1E ik iF 41f if M 4 if if 1h 1F 4 ff it 7! M�f if it k ff k it 1t if 41t if it M it i! if if 1f i! 1E it if if iE �f
I N D I V I D U A L F E E B R E A K D O W N
TYPE
SFR
SFR
SFR
SFR
QTY
1941
93
441
D E S C R I P T I O N
DWE—TYPE C�—WOOD FRAME —GOOD
RES—HALCONY, EXTERIOR STAIRWAY
RES—PATIO COVEA—POST '6 SOLID AOOF
RES—GARAGES TYPE V
END OF FEES
,�X'�I ��°1 �- l,V�
¢
UNIT COST TOTAL COST
74.00 197,334.00
14,80 606,80
19,80 1,376.90
18.60 8,202.60
ai ooi�o�o7-oa��osaz v��Y ess.zs
DATE: i0/.i1194 iltfE: 11:16
� CdNSTRUCTION ANDPLANNING
APPROVAIS Permit#
7. Temporary Electrical Service or Pole
'� $pil P�re-Undrgmd.
i' .
3. Electricaf Conduit Uti�ity�Undrgrnd.
4. Electrical Condu'rt-Undrgrnd.
. 5. Sceel Reinforcemenc
6. Eiectrical uFER Grnd.
'� 7. FOotings .
� 8.'Foundation �/Q` �
/� !/ ��
9. WBter Pipe�Undrgrnd.
10. Structural Floor Svscem
11. Pr�opertY Sewer Line & House Connection
12. Sewer Cap
13. ROof Drains
74. flough Plumbing
15. Rough Electricat-Conduit
76. Rough Electric Wiring
77. Rough 4Viring Sign'
18. Aough EtectricaY-T 8ar Ceifing
19. ROugh Heating & Air Canditioniog
20. Rough Factory Fireplace + � .
•�
21. Dutts, in Structure , " , �
22. Ducts, Ventilating. � -
23. Gas Pipe�Rough & Test
��
24. floof Framing � , •
25. Roof Sheathing � . 'I
�
26. �T�Bar Ceiling lSuucturaq & Monocoat
27. Frame and F!ashing . _, �/L
�
.28. Lathing 8 Sidin � . � . . �Z
29. Insulatidn � �' ' � �'��
30. Drywall Nailing
37. Piaster Brown Coat , „
32. Electrical ?ower MeterFinal •
33. Final Elec;rlc � � ,
34. FinaL Heating & Air Conditioning:� ''
35. Final Gas Pipe-Test '
36. Hood or Canopy � . '
37. Finai Factory Pireplace • �
38. Final Plumbing . � � ��
39. Water Service�Final �
40. Gas Service-Final .
41. Solar pomesticFinal �� � �
42. BaCkflow Preventer � '� .
43. Backflow Irrigation '�" �
44. Landscape Irri9atiori System .
.45. Sound Attenuation �.
46. Handicap Regulations ;
47. FINAL STRUCTURE & BUILOING
48. FINAL PLANNING , ',.' ,
49. Electric Release to Edison
50. Gas Release to Southern California Gas Cc
51. CERTIFICATE OF OCCUPANCY
Date
Oate
Inspector
�
�. i �
., i
POOI 'A
APPROVAIS Permit # Date
52. Pool & Equipment Location •
53. Steei Reinfiorcement .
54. Forms �
55. Elecvicai Bonding
56. Rough Plumbing & Pressure Test
57. APPflOVALTOCOVER-GUNtTE
58. Electricai Conduit�Undrgrnd.
� 59. Gas Pipe, � Undrgrnd„ Test
60. Backwash Lines, P�Trap, L� Unct�gmd.
67. APPROVALTODECK •�
62. Backwash & Receptor�Final ��
63. Heater & Vent-Final �--5
64, Plumbing System � Final '
65. Electrical-Final
66. Solar SYstem-Final '
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL;SPASYSTEPASFINAL
FIRE DEPT. f2EQUIREMENT
APPROVALS Permit �
70. Under9round Hytlro .
]1. Product'Piping �Gas ClOil
72. Undergro�nd Flush , . �
73. Undergrnd. Storaye 7ank G Gas ❑ Dil �
74. Overhead Hydro
75. Dry Chemical ' ` '
'
76. Dry StandPipe - �
_ 77.- FIXED SYSTEM FINAL �
' 78. FIRE PREV. FINA1 � � � �
HEALTH �DEPT. REQUIREi�/IENT
79. FINAL INSPECTION � .
- 80.�:POOD CERTIFICATE ISSUED
�Not�s: . , ,' �. ' ,
Inspetto�
�
0
�
TO:
Applicant:
Address:
NEWPORT-MESA UNIFIED SCHOOL DISTRICT 13 9 7 ,
CEE ICATE OF COMPLIANCE OF DEVELOF.__NT FEES
. PURSUANT TO AB 1600 AND AB 181
(�) City of Costa Mesa District Receipt No. ����
( ) City of Newport Beach �]
( ) County of Orange Plan Check No. �D � 7�- IS _
Telephone Number:
%� �45� �SS�L. L
�G f _ �F�.�/t� �Zis
€'33 - S�Y7
�Z7DS�
TracUParcel and Lot Number(s): ,�
Location of Project: 36 � - �� �`� fr �� �s �-� ����
Number of Square Feet of -/�6 5/•5 «"��
Residential Space T�_.3`J• 5 x$ 1.72 Total ��. 30 3.�`�
Residential /
Sr. Citizen Space
Commercial and
Industrial Space
Warehouse Space
Commercial / Industrial Project is: (Check One)
Warehouses
R&D
Movie Theater
Mini-storage
Heavy Industrial
Regional Shops
Light Industrial
This project is exempt because
x $ .28
x $ .28
x $ .2235
Motel
Bank
Neighborhood Shops
Racquet / Health
Hotel
Medical Office.
Office Park
Total
_ Total
Total
Preschool
Auto Repair
Hospital
Large Office
Office Bldg.
Restaurant
Fast Food
This certifies that the above-named Developer/Applicant has paid school faciliry fees in compliance with Government
Code Sections 53080 and 65995. The Building Permits for this square footage in this proposed development may now
be issued by your jurisdiction.
Checks are to be made payable to Newport-Mesa Unified Schqb� District.
The above representation as to square footage is true. Applicant agrees that if it is later determined that such
representations are not true then this certificate shall automatically te minate and the appropriate City/County shall be
notified.
Date: �b 3/ 1 � �1�G`s/l��i/Y,
� plicant
t
�
�
pooness: 368 E 16TH ST
asx�me ygb 16TH ST ASSOC
pDOflESS: 1�j3( E DEERE 1t215
SANTA ANA. CA 92627
uxir: A
263-1920
AHCH/ENGINEEX.^ DON FLAI R xec.no.: C 1 2 9 2 0
pDOflESS: S% B�J S VON KARMAN uNiT: q p q
IRVINE CA 9Z174
PENMITTEE: 2�jO 16TH ST ASSOC LP ( 714 ) 833-5047
ADOflE55: 193G E DEAR AV 215
S.A. CA 92715
LICENSEO CONTNFLTOP �ELUIPPTION: I �ereEy allirm �hat I am licensetl untler O�ovisions oi Chapier 9(commencing wi�� Section
70011) ol O�hsion 3 of �he Business anJ Pmfessions COGe. antl my license is in fu0 torce anE eflect.
arr uc.: sreTe uc.: cuss: EXP :
Oale: SiB�amre:
wONKEBS' COMPENSp7lON oECNNA7I0N: I nereoy allirm Inat I have a cenificate ot consent ro selhinsure or a certiticate ot Workers'
Compensalion Insurance, or a certified copy �nereol (Section 3800, Lab. C�.
POLICY NO�� EXP.-DATE:
LOMPFNY:
❑ CenilieG copy is hereDy lumis�etl. ❑ CetlilieC wpY.is tileU wil� t�e ciry Bu�ItlinA OMsion.
.a�e: Applicanl:
ESEMFTION FBOM WOPNEPS' COMPENSATION OECUPqTION: (This sectia eG no� be comple�ed il0e permil is lorone AunEreO (5100) or Iess�.
I cetlily Iha� �� ��e petl ante o� Ihe work �or which Ihis �mit is iss , shall not emplay any person' ry manner m as to Eecome
wqect w m ao�ke� cam nudun Laws nl GGtomi =. L ���
Oate: � SipnaWre J . C��
NOT E: II. Iier ma ng Ihis aeclaralion, you s�o 0 bec6me su lec� to t�e Workers' Compensation pmvisions oi Ihe Lahor
CoOe. /pu ust fo ith comply witA suc� pmvisions or Nis permil s�all be deemetl revoked.
CONSTNUGTION LENDING RCENCY: I here�y affirm Ihat t�ere is a consimc�ion lending apency for the peAormance al ihe work lor
which Ihis oermit is i<sueA (Section 3W7. Gv. C6 �
LENOEX:
pDUPE55:
OWNEfl BUILOEP �ECIANATION: I herehy a�firm that I am exempl irom the Con�fac�ors' State License Law �or �he followinp rea50n
ISeclion 7Q71.5 Business and Pml¢ssional CoUe: any city of county which reQuires a oe�mil to consiNct, atler, impmve, tlemolish, ar
repair any slmtWre. prior to ils i55uante, also repuires Ihe apP�ican� for SUCh Dermii �0 lil¢ a SiBned Slatem¢nl Ihal hels�e is IiCenSCE
pursuanl Ia ��e pmvisions ol lne Coniracmrs' SIaIe License Law (ChaO�er 9(commenGnq wlh $ec�ion 7000) oi Oivaion 3 0� the BuSiness
an0 Pmfessions Coee) or ihai he/she is exempl Inerefrom ane ine basis lar the alleqea exemption. Any nolaiion ot Section 7031.5 Dy
any apD�ica�� lor a oermit sueiecis �ne apolicanl lo a civil penalty ol not more ihan live hunEreE Aollars (SSW).
I. as owner al Ihe propeny or my emVloyees with waAes as iheir sole compensation, will tlo ihe work, antl Ille
❑ simcWre is not imenaeU or oflere0lor sale �Section 76aa, Business ana Professional Code: The Comractors' State License Law
tloes not apply to an owner of a D�oDeny who Cuiltls orlmDroves Ihereon, and wAo tloes such work himsell/herself or throupll
his or �er own emDloyees. pmvi0e0 Illal suc� improvemenls are nol inlentleA or oflered for 5dle. il. however tlle EuilAinp or
impmvemeni is soltl wiihin one year oi completion, �he owner vnll �ave the GurGen 01 prodnq �e/5hE 4iA noi EuiIE or imDrove
lor Ne purpose ol sale�.
I, as owner of Ole pmpeny, am exclusively con�ractinA H'i�h licensea coniractors to consimct tAe prolect (Section 7044, Business
� an0 Pmiessions CoGe: The Contrac�ors' State License Law aces rrot apply m an owner of pmpeM � hmlGs or improves Ihereon
yp� Wh0 L�PV2L15101 S�L� PfOjCt�S wl\11 2 COp�fdC40f{5) IK¢1150 pllf5lld11i 40 lhC COOh2Ci0f5' $1210 UGC115C LdW�. 1 drtl dWdfC
�ha� Vmol of �heir Warker's Compensalion insurance shoultl be pro itle0 to me.
� I am exempt unUer Section: 9. 8 P. C. '
lo� ��is � ason:
� �
Oate:/G Or+ner.
I Oo hereb cenify ih I am aware of antl untlerstanU Ihe requiremenis ol Califomia Health antl Safety Cotle Sectians 255 , 25533, antl
25534 anU ��at I or any tuwre builtlmp occupam will/will not (circle one� need to comON ��h 5aid state coEes an0 ��e requirements tor a
Oermit lor consimction or moUilicatian fmmlhe Air Oualiry Managemenl OisiricL ReSidentiaiwnsiruction apDlications are exemD� ��om
��ese pmvisions.
Daie: Applicant:
I hereby ce�iify ihal I have rea0lhis apOhcalion anA s�aie Iha� Ihe ahove informa�i correct. I aA�ee �o comply wilh all city an0 counry
ordinancesantlstaielawsr aiingtobuiitlingcons�mciionandh yaul�orizerepr e ta�ivesalthiscirytoenteruDonlheabove-ment�oneC
pmp¢tly lo� ins [Uon 0 OoSes � C
Oate: � � Siqna�ure: f
orivers L'ense o� onai Securiiy x:
�6aLG6 W��i�e-9utlamg�, Green—Code EnbrcemmC Canary—ApP�icanl; Pink—Revanue; Goltlenrotl—Assessor
CITY OF COSTA MESA — BOILDING PERMIT PERM NO: B 069684
PERMIT NO: B 069684 pLAN CHECK NO: 03575-94 A GOVT: N SUPP; N
CONSTAUCTION TYFE: PERMIT TYPE: STA PURPOSE: NEW
JOB DESCRIPTZON ; 1119SF 2ND FL, 872SF iST FL, 441SF GARAG SQ FT: 2,566
CLAIM VALUE; 150,000,00 CALC—VALUE; 157,519,80 GROUP OCC: R-3 /M-1
COMMENTS; 41SF 2ND FL DECK, 93SF FRONT PORCH
it�t*�t*ar****r*it***itrif�t*�tit**�t*fr+E*�tit+�it**�t*it*�tr�ar*it�t**t�r�itx��t*r�*�tx�*�t*it*ic*r�ac*at*�t**iEit*
Z O N I N G A E Q U I R E M E N T S
S E T B A C K S
------------ MAZN BUILDING ---------- , --------- ACCESSORY BUILDING ---------
FRNT: 30 FT IN REAR: 22 FT IN FRNT; FT IN REAR; FT IN
LEFT; 18 FT IN RGF3T: 8 FT 8 IN LEFT: FT IN RGAT; FT IN
PARI{ZNG REO• 6 PROV: 6 PARCEL: 42519119 2NE: AS—M REF NO: DR-92-13
F+LANNING NdTES>. 1 DU OF 2 CONDO PROJECT. REAR SETBACK IS SEPAAATION. VESTING
> MAP•EXISTS�,FOR THIS PROJECT, PARKING IS PROJECT TOTAL, P/E
***ir�r�r*�rx**�r�r*ir*�r�r�rxi�****�r�r*x��r*ir*�e*r*�r*�r�+r***r�r*�r*+r�r*+r***r*x�**x��r�t**********�*
D E V E L O�P M E N'T S E R V I C E S. R E Q 0 I R E M E N T S
20NING APPROVSD BY•• - � �� DAT£; r� I�
BUILDING APPROC'ED BY ;• ��; ��-/� DATE; �� T/ �\�
APPLZCATION ISSUED'BY: � � /�� " DATE: �� 3 ��
+��r+rfr***ir�t***�firirfr*r*iriririFiFiF�FiFiF3F3FiF'iF'iF�F iF"iFiFiFi�i"r3F3F'���,^�*******�..�* �.�.
itk if it i! ififiEiFif if iFitit af if ilif if�k ilif if if 1f 1f if ifjfif it if �f M 1E iE 1f if if�f.iiit r it if iE M iE M�fiF ifif if ifififjf it itif 3f 1E iF ifif 1f iF it if if jk if�lif if k�E
LEGALIZATIOSd;N F E E'. S U M M A R Y .. STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING 'ELECTRIC �MECHANIC FIRE SMIP/AES GRADING
PERMIT 842,50 15,75
SMIP/NON—RES
PLAN 136,91
ISSUE FEE
BUILDING—DZV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 858,25 0,00 136.91 995.16 995.16 .00
REVENUE DIVISZON TOTALS--> COLLECTED; 858.25` OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/TOT GRADING PLAN-CHECK
842.50 15.75
iE i! iF ik 1! ik ik iF if �t ik 4 iE iE iE i! it if 1k k iF 1k ii if k if if iE ik ik ik it 1k iE iE if 4 if if Mif it 1hiF iFjF1k 1E k 1E 1F it M iF if iF iF it iF iF it i! %iF iF 1F iF �F it iF * 1F it jF aF M it iF jF
I N D I V I D U A L F E E B R E A K D p W N
TYPE QTY D E S C R I P T I O•N
SFR 1991 DWE—TYPE V—WOOD FRAME —GOOD
SFR 41 RES—BALCONY, EXTERIOR STAIRWAY
SFR 93 RES—PATIO COVER—POST S SOLID ROOF
SFA 441 AES—GARAGES TYPE V
EXPIREDEND OF FEES
n� ��r� L1f� � .
UNIT COST TOTAL COST
7A,00 147,339.00
14.80 606.80
14.80 1,376.40
18.60 8,202.60
ai aoi�osai-oot7osoz r��r ��s.2s
on7E: f0/;1/9S TIHE: 21�13
CONSTRUCTIQN ANDPLANNING POOL A
,•APPRO4ALS Permit# Date Inspector p,ppROVAIS Fermit�k Date Inspector
i. Temporary Electrical Service or Pole - 52. Pool & Equipment Location , '
y, $pil PiE•��Undrgmd. j r� 53. Steel Reinforceme.nt ' .
.3: � Electrical Condult U3itity•Undrgm0. � 54. Forms , '
4. Electrical Conduit-Undrgmd. 55. Electrical Bonding
5. Stgel ReinforcemBnt 56. Rough Plumbing & Presture Test
S.- Electritat UFER Fimd. 57. APPROVAL TO COVER�GUNiTE
7.�FOotings _ � 58. ElectricalConduiFUndrgrnd.
8. Foundation �� �,/,�A /,�_/�/ �j�- 59. Gas Pipe, (7 UnCrgmd„ Test _-y-r'
��_ 1.�. �.� r�
9, WSter Pipe-Undr9md. � �_��' 60. Backwash �ines, P�Trap, L� Undryrnd. �
10. Structural Floor System 61. APPROVAL 70 DECK _ ' �
t t. Property Sewer Line & House Conneciion 62. Backwash & Recepior�Final --- --
i
12. SeWer Cap 83. Heater & Vent�Final • �
-- , i
73. Roof Drains 64. Plumbing System - Final
:
74. Rough Plumbing � ; 65. Electricai-Finai � !
15. Aough Efettricaf-Conduit � 66. Solar SVstem-Final � -
16. Rough Electric.Wiring 6�. Fenciny & Access Approval -,;�' � -
17. R�ugh Wiring Siyn 68. APPROVED FOR P�ASTERING.. �� �
18. ROugh Electricai�T Bar Ceiiing 69. POOL(SPA SYSi EM1;7S FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Ro�gh Pactory rireplace �. . •APPROVALS Permit #
21. Ducts, in Struciure ,� . . . : ' - 70. Underground� Hydro
22. Ducts, Ventilating . ' 71. ProducCPiping G'Gas OOiI
23. Gas P�pe�Rough & Test � ' � . - � 72. Underground Flush� ._ ��
2-0. Rodf Framing � � � 73. �Underyrnd. Storage Tank O Gas ❑ Oil
25. floof Sheathing �� `_eG(L ,/�w� 74. Overhead Hydro- 1L„r
l �w
s + �
26. T�6ar Ceiling (Structural) & Monocoat � 75. Dry Chemicai �
27. Frame and Flashing� � � �Z,-2�jr �CtU �(,�- 76. Dry Standpipe � � !"--� �
� '-
i
28. Lathing +Sidin� . t '�j_J���'(16L,,,d( 77,.•FIXEDSYSTEb1 FINAL ;
29. Insulatio,n ' .' �' 11.:J�,�-qC�(y(,�,�ir_ 78.. FIRE PREV. FINAL �� "
30. DrY�vall Nailing - � �-j.�•y' � HEALTN�DEPT. REQUIREMENT '- '
31. Plaster Brown Coat ;. ,„� � ,]9. FINAL INSRECTION �
32. ElCctrical Power Me.er,-rinal �� �� •�80. FOOD CERTIFICATE ISSUED �
33.-Final Electric . � . ��Notes: � , '
�34. Fi�al Heating & Air Conditioning � ' � / �� Z �� �/` �O /i � �,/h�` /�. /
[ (T- (II......�
35. Final Gas Pipe�Test "' .. ' �q /,�r ���
' _f1_� �.l..Q���vIL��/ .CJI
36. Hood or Canopy � -
37. �Final factory Firepiace � ' . ' .
38. �Final Plumbing � � �
39. Water Service�Final ' • �
40. Gas Service-Final . . , , � . � .
47. Solar OomesticFinal � � , �
42. Backfiow Preventer� . � � . �.
43. Batkflow Irrigation • " • -'
44. Landscape Irrigatior, Sys2em . � �� , .
45. Sound Attenuation - �� � ��
46. Handicap, Regulations , - � . . � .
47. FINAL STRUCTURE & BUILDING ,
48, FINAL PLANNING � ' - � • ,• � -
49. Electric Release to Edison � � �. ' �
50. Gas Release io Southem Califorqia Gas Co ,. �.
51. CEiiTIFICATE OF OCCUPANCY - . -
No. Date
� NEWPORT-MESA UNIFIED SCHOOL DISTRICT 13 9 8 ��
TO:
CER. _ ICATE OF COMPLIANCE OF DEVELOF,.._NT FEES
PURSUANT TO AB 1600 AND AB 181 ,
(�4 City of Costa Mesa District Receipt No. �'`-"
( ) City of Newport Beach p� Q�—l�
( ) County of Orange Plan Check No. 7
Applicant: 2� � �� � f � �saC' � �
Address: �p%� 6 � � , �l�E�, �Z/<� �i�tYT'� �"hr'�
Telephone Number:
lY%�33 -- � �'
TracUParcel and lot Number(s): „/
Location of Project: 3� � f- �� S� C�� �����
Number of Square Feet of
Residential Space .
Residential /
Sr. Citizen Space
Commercial and
Industrial Space
Warehouse Space
i, 99 / r�i
— G5/, S
/� 3 39. S x$ 1.72
Commercial / Industrial Project is: (Check One)
Warehouses
R&D
Movie Theater
Mini-storage
Heavy Industrial
Regional Shops
Light Industrial
This project is exempt because
x $ .28
x $ .28
x $ 2235
Motel
Bank
Neighborhood Shops
Racquet / Health
Hotel
Medical Office
Office Park
Tota� ��� 303 , `�5�
Total
Total
Total
Preschool
Auto Repair
Hospital
Large Office
Office Bldg.
Restaurant
Fast Food
This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Govemment
Code Sections 53080 and 65995. The Building Permits for this square footage in this proposed development may now
be issued by your jurisdiction.
Checks are to be made payable to Newport-Mes�
The above representation as to square footage is true. Applicant agrees that if it is later determined that such
representations are not true then this certificate shall automaticaily termina e and the appropriate City/County shall be
notified.
Date:�
� � � % �/
n�r��
�_'
h
�
��
Pq0.1ECTA00flE55: ,3(�8 16TH PL
-A1lWNEN'SNAME: VOCHELLI, JULIAN PAUL TR
aoonEss: 19322 PITCAIRP] LN
i HUNTINGTON BEACH,CA 92646
RNCHIENCINEEH� 9 6 3— 3 S 4 3 flEG.NO.:
nooness:
�I
uxir: GARAG
uNiT:
PEflMITTEE: JULIAN VOCHELLZ ('714)963-3193
nooness: 3 6 8 1 6 TFi PL
C,M. CA 92626
LICENSEO CONTBACTOfl OECIAMTION: I nere0y auirm Inai I am Iicense0 unaer prw¢iws af Chapter 9lcommencinp with Sec�ion
7000) of Drv�sion 3 ot I�e Business anE PmlCssions COOe, anU my license is in lull torce anG ellecl.
CITY LIL.: ffiR7E OC.: C1A35:
Oaie: Signamre:
WOfl8EB5' COMPENSATION OECIABATION: I nereUy allirm t�at 1 �ave a cenilicate ol consenl ta sell-insuro or a cerii6cate ol Worker5'
fAmpensdlian Insurance. or a cendi¢O Copy ��errol (Seaian 3800,1ab. CI.
POLICY NU.: E%P. O�TE:
COMPANY:
❑ Ceriiliea copY is �ereGy fumishea. ❑ C¢M1ilieG�tupy R IileO wit� �he Gity BuilOing DiviSion.
Uate: A7W����>—
EXEMPfION FflOM WONNEFS' COMPENSITION UELIAPl�T10 (ilus
I[erii�y Ilwl in Ihe p¢tlormanc¢ o� Ihe work lo� M'hk� INS ¢rmi� i�
su - � lo �ne worker5' CAmDensE6on Laws al Calitornia
Oale: Sipnalure:
NOTICE: II. alte akin ��is Oeclaratmn. You slioul0
COGG. y0u mu5i IafllFxiill fArtqlY VAlI15�t11 DrOviSip115 1
CONSTPUCTION LENDING RGENCY: I �eieDY altirm Itut I�¢r
whlc� this Oe�mil is i55u0G (Section,3097. Li�. C1. • '�
LENOEN:
FUOPE55:
ne MiMreE (5700) or kss�.
(IId011Cf 50 d510 bPCO�@
J
suqea m tne Morkers Compenution provisions of 1�e Labor
perml 5tu0 Oe aeertreE revOkttl.
a construction lending aAenry for t�e performance oi t�e work for
OWNEB BUILDFfl OECUIMTION: I hereUy allirm ttut I am mempt Irom tIM Coniractor5' Slate LiteM1tE Law lor the idlowinp reason
(Seclion 70.7t.5 Busineu an0 PmleSsiondlC04e: My city ol tounty wNc� repuiru a permil to COnStNct, alter, improve, aemolish, or
�epair any siNclute. O�br la ils i5tuance. alsa reVNres t�e appliCant for SufJi permit lo lile a 9B�eE slalemenl tlWl hPJs�e i5license0
pursuani to t�e O�ovisions ol t�e Cantractors State License Law (Gupter 9 �commencinq vnih Secibn 7000) ol Oivision 3 0l the Business
and Pmlessions COCe) or �na� ire/s�e is erem0� ��erefmm an0 t�e Oasis tot t�e al�¢qeG eaem0�ion. My violation of Seclion 703t.5 Oy
any applicant br a Dermit su�i��s ine aDD���nl to a civY ce���y ol no1 more ttun live huMreA donars (5500�.
I. as ovmer ol i�e proDeny or mY employees wit� wapet as t�eir sole campensation, wi0 Ua ��e waM1, anU Ne
❑ SlrucWre B n0i intGMetl or olhfeE laf sa�e (Seciron 70aa, Busmeu aM Pmtessiaul Cotle: ThE Comractori Sute Littnse Law
Ooes no� apply lo an owner ol a pro0eny w�o �uilQt o� im0�avu l�ereon, antl who Ooes Suc� work �imselllllerself or I�mup�
nis or ner ovm emo�Yees, pmviaea ��i sucn imOrwemems are na� intmdM ar atlere0 lor ule. It, �owever iAe builamp or
impmvement B soltl mt�in one year ot completion. �ne mvner will luve �he CurOen af D�a�9 ���e Oi0 not bui10 or imD�ove
� ior �ne Ourpose ol sale�.
�� I, as owner ol I�e Dmp¢ny. am exclu4ively conttactinp wit� IicenSeG contractors to fAnsimct ihe Dmlect,Section 7044, Business
an0 Proleuions CaOe: Tlce Contracm�s' State Lkense Law Oces not appy W an own¢r ol DmpertywM GuAEs w improves t�ereon
ana wtlo cantracis lar such prqetl5 m!� a canlractoqs�license pursuanl to t�e Cantracbrs' State License Law�. I am aware
�hal pmol ol I�en WorkeYs CompenSaUon msurance should 0 �oNOeA lo me.
� I am eaempl unae� Setiion: B. 8 P. C.
b� I�is reason: �
Oate: �� Oa'ner.
I Do �ereey ceitity tha� im aware ol and undersiana t�e repuiremems ol Cali 'a Healih ana Safely e Seclions 25505, 25533, anU
2553a ana tnai I or any imure Ouilemg occupant wilUwill not �circle one) neea to pM �ih ui0 state toUes ana ihe requiremenis �or a
permi� tor conslmtti0n or motlificalion Irom I�e Art�uahly Manapem0nt Disirkt. vAentul con5iruction aDPlications are eKempi Iwm
Ihese D�ovisions,
�ate: MPlitan�:
I ne�eDy cenily i�ai I �ave ieatl t�is appiiwtion and siate 1 I�e aUwe inlormalion i5
ortlmancesantlslalelawsrelalingloUuilOingcOnslructiona �erebyauttror'¢ere0� em
piopP ry lor inspectian pmpases.
oate: �� Signawre:
�river's l¢ense or ial Securi�y u: -�
to comply with all dty and county
to entp uDonihe a0ove�mentionetl
1.\\.11 D
16At�a6 Wl�ne—Bwlaing; Green—Cotle 8��orcemenC Canary—Applicant: Pink—Revenue: Goldenrad—Assaswr
CZTY OF COSTA MESA — BUILDING PERMIT PERM NO: B OG73SE
PERMIT NO: B 06735G PLAN CHECK NO: 03533-93 L GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: NEW
JOB DESCRIPTION : CONSTRUCT 462SF 2—GARAGES W/PATIO IN BET SQ FT: 652
CLAIM VALUE: 7,000.00 CALC—VALUE; 11,905.20 GROUP OCC: M-1 /
COMMENTS; INSTALL 190SF TRELLIS BETWEEN THE 2 GARAGES
*********�r**�c***x*r��-*�**�t**r�+�**+r*�i�+��*+r**********�e**+�***+�*******fr*�r*ir�r�r*i�*�r�**
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 ---------
FANT: 20 FT IN REAR: 62 FT IN FANT: 113 FT IN REAR: FT 2 IN
LEFT; 15 FT IN RGHT: 10 FT IN LEFT: FT 2 IN RGHT: 11 FT 6 IN
PARKING REQ: , PROV: PARCEL: 42519216 ZNE: R2 REF NO:
PLANNING NOTES> ADD�TWO 10�X-20' SINLGE—CAR GARAGES AND TWO OPEN PARKING
> SPACES TO TI{E.•REAR OF PROPERTY.
*****�x�***±�***x�******�*�*�*?� �i��r�+�x�-*�-*�*****i�**�***�r+f�******��+t+�*+�***���-***��+t
D E V E L O P M'E N'T ., S E R V I C E S R E Q U T A E M E N T S
ZONING APPROVED BY ' � ! �9E� � DATE: aC i.�j I��'�
BUILDING APPROVED HY' c '�.' � DATE:
APPLICATION ISSUED BY:� ' � �I ��J
�c**+��+�******��v*****jF�±y " + �*��D��**�i,�`�:iF':'¢�*
iE iE if i6 iF 1E iG iE iF 1f iF iE iE i i: if iF iF if jE if iF if iE 1� if aE if if iE # M K K iF+f iF if iF iE 1f 1f iP K if i6 iF if iE if M fF 1F ik iE iE it 1E �E iF IE if 1f if 1E If �F iF if a: iF iE iE iE if iF iE aF if
LEGALIZATION:N . F E E S U M M A R Y STP.UCTURAL SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 135.00 1.14
SMIP/NON—RES
PLAN 87,75
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 136.14 0.00 87.75 223.89 223.89 .00
REVENUE DIVISION TOTALS--> COLLEGTED: 136.14 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/TOT GAADING PLAN—CHECK
135.00 1.14
jE if if ik if iE fE if ft M iE iE iF if iF iE �t iE if iE if it iE %!E i� if if iF iE if # iE iE �E 1flF i: jt iF M iE iF if IE If �1f 1E iF iE iF M if 1F if if r if if 1E 1f iE iF iE iF it aF if M�: if %1f iE if iF # iE 1t
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
SFR 190 RES—PATIO COVER—POST•S TRELLIS 14.80 2,812.00
SFR 462 RES—GARAGES TYPE VEND'OF FEES 18,60 8,593.20
E�PI�D
DATE��� �r " j:
01 00161270-00161271 T O T 2,3b.14
DnTEe 05/27/94 TIHE: 11:06
i � COCdSTRUCT10tJ ARD PLANN{NG
�AVP30V�,1LS Permit 5�
1. Tempnrary Eicctneal Sereice or Poie
�2. `.o�l Pii�e Undrgrnd.
IOCtriral Canduit L't hty�Undrgmd. �
4 Elcdlriral CondwFUn�.grnd. �
5 c.p:�' �inn�fo.�,.�mPn; 1-i�
�------ - - I
� �+. C�.rb�[c' UF ER Grnd. ���1
`-' �--� -- - ---- -" �.l
, o', . ----� �
I-E._F ,r�l.to�i �/ � „-,IA �
�. (/1/// /�(/v//
° :...✓'.p�rJit.lrc�r.�.
�' __ • _-_
, lU. 5:�.,tt,r�: F'a�.�� SY�.!ern
11. Pr�p���y Srv:�,� Linc & Hn�sa Connection
� 72. Si:.ui G.n
; -- - ------
, 13. Pv�F Jr,:�n:�
�-'- - - -----
lv .�.,nbF��r�n,ng
�_._I _ _ _ __
' 5 P_��,� =i.:!.,c:'.Condu.t
�-- -
� i6. Rnu9n cin.c`rlc!'!iring �
I ,�7. Ra,.��hlY:.��3cr,r
��E �.o� 3h E�c!��wl-T Bar Ce�.l nq
CuGh Hadnng & P�iI COnG'iiiOning
�C. ,',o_�h -. ..tory F�reP•ace
7�. puct^ 5'ructure
22. D��.:,, V,-m � ahng I
I ?3. G ' ` '�a�.yL & Test �
�-___ - _._
� 7y ,�.�: c.n,r•-3 �
r70 . .� ,� :�,..Jtr'� itq ___ �f
� 7f. �. ,. C i r,Str�Cu'all L i.'a`n[�a! J
�-_' _ _ '___- -_
� 27. ��-� .n,� iir.�i � id.liing ��
?E L.'h.r:� ri S�tlln3 - -- �.
-- --- �
2�J._li�_ u'at,o�� ��
30 C,ym.e, �.�aihnn 7
.'.i. P�a:tt� G:u.:n Coat 7�
32 F.'w r, c]� P.r rr .'.:nter�F � n; _-_ __ �
� 33 ��^.; yr�t,�c ---
I.i�l. r : I-lo..[ !'y �: Fi:r CO^d.LC..� :.y _ _�
ss. r���� �,,5 Pfp2•Te;t
36 liood ur �u^.opy
37. F���..I f;.�tory FvePlace
38 Final Pl�mbinq
�. `::at�r S?•�tic2�Final
' 40. Gas Scr��cc�F�r.al
rJl. S�Inr Co.i:tst,c-Final
^2. : c'�:t'c.� P�c�aoter
C3. F7.c:cflo�7ln�_a!ion
44. I andscaGe irn4ation SYs[cm
45. �our.d Attcnuation
46. Handieap Regulations
4). FI�AI. 5-RUCTURE & BUILDliJG
4�48 FIRALPLANNING
t�:c F:!case to Edison
50. Ges Reluse to Southam Cahforma Gas Cn
51. CERTIFICATE OF OCCUPt1WCY
_,_ a e
I POOL P!i" - I----- I- -=" I
Dote Inspector I �APPROVALS Permn 5� I Date i In<pettor I
52. Pooi & Equipment Loeat�on
�J3. $t2Cl j�C���fO*C_file't
54. Form:
�pGv�55. Eleetriwl Bonding _
�-p.�-J--}- 56. Rouq-h Plun-�,I�ing � PreSsure Test
I 57. AFPFlOVAI. TO COVFR�GU�J17E
' - � -- -
� W(� j 5E. Elcctrinl Cord.Lt�Urd:grntl. --
p�l 59. Gds �ipc, i.l Un;7rqrnd., Tfst
- �
E0. Eet!:crash l aics, F'-Tr;.p, � Lr.drerrd � � ,
67. APPROVAL TO DECK '--- , --T- -- �
-- �-'
62. Backvrosh & Recepto��F�nal � � I ,
63. Huetar & VunbFinsi
� 64. Plum6ing SVstem • Final
65. Electrical�Final _
� � 66. Salur Systm�F��wl
67. F�na�g & Atc:'S5 Anproca! _
68. APPflOVED FGR PLASTEFi11G
u9. POOVSPASYSTECSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permrc,x
70, Undcrg�ound Hydra
71. Product Rrin9 t] G�s �30if
%Z. Unaarc�round Flu�,'•
I 73. Undcrgmd. Stora9�: ?ank :' Ga; -� .�. '
�C,i�I --�-- -�
74 C:�rY,rad Hvd�n __ I �
�_�___-_- __ _._ _- 1 . .
�, o. �r7 C:nvmic,J � '.
__-__ _. _ -__ -___ _'w
�(,!„!�� 76. �ry StandP�Pe I �'.'
�G�/�! 77. FIXED SYSTEi�^ FI;JAL _ � ;
_ �,,,
_--- 78. fIFE PREV. FINAL -- - -. � .- ---� - � ---_�
Y Gl[�) �� HEALTN DEPT. RL-�UIRE�y,:'��T
?-qy�,Lt��7°. FI'lAL_IKSI�CCTiC-�--- -- - - - -1 � - - � ---
� 1
�BO. PqOUCfH�����CA:E'SS�EJ �
--� a ------------- -------�----"
�
��otes: .
�-Z�9.�f_� ��f�--�r��l�
--- ---�
--- --�- - --- -- �
-- � ---- - - - i
- - ----�
_ _- _'
--- - - �
--- - - - -' - - - --- -�
---- - -------- -------�
I
- -- - j
- - -- I
1
/
�
PROJECT FOONESS: •^ 3(j 8 E 16 TH S T
OWNFfl'SNAME: pAUL HERRICK
pooness: 1936 E DEAR AV tt215
SANTA ANA, CA 92715
� 833-5047
APCHIENGINEEfl:
nooxEss:
xEG.NO.:
UNIT:
uxir:
PEHMITTEE: Z9O 16TH ST ASSOC LP ( 719 ) 833-5047
nooness: 1936 E DEAR AV 215
S.A. CA 92715
LICENSEO CONTNALTOfl DECUMTION: I �ereGy aHirm tnal I am �ceiaea imner D�o�sbns of CluOur 9(commencinp wiih Section
7000� of Division 3 0l t�e Buvness an0 Prolessions CaUe, an0 my license is in tullfarce an0 efleci. ��.
CRY LIL.: STRiE LIC.: CUSS: EXP :
Da�e: SiA�aiure:
WOHNENS' COMPENSRTION DECUMtION: I trem�y altum Ihat 1 tave a certdiwte ol consent m ulbinwre or a cenifiwte af Workers'
Comoen5ation Insurance. or a arldied copy tnereot I�ction 3800. LaE. C1.
POLICY NO.: E%P. DRTE:
COMPRNV:
� Cenilietl copy is nere0y mmisnea. ❑ Cetlifie0 copy i5lileE wii� t�e ciry Buil�inp Oivision.
Oate: . PppliwnL
E%EMPTION FflOM WOflKEflS' fAMPEN$ATION OECUPATION: Qks SeCIiOn nEeG ml be COmplet¢E if Ne pemtit 61or me �urMreA (E11p) or I¢Ss�.
I certiiy ihai in I�e Oedormant¢ o� I�e w'od �or whit� IN Derrtu� i5 iss . I shall n0i ¢mOb9 atry DErsOn in any manner 50 ds l0 betome
�su0jetl to e W ers' mpen5atian Laws ol Calibm
�ate:���9� Si9namre �
TItE: 1. atl r makinp t�rs Eeclaration, you s�o hewme subjep to t�e Workers' Compeirsation pmvivons of c�e Lahor
Cotle. you must lonnwiin comply vnin sucn provisions ar this permrt stwll oe tleeme0 revoked.
.CONSTflULTION LENDING �CENCV: I Aere�y atlirm ttui I�Bre is a consiru[IiOn IenElnq aOe��Y �or [he pedormante ai Ihe work lor
which this oermil is issuea ISeciion 9097, Civ. C1.
LENOFfl:
FDDNESS:
OWNEB BUILOEB OECIANRTION: 1 �ere0y allirm i�at I am eKempt imm I�e Comractors' Siate License Law lor Ihe followinp reason
�Setlion 7031.5 BuSinE55 an0 PmIe55i0nal COtle: Any tily ol COuniy wAith a0uire5 a permil Io ConslfuCl, atler. imprOVB, demolis�, of
repai� any slruclure, prior to its issuance. also r¢puires Ine aDOliWnt lor sucn permil to lile a siAneO statement t�al ne/she is licensed
Oursuant lo t�e pmvisions ol Ihe Comracmrs' Stale License Law (CnaO�er 9 �commencinp wil� Section 7000� ol �ivision 3 of IAe Business
and Pmlessions Cotle) o� ihai Ae/sne is eRempi thereimm anJ �he Casis lor the allepeA ecemption. Any vioWtian al Section 7031.5 oy
any aOPliCant �or a p¢rmii SubleCis �he applitanl l0 a tivil penally a� n01 more I�an live hunCreE aollari (5500).
I, as owner oi Ihe D�aDerty or my ¢moloy¢e5 with wapes a5 l�eir Sole campen5ati0n, will Eo Ihe woM1, anC I�e
� stmcture is not intenaea or allereC tor sale (s�tion 70aa. Business an0 Pmlessianal CaUe: Tne Contracmri State Licenu Law
Does no� aDPq to an owner ol a pmperlY w�o OuilEs or impmves t�ereon, anG w�o Aaes such woM1 �imself/Aerself ar Ihroup�
� Ilis or ner own empl0yee5. D«4eA t�di suc� imprOvemen6 are notintenC¢E or oflereE lar Shce.lf. Mwever tAe builtlinp or
imo�ovemem is sal0 wit�in one year of camplelion, i�e owne� vnll twve t�e EUNen of O�odng Ae/s�a tliE not Uvild ar improve
� for ihe OurD�e of sale�.
I, as awner oi me D�openY. am eeclusiveN wmractinp wii� IicenseE mntractors to wnstmct t�e project (Sectlon 7044, Business
❑ an0 Pr0lessions CaGl: Tl�e Canlraciors' Sute Liceiw Law Oas not apply ia an v.mei al properry wM W9As or improves tAer¢on
ana wno conlracts br 5uc0 D�ojects wit� a camracmqs� littnse pursuam to ihe Coniractors' Siate License Law�. I am aware
Ihal pr001 Of I�eif Warkei 5 fAmper¢ation insuraxe StquW Ce prwiOeE ro me.
� I am evempi unAer Sectbn: B. 8 P. C.
lor inis easo '
//�� /
Oale'. �� � Qwner.
I aa hereoy ceNiy inal I m aware of an0 unaeRunU ine reQuirements al G lomia Meatln an0 Safery Co�e Sectiom 25505, 25533, ana
25i7< an0 �hat I or any luture GuilUmA �upant wilVwiA not (drUe ane) neetl to campty wi�ll saiC s�ate mUes and t�e reQuiremenis far a
p¢rmit lor ton5lmtlian or moGibqti0n imm I�e Au Ouabiy Manapemenl USintl. flB5i0¢nlial ComVutl'wn apDlitation5 are exemDt �mm
inese pwvisions.
Date: Appican�:
I h¢�¢by [¢tlity Itwi I Iwve r¢atl I�is aDD���ion anG 51a1e IIWI ��e aEWe n tma�ion ¢ Corr¢ci. I aqre¢ l0 tomply With all ti�y anE counry
orainances ana siaie Wws ielatinq to GudGmO ������ion G �ereDy aut ' e reD�asematives al tnis dry to enter upon t�e ahovrmentbne0
pmpetly lor'nspecpJ .� pu(�oses. �
�a�e: �u`/__! [_ Sigruiure.�, �/� �
'i, oriver' Licen,e or SoE�ai s����av •:,. .. _ .. .
t64L<6 White—BmlOing: Green—CoOe EnlorcemmC Canary—AOW��ant Pink—Revanue: GOIEanraE—Asseswr
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: BP 068947
PERMIT NO: BP 068947 PLAN CHECK NO: N GOVT; N SUPP; N
CONSTRUCTION TYPE: VN PERMIT TYPE: PLU STR PURPOSE; DEM
JOH DESCRIPTION : DEMOLISA SINGLE PAMILY RESIDENCE SQ FT:
CLAIM VALUE: CALC—VALUE: 1,000.00 GROUP OCC: R-3 /M-1
COMMENTS: DEMOLISH RESIDENCE IN PREP. FOR 2 SFR �
*�+�**�*�*r**�*****+�*�*******�rt+r*�x���**+�**�***�+r�r**�+��***+�**+r���r**�*��****�►�***
Z O N I.N G R E Q 0 I R E M E N,T S
s E T e a c x s
------------ MAIN BUZLDING ---------- --------- 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: 42519119 ZNE: REF NO:
PLANNING NOTES> �
>
*�t�*�r+r�r*:+�+r�rx*+r+t*+t+t�r�r*���r*�r*+r*�r�r*�**x��r�r*�*+r*+r*k*****�**+�*�r*�r**�r��r*****+r+t*�**u**
D E V E L O P M E N T S E R V I C E S}�i R E Q U 2 R E M E N T S
1�
ZONING APPROVED BY ��� DATE;
BUILDING APPROVED BY : DATE;
APPLICATION ISSUED BY; DATE: —1 �
1E ik ik iE if if if'lE if'lE'1F')f'k!E!h 1E iFlf if if'It iFiF����{F �"iFiF it�itTF iF iF �F iF3FiF��ik3F ' i!3F�'iFit�{iF�t��iF'X� 1E iE if')f 1E if 1h iE if�i�. � �!f if
iE it k iF iE iE iE iF if if if !f iE iE iE 1E IE jE ik if 1F 1E if iE iE if i! iF iF iE iE it iF if if if if it it iE 1E iE iElf 1! iE iF if iElf ff if iF if it ik 1f jF K iE iE iF iE if fE M?t iE iE if iE i! iE iE i! k ff 9E iE
LEGALIZATION:N F E E S U M,M A R Y STRUCT(]RAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 25.00 7.00
253 SMIP/NON—RES
PLAN .50
ISSUE FEE 20.00
BUZLDING—DZV—> PERMIT ISSUE PLAN-CHECK TOTAL PAZD DUE
TOTALS----> 32.50 20.00 0,00 52.50 /' S2.50 ,00
AEVENUE DIVISION TOTALS--> COLLECTED: 52.50 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRZC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
25,00 27,00 ,50
ifililiEiFlEilitililifffifil3klEifit�liF4fE1k4fEiEitikiFiFiEitifilifkifltitiElE�EikiFiEiEiEiE�liE1!%if3flEifitikiFiEiF#iElEitffkifiFjFiFiFifitiliElfilM
I N D I V I D U A L "F E E B R E A K D O W N
•' i
TYPE QTY D E S C R I P T I O N . UNIT COST TOTAL COST
PLU 1 SEWER CAP / DEMOLITION �• EACH 7.00 7.00
END;,,OF FEES
�
r J
�
52.50
%
i'
01 0016E025—OO1bE027 TO T
DATf: 09/2D/94 tI!1E: 09:21
\,
CONSTRUCTION AND PLANNING'
POO� .PA ��
APPRO�!ALS Permit #'� Date Inspector p�ppROVALS Permit # Date Inspector i
t. Temporary Electrical Service or Poie 52. Pool & Equipment Location , .
2. Soil P�a¢�Undrgrnd. 53. Steel Reinforcement '
- 3. Electrical Conduit Utility�Undrgmd. 54. Forms �
4. Elec,trical Conduit•Undrgmd. 55. Electrical Bon�ing
5. Steel Reinforcement 56. Rough Plum6ing & Pressure Test
6. Electrlca� UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings _ -- 58. Electrical Conduit�Undrgrnd. -
8. Foundat�on 59. Gas Pipe, O Undrgrnd., Test '
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structura� Floor Svsiem 61. APPROVAL TO DECK ---- .
i i. Property Sewer Line & House Connectio� 62. Backwash & Receptor�Final , I
72. Sewer CaP 63. Heater & Vent�Final �
73. fiooi Drains 64. Plumbing System • Final '
{
14. flough Plumbing 65. Electrical•Final �
�
15. Rough Electrical�Condu�t 66. Solar System•Final
76. Rough E�ectric Wiring 67. Fencing & Access Approval � _� '
17. Rough Wi�ing Sign 68. APPROVED FOR PLASTERING
18. Rough Electricai-T Bar Ce�ling 69. POOL/SPA S1'STEPAS FIiJA� '
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Under9round Hydro
22. Ducts, Ventilati�g 77. Product Piping �Gas OOii
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof "rraming 73. Underymcl. Storaye Tank 0 Gas ❑ Oil
25. Roof Sheathing 74. Ovenc�ad Hydro
26. T�Bar Ceiling �Structuraq & Monocoat 75. Dry Chemical
27. Prame and Plashing 76. Dry Scandpipe
28. Lathing & Siding • 77. FIXED SYSTEM FINAL
29. Insulation 78. FIflE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REnUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power MeterFinal ; 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final HeSting & Air Conditioning �D� C�I 6��`'� - C����
- � •4'--
35. Final Gas P�Pe-Test
G{�_L,�
36. Nood or Canopy
-Z� � h!t, _r_ ,/
37. Final FactorY Fireplace � I
38. final Plumbing i �
39. Water Service-Final '
40. Gas Szr�tce�Final
41. Solar pome:ticFinal
42, Backflow Preventer
43. Backflow irrigation
44. Landsca0e Irrigation System
45. Sound Aitenuation
46. Handicap Regutations
47. FINAL STRUCTURE & BUILDING �
48. FINAI PLANNING
49. Electtic Release to Edison ,
50. Gas Release to Souchern California Gas Co -
51. CERTIFICATE OF OCCUPANCY
No. Date
PXOJECT AO�flESS: , 3� 8 E 1 6 TH JrT � UN17:
OWNEN'SNAME: z9O 16TH ST A$$�C
PODRESS: l�jj( E DEERE #215
SANTA ANA, CA 92627
263-1920
APC�IIENGINEEfl� VALLEY CONSULTANTS eEc.xo.: C29329
aooxess: P,O,HOX 10516 uxrt:
N.B. CA 92658
PEXMITTEE: Z9O 16TH ST ASSOC LP ( 714 ) 833-5047
aoosess: 19 � 6 E D EAR AV 21 S
S,A. CA 92715
LICENSEO CONTBACTOB OECIAApT10N: I hereCy allirm t�al I am Iicense0 un0er pmvisions a� C�apler 9(commencing wiih Sec�ion
70f10� 01 �IN51011 � 01 IIIC BOSItICSS dOtl PfO�¢SSIOf15 COEC, dtlG IOy li[COSC i5 10 �I111 �OftC d0A EIIECI.
ciTx uc.: sraTe uc.: cuss: EXP :
oate: Signature:
WONNEBS' COMPENSRTION DEGUINFTION: I �erehy atfirm tAat I �ave a certificate af consent to self-insure or a rertifiwie oI Workers'
Compensation Insurante, o� a cEnilieE capY ��ereoi (Seciion 3800. LaU. q.
POIILV NO.: E%P. ORTE:
COMPFNY:
I ❑ Ceriilied copy is �ereby furnished. ❑ Ceni�ietl copy is �ileG with the ciry Builtling Division.
Date: Applicant:
EXEMPTION FflOM WOflNEflS'COMPENSATION OECUPPTION: (This sec�ion neetl nolbecomplete0il�he permi�islorone hunEreE�3100�orless�.
I certily lhat in the DedarmanCe o� �he work �or w�ith thi5 p¢rmil is i uetl, I s�all not emplop anp person in anY manner m as to become
tl la Ihe 0 ers' Compenuli0n laws o� Caliior� l� `"i�l
ate: � � Signaiurij --
TICE: II. aller making ��is tleclaratinn, you ShoulG Oecome SUGIeci to I�e Workers' ComDensa�ion Dmvisions al l�e La6or
otle. you must lonnwith comply with sucA O�ovisions or tAis Dermit s�all be tleeme0 revoketl.
COxSTPUCT10N LENOING AGENCY: I nereby aifirm that tnere is a wnsimction IenOinA apency for Ne Dedarmance oi ihe work tor
which ihis Oermit i5 iSsu¢E �Sedion 3W7. Civ. C�.
IENDEP:
aooness:
OWNFP BOILOEB OECLAHATION: I Aereby allirm i�at I am e�empt tmm ihe Comractars' State License Law for the tollawin0 rtason
�Seciian 7Q31.5 Business anA Pro�esSianaiCade: Any cily o� roun�y which reQU�res a permilio wnstruct. alter, imprwa, Eemolish, or
repair any simcmre. prior to i�s issuance, also �equires t�e apD�icant for such permit to file a sipned statement that helshe is IicenseA
pursuanl lo the pmvisions ol �he Gonlraciors State license Law (Chapter 9(commencing vnt� Section 7000) ol �ivision 3 of t�e 8usines5
antl Pmles9ans fAtle) ar Ihal h8/sne is exempt Inerelmm antl ine Oasis far the allepetl eKemo��on. Any Molation of S¢ction 7037.5 Cy
any applicant for a permit su�lecls ihe aD�litant Io a civil Denalty of nat more l�an live �untlre0 tlollars (5500�.
I, as awner ol t�e D�oDeny or my emyloyees wit� wages as IM1eir sole compensalion, will Oo ihe work. antl I�e
❑ simcturels nolintentled oroffered Iorsale�Section 704d, Business an0 Prolessional Code: The Coniractors' State License Law
Ooes not apO�Y �o an owPer of a pmpeny who builAs or impmves thereon, an0 who does such wmk Aimself/Aersell or t�muAA
his or her own employets. pwvitletl ihai such improvemenis are not intenJea or ofkreE for sale. 11, Aowever ihe 6uilainq ar
impmvemem is sold witpin one year of comptetion, the owner will have ihe burAen ol pmving he/s0e did not huild or impmve
lor �he DurpoSe ol sale�.
I, as owner of �ne propedY. am exclusively conlractinq wilh licensetl conirac�ors �o conslNct ihe proled (Section 7044, Business
� antl Pro�essions Catle: The fqnUatlors' State Lkense Law Aaes not apDb �o an ovme� al property who OUiltls ar imprOves lhe2on
' an0 w�o coniracis lor s�e� Cmjects wi�h a convacmqs) license pursuant io the Coniractars State License Law). I am aware
I�a� 0��� ol ��eir Workir'S Compensation insurancc shoulC be protiOeG m me.
I am eKempt ntler Section: B. 8 P. C.
lor Ihis easoi
� �
�aie� � PNnec
�ere�y enify at I am aware oi ana unders�anU Ihe requiremems of C lifomia Healt� and Safery COUe Sections 25505, 25533, an0
25534 ana IAat I or any lu�ure builAing octupan� willlwill no� (circle one) need �o comply wiih said 51aie cotles antl the reQuiremen�s �or a
permn br cons�mction or moailicalion imm ��e Air Oualiiy Managemen� Disiric�. flesitl¢n�ial Conslmction applications are ¢xem0� ��om
IhESC D�Ovi5i00t
Oa�e: ADPlicam:
I hereby cerlily I�ai I �ave rea0 ��is applicalion antl sla�e Ihai �he a0ove m�a maiion is Corr¢cL I aqree tu tamply wi�h aIl ci�y anA county
arCinancefsOan s�atela relaiin io �uilding con5lmciion �n�h^Oy aulhori f2pfCS2l1(d��NSG(yt0 CtllCf Up0111�db0V!-IIIPOIWOlE
o�operty lor' sDec�m ourpos s�
��ai :� y L SignaWre: I � �
ei's Lic se oi oclai 5e rity p:
tbaba6 Wnne—Builmng; Green—Cotle EnlorcomenC Canary—Applicant: Pmk—Ravenue; Goltlenro0—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; GRA 069681
PERMIT NO; GRA 069681 PLAN CHECK NO: 03577-9q A GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE; GRA PURPOSE: NEW
JOB DESCRIPTION : GRADING FOR 2 SINGLE FAMILY AESIDENCES SQ FT;
CLAIM VALUE; 10,000,00 CALC—VALOE: GROUF OCC; A-3 /M-1
COMMENTS: X
�r�e*�r*x�t«�r�ri�**�r�x�e�e�r�t**�t�*�t+r*�t****�**x��t�trw�-**********r�u*�-iFx-x��t*i�***�t**�+t�r�r***�+��r*
2 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 BUILDItJG ---------
FRNT; FT IN REAR; FT ZN FRNT; FT IN REAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ • PROV; PARCEL; 42519119 ZNE: REF NO:
PLANNING N6TES>
7
if if if 1t 1F f! �t if M 1f M if iF 1tlf 3f it ik �f iF at if it M it 1f f! if 1f ih it if iF if if if ik M i! M 1t 4 if i� ff if i! %iP 1f if If if K jf iE M iE if i! 1E if IE if if if if iE af M if 1f iE aE if �E if iE if
D E V E L O P M E N T 5 E R V I C E 5 R E Q U I R E M E N T S
ZONING APPROVED BY DATE;
BUILDING APPROVE➢ BY ; I�C/� DATE; �O � q�
APPLICATION ISSUED BY: 1
*�*r****x�+��er�r*�r*w**rx*�F�FiF3FiF'iF��3F���iFif3FiF�iF��r�riF�riF***f�D***irr � *k
fFiflEifiFiEifMlfititikif44ifiFikilitifMititiEifiEifltifif�FMlfMifMMififlElEititiflFik4ifMifififlfif4MififiEifiFiEMif1!+FiFitiE ififiEiffFiflfit
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRZC MECHANIC FIRE SMIP/RES GRADING
PERMIT 33.00
SMIP/NON—RES
PLAN 5,63
ISSUE FEE 3,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CAECK TOTAL PAID DUE
TOTALS----> 33.00 3,00 5,63 41,63 q1.63 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 36,00 OVER/SHORT: ,00
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
36,00
iFifkifkififififlfitifklfiFiliflfrltikltitififkiFltlfitik�fkiFifMif4MiFifkllr41kik1ffFM1f1f4iFifrrififit�fifififkit4fliFif4ifif�fNikM+fi4
I N D I V I D U A L F E E H 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
NO FEES WERE SELECTED FOR THIS PERMIT
EXPT�ED
D��-_ �Z-�� u�
01 �417U8G5-001703C5 T U � 36.OD
DATE= 20/3i/94 TIP;E: 11=?S
`' CONSTRUCTIONANDPLANNWG POOL ,PA '
APPRO1;Al5 Permit # Oate �� inspector APPROVAIS Permit # Date Inspector !
t
t. Temporary Electrical Service or Poie .i � 52. Pool & EGuipment Locacion =�- ±
'2. Soil PiNe�Ur�drgmd. � 53. Steef Reinforcement _ -"
� 3. Electrica! COr1duIC Utility-Undrgmd. ' 5A. "rorms _- ' �
4. E�ectrica; COndu'rt-Undr9rod. 55. Eiectrical 8onding i
� 5. S[eel Reinforcement 56. Rough Plumbing & Pressure 7est "'
6.' Efectricai UFER:Grnd. 57. APPROVAL TO GOVER�GUNITE _
� 7. foqtings' -�_- 58. Efectricat Conduit�Undrgrnd. --_ '' !
8.-Foundation i� =. 59. Gas Pipe, � Undrgmd., Test � �
9. Water Pipe-Undrgmd. '� 60. Backwash �ines, P�Trap, O Undryrnd. I
10. Structural Floor SYstem � 61. APPROVAL TO DECK "-j -`
11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final � i
�
12, Seiver Cap , 63. Heater & Vent-Finai '��'� , i
13. Roof Drains' . � �
64. Plumbing System � Fina� �
14. Rough Plumbing �' 65. Electrical�Finai �
15. Rovyh Elecsrica6Conduit 66. Solar SYstem-Fi�ai . '•
76. Rough Electric N'iring 67. Fencing & Accass Approvai ""� " �
17. Rough VJ;rin9 Sigh 68. APPROVEO FOR PLASTERiNG
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTeB4S FINRL
19. Rough Heat�ng & Air Conditioning FIRE DEPT. REQUIREMENT �
i �
24.:Ro�gh Factory Fireplace .. - � APPROVAtS :�- Permit #
27. Ducts, in.Structure � . �-. ' " � � . J0. Under9round' Hydro � �
22. Ductis, Vertilating , �' _ ' 'i}, psoduct'Piping CiGas 170�4 !
23. Gas Pios'Rou9h &'Test � r � 72. Undergroond fiush, - 6 � �
24. Roof Framing � � � �� �. . 73. Underyrnd. Storaye Tank G' Gas G Oil �f I
25. Roof Sheathing � � ' , . 74. Overhead Hydro �
26. T�Bar Ce�ling (Structurail & Monocoat � � :n ` 75. Dry Chemical ' � }t,`,� '
I
27.'Frameand Flashing �� _ � . � 76. Dsy Standpipe . - � s � `
28. � Lathing F'u Siding � . � ^ . � � �� 77. FIXED SYSTEM' FINAL _ \ �
29. Insulation � -' " ' '` � 78. FIRE PREV. FINAL i - I
�30, prywali Nailing - HEALTH.DEPT. REnUIREMENT
-31. Plaster BYow�n Coat' � ' 79. FINAL INSPECTIO'N ' � , �
32.-Elecv�cal Po�'er h,9eter�Final� � � 80. FOOD CERTIFICATE ISSUED � i
33.-PinalEiectric _. _ �Notes: �
34. Finai Heati�g.& Air.Conditoning-� , , ' _ . ., �, '
�
35. Final Gas Pipe-Test ' � , � - �
36.- Hood or Canopy , , - , � . . . ' ; (
37. Final Faetorv F��eplace , � ' � � . . j
38. Final Plumbing . . .. � . �
39. Water Service-Final� .. � . . ' � �
40. Gas Sarvice-Finai . � , . -� � �
41. So�ar OomeSticPinal � - - � �
�
"42. Backfiow Preventer . . � • �� . .
- i
43. Backflow Ir�igation � . ' � �
44. landscape Irrigation System. . ,, � . �
45. Sound Attenuation - � - �• '
i
46. Handicap Regulations � . � � � � �
47. FINALSTRUCTURE&BUILDING - . '
48. FINAL PL,ANNING ' � " , ,
49. Electric Release to Edison / � ' '
56. Gas Release to Southem Califomia Gas Co "-_ , . . •
51. CERTIFICATE OP OCCUPANCY -- � . �-
No. Dace
` \-
�
�
�
PflOJECT AOOflESS: 3 6 8 E 1 6 TH ST �
OWNEN'SNFME: Z9O 16TH ST ASSOC
AOOflESS: 1936 E DEERE 8215
SANTA ANA, CA 92627
263-1920
uxir: CITY OF�COS�A MESA — BUILDING PERMIT
PERMIT NO: E 069390 PLAN CHECK NO; N
CONSTRUCTION TYPE; PERMIT TYPE; ELE
AflCHIENGINEEN: flEC.NO.:
FODNESS: UNIT:
PEpminEE: TEMPOAARY UTILITY SERVICE ( 714 ) 662-2525
aoosess: Z�20 AEGAL PARFC DR
ANAHEIM CA 92806
LICENSEU CONiflFLTOP DEClAM71UN: I �ere0y aifirm tlWt I am IiCenSeG mMer orOvi5ian5 oi C�apter 9(commencing with Seclion
CI�T�Y'UC n�v}Sipp 3 p( Ipe9usin¢ TpTE LIC.1e�ipp�C�¢, y�0 my Iice�CtASS:'uClorcy �nC eEXP : OO / O O
1/�1b3J L 7b b
Oa�e: _�% /�—� � / �! y Signature: _�
WOflNEflS'COMPENSRTIONOECIAHATION: I�eRGyaHirmllwtllwveareni wt otconsenitoseu-insureoraceeificateolworkers'
Compensauon ��y�� ���q cprR sye�o�lsectian 3eoo. �an. fl l 1/ 9 4
roucv xo.: STATE FUND exv, oare:
COMPPNY: }[
p Ceniliee copy is nereGy tumisnetl. U Cenilied copy is IileG witA the ciry Builtlinp Division.
Oate: ��! /�__�__ �/�/ � _ Pppiicani: �r� � �"`�"
E%EMPTION FflOM WOXIIEPS' COMPENSATION OECLAIIATION: (iNs ucoon nee0 rot be completeG if Ne pcmit is for one �unGreG �5100� a less�.
I certily Na� in �he �erformanCe of lhe work tOr whith lN5 oermit k i55ve4 I 5hail not emDloy any person in any manner so as �o heCOme
, Sub�ecl Io t�e Nlorker5' Campen5aiion LawS o� Cali�omia.
Date: Signature:
NO7ICE: II, atter making tnis OeUarati0n. you Slioul0 �eWme whjett to the Warkers' fAmpenSatian provisions at ine Laoor
CoOe. you must Ionhvni� compry wii� suc� Oromions or tN5 permit stw0 be OeemeG revokea.
CONSTNUCTION LENOING RGENCY: I hereEy atlirm Itwi lhere R a cOriStruction IenOinp aqency IOr U�0 De�o�mance ol lhe work lor
which ihis permil is i55ue0 (Section 3097. Civ. C�.
LENUEN:
nooness:
, 7 . • \ • � 1 . • Y
�K.vr�ea.�.��»sa,�
PURPOSE; NEW
JOB DESCRIPTION ; TEMPORARY POWER POLE FOR 2 SFR SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1
COMMENTS; X
rr�r�r*r****r****fr*xr*r«*r**�rr*r**r*rw+tir�rxw*r*rw*rr****�r***�rr*�r�r+�r**�r**r*rr�r*r**
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 HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT: ET IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ• PROV; PARCEL; 42519119 ZNE; AEF NO;
PLANNING Nf5TE5>
>
ilMkkMitMMMffMMifkkiflkiflhitifiklkikffiFitititMiFififiFiFiFltifilffifkitiFilifkMMItMMMMitititkMltMifMilM1f41fM1FfFffititikM4lfff
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: �b��
*wrxfrir�rx�t�r**�r��rw�ir�r�tirw�iF'iF'�riF�FiF * e r t* f ti"iFti�Fir�Fi'rir��i*itr�rr***�rr�r �rr **+t
ltlfilMlfl!!!ilMitMIhMMMltffM441l1t1f1lilMkMlfihMMMifMMihltMMlfMMMMlhifMMYM1f!lMifMitYk7fMkltMMM4MMkM41F1fIfMMifM
LEGALI2ATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
OwNEBeWLOEBOEtLAMiION: Inere�yatlumtnatlamexempUmmtneComracrori Statelice(seLawfortAelonowinpreason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
�Section 70.71.5 Busineu an0 Pmlessional Cotle: Any ciry al county w�ich aQuires a permit 10 coniwct, alier, improve. Eemolish, or P ERM I T 1 S, 0 0
repaie any simcmre. prior io i¢ iuuance. atsa repuires t�e aDW�Unt lar wU permii m lile a vqne0 statemem tlut �eJshe is Iicense0 S 0= SM I P/ NON —R E S
pursuanito��e pmvisions allhe Canlraciors' Slate License Law�Clwpttr 9�commencinp vnfA $eciion 7000)o�Divisian 3 o�lhe Business PLAj•�
ana Pmlessions Coael or tna� he/she is e.empt tneretmm ana tne Oass for me allepe0 e.emptian. My vidation ol Sectiw 7031.5 Oy I S S U E F E E 1 S, � �
any aoe�icam �or a uermii suUiec�s ine apo�itam m a civi� penauy o� no� more �nan �iva nunereE eollars 1`�1. BUILDING—DI V—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
i, as awner oi me propeny or my empiayees witn wapes as ineir mie comvensation, will ao me waM1, ane me TOTALS----> 1 S, 00 15 , 00 0, 00 30 , 0� 30 . �0 , 0�
❑ stmcWre is �ot imenCeE or offerea for ule (5���� 70a4. Business and Prolessional CaOe: Tne Contracrori Slate License Law
Ooes no� appty to an ownei al a pw0e�y wlb Guilas of imD�wes i�er¢On, anE wllo Uoes suc� vrod �im5¢I�/�lr5811 or IAroupll
nis o� ner own empbyees, o�odtleOlhal sucn imDrmements are not intenaM or olkreE for sale. u, howaver tne Euildinp or RE VENUE D I V I S ION TOTAL S--> COLL ECTED ; 3 0. 00 OV ER / S HORT : � 0
imo�ovememissdavnihmaneyea�olcompletion.meovmeiwillnavetneOurUenotO�oNnphUsne0i0nat0uilaarimD�ove BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
tor me ourpose ai uiq. 30 , 00
I, as owner ol I�e pmperty, am erGuSivety canuactinq wil� IitenSeG mmraciars �o wns�mct t�e D�ojecl (Sectian 7044, Business ,
❑ anEProtessiauto0e: TheCanVactor5'SureLiceRSeLawEcesnotaVdYtaanwmuofpruce�Iy wlaDutlQso�imProveslhereon ififif�fi:MitiEMlEMifMMiti'ititMlhihlfikMif1F1t1tikMMMMMifMititilMifitiffkMMlFiflhif7fit1tlfMitltMititihkM47�iF1lifitlflfitltitMlFiFifif
. an0 w�o conVacis lor such pr%ects wi�� a cOniraclor�s�license pursuant IO I�e Canirac�ors' $Ia�e L¢¢n50 Law),I am aware
mai o�oo� oi tneir wwkers Camce�sation inwranu sromo oe prmriaN to me. I N D I V I D U A L F E E 8 R E A K D O W N
� i am e.emo� u�ee� secuon: e. a v. c. TYPE QTY D E S C R I P T I O N UN IT COST TOTAL COST
lor Inis �ea5an:
oaie: Owner: ELE 1 TEMP SERV PWR POLE W/OUTLETS EA. 15,00 15.00
i ao nereuy cenny mat I am aware oi ane uMerstand ��e reauirements of Calilomia Healin�an0 Salery Coae Sections 25505, 25533. an0 END OF FEES
T553a antl Rut I or any fuwre builamg acupam mNvnil not (prGe one) nee0 to compty v.i�6 saiE state cades an0 the repuiremems for a
permit lor tonsimclion oi motlilication imm Ine Air Ouality MaNqement Uslrict. fleSiEentul COnsiruttian apD�iutions are exempt Imm
IAeS¢ D�ovisions.
Date: Ap0licanl:
In¢reGy certity IAaI I have read I�is aDDlication antl State�hatihe aEov¢informationis torrect.lagree l0 tamply vn�� allciiy anA coun�y
orUinances ana siate Wws relating ta GuJGmg consiruction anU �ereW aurtnrize representatirrs al tlus dry to emer upon ihe a�ovo-mentione0
pmpetly lor inspetlion wDoses.
Uaie: O G (' Signamre: � � � ��-^��
oriver s license o� Social Security <:
164��c6 Whi�e—BmWmg: Green—Cope EnforcemenL Canary—AOplicanl: Pink—Revenue: GdOenrotl—Asaessor
01 00169927-00164917 T�] T 30.OQ
�ATE: ±D129/y< TIM�: 1`:18
CdNSTpUCT10N AN6PLANNING POOL 'A
APPROVALS Permit# Date Inspector APPROVALS Permit�k Date Inspector
1. Temporary Electrical Serwce or Pole_ �_ �� _ 52. Pooi & Equipment Location
2. Soil Pipe�Undrgrnd. - 53. Steel fteinforcement
1'3�'�ectiicalCorT.i�t�Jtility-Undrgrnfl�� 54. Forms
-A. Eiectrical Corr,¢tatriilndrgrnd. �;;� 55. Electrical Bonding
�`;6,.$tee!:fieinfor�;t�rrtt r"`7 56. Rough Plum6ing & Pressure Test �
.,�..6,�61ectricalUFEf3,;Grnd. ��� . 57. APPflOVALTOCOVER�GUNITE �..
C 7*�Fooungs � � 58. Eiectrical Conduit�Undrgrnd.
r •
�:.'�,, Foundation � 59. Gas Pipe, fJ Unqr�rnd., Test �-
-r.�- �
��-95 WBcer Pipe-Undrgmd. 60. Backwash Linee, P�Trap, C Undrqrnd.
10. Snuctural Floor-Syscem _ 61. APPROVAL TO DECK _�
17. property Sewe� Li�e & HouseConnect�on 62. Back�n�ash & Receptor�Final
12. Sewer Cap � 1 ' 63. Heater & Vent�Final
73. floof Drains � 64. Plumbing System - Pmal
14. Rough Ptumtring � 65. EfectricabPinaf
75. Rough Electr«al�Condu�i . 66. Solar System-Final
16. ROugh Electri8 Wiring _� 67. Fenciny & Accest Approval
17. Rough WiringSiyn `� 68. APPROVED FOR PLASTERING
18. Rough Electric8l�T Bar Ceiling 69. POOL/SPA SYSTE>>AS FIiVAL
19. ROugh Heating & Air Conditioning FIRE DEPT. REQUIRENIENT
.. - , ,. �. -r . ,
2Q:t RcLU9h facrary �cir.ePlace : i'-�� _. -. � � - o -. APPROVAL"S�� ` Perinit # * �
_ �.
... " " [ I P r. a .-� � � ' G, �, -. n
27':1 Dq.�ts, io St�uctytg � .. .. _ . � . � � 70. :Undergr;opnd Nydro
22. DJCts.lfenClati � ('_ '
_ !'9 _ : 71. Produe Pip'ing L'7 Gas OOiI
23.;G�s;P�P'e: Rndgh &'Test � �r . � n =' `' 72, Undergiourid Ffysfi .
24r, Rp9f Fram�ng � ,,- ��� . � � x ' 73c Underymd. Stora9� Tank"O Gas ❑ Oil
,.
25. Raof S�athing ' = _ `'' `� .';: . ' 74". Overhead'Hydro;' �
26;.T��Qr Ceiiing (Structurall &�Mor+ocoat = r; r: 7r.' Dry Chemical ," � ,n
275• Frame and Flashin§ 5' - j ,4. 76. Dry Stan�pipe �': ji <� m -�
_ 28. Lathing;& Siding , -7�� �7 3' i • 77; FIXED SYSTENf;.FINAI � i,
"29. InsulatlPn * ^ <. .... -.. � r ' �a ', 7&.= FIRE PREV. Fid�}AL . ^ �; �
:•30. DrY�valt�Nailing • � �� + y � � - �iEALTHIDEPT. REQWIREMENT
� ��_.
�_ 31. Plaster $�own Coa( -- ; � ,, r �� .' • 7S.' F INAL INSFECT{0'N ; ' ' `'
� '. . I _ " � 1�T . ��._4 _�.'�_��T�
,_.32; Electriql Poy+er Meter�Final � /�j�rp�, I: i+80* GOOD CERTIFfEATE 19SUED �'�
- .i�y"� �i _ �
33; Fi I Electric F ' /y-���} i '�� ,�oter .� •:. . ` .,
.- .� �, r�_ '::
,. � �
'34:.Fil�1 F{8atio� & Air CottditiON�g � � � e . - J � ' 'i. ` ` . '
� 1
�35"Pinal G3s Pipe-Test _ �r . I' -� _ ., .. � a � - * -
: � I i� - x
. .. L � - - �-. .. �
�3G''Hood oF�CanoPY . �, ,.•- - , ; f � �c ,�i.
� n �m
'37.^-Final Factory Fire�IBcg. ='T ' ' �� � - �.
. . ' .. �. .�. X �.0 , .
;38. Find1 Plum6ing . � � � y . � I �a r S • �•
' 39. Water Scrvice-Fina! � - � � ` ° � -- ' =
' i �_ : c t r
�;;40. Gas Service-Final ' � . i ' • . � �
t r � t' .
z:47. So�ar pomescic•FirtaP-. - •• �� _ • -:�� ''
'l . } _ I I •P i�i �.` 1 .Z�
`'A2- Backflow Prevente� �' ;� t ' � � �� , � j.. :�7 �
43. Backflow Irpigation _ _ * ^ ' �'� _ - , '
• �� . i �
�44. Landscape IrriqatiQn Syr,ert}�i?;� - r, � � r n; -� � '�� �•
�.45.:Sound Attenuation :�:�.; ,- " . �- " ,_, ,� ,� -r
1 ,� -n ri+, t-. _ .
n . • .,�
�46 ;HandicepRegulati�ns � ' � ��, . ' .�.� ���-
�
��47�,fIfdAL STRUCTt1�E & BUtLDING - i �� ^ =
� r � �� �
•48„ FINAL PLANNING � _ � - ' �� .
�49,_ El�eZric Release to•Edison ; � �• � + '
r
�b0. Gas;Release to Soujhem Calyt¢r.NpGasCo � � _; � � 'r � .
.
'=51. CERT{FICATE OF OCCUPAf�SCY r. ,�c, . � -
No. Date
VFOJECT p00HES5: 3 G S E 1 6 TH S T
OWNEN'SNRME:.�''.90 16TH S2 P.SSUC
nooAcss: 1936 E UEEP.E #t215
SANTA ANA. CA 92627
UNIT: H
263-1920
PHCNIENGINEEfl: DON FLAI R flEG.NO.: C 1 Z 9 2 O
aooness:17675 VON KARMAN uNiT:404
IRC'ZNE CA 92174
PEPMITiEE: CROSS STATEELECTRIC f 909 ) 737-8870
aoosess: Z445 RAILROAD ST
CORONA CA 91720
LICENSEO CONTflACTOB OECUIPATION: I hereby aftirm �hal I am licensetl unAer pmvisions oi CAapter 9(commencing with Seciion
7000� oi omision 3 of Ihe Business antl Pmtessions CoOe. and my license is in lull brce antl effect.
ci uc.:�t2787 STATEUC.:41ZO6S �,SS;C 1 EXP'/• 0^8/95
��aie'. �'�' � SignaNre: `Y� „ 'J' � �[��
W�fll FS' COMPENSATION OECIABpTION: I here6y allirm that I have a certificate of consenl to sel4insure o� a ceRilica�e o� Work¢rs'
-•Cmpensalion lns�yr�r�. pro egtlilie� aopy therea� (Seciion 3800. La�.��7 � Q 1� 9�
raucv wo.: y-TATE FUND EXP. DATE:
COMPRNY:
� 0 CerliM1ed coDY is here�y fumishea. � Ce�iliea copy iSSS ���\\\filetl wilh �he ciry^ Builtlin Dinsion/./ /�
�y �7 APPlicant:�K�.Li —�•C�J`." '
T �NiXOMWOAHEHS'COMPENSATIONOECIAflATION: QhissectionneetlnotbecompleleAilthepermitis�oroneAunArtA�5100�ark55�.
I cetlily ihai in �he peAormance o1 ��e work �or whic� I�is pe�mii is issued, I shall noi emDloy any person in any manne� so as lo become
sublec� lo Ihe WorkerY Compensalion Laws oi Calilomia.
�ate: SignaWre:
NOTILE: Ii, afier making ihis tleclaralion, you shaultl become suhlec� to Ihe Workers' ComDensa�ion pmvisions otlhe LaGor
Cotle. you mus� forihwil� campty wiih such pmvisions or �his De�mi� s�all Ce OeemeO �evoked.
CONSTPUCTION LENOING AGENCY: I �ereby aHirm tha� lhere is a con5imc�ion lentling agency �or Ille pedofmance af �he work �or
whicA this permii is issuetl �Sec�ian 3097. Civ. C�. .
LENUEH:
aooeess:
OWNEH BUILDEfl DECLABRTION: I hereby aifirm Iha� I am exempi tmm �he Conira[�ors' S�a�e License Law for Ihe foliovnng reason
(Sec�ion 7031.5 Business ana Pmie55ionai Code: Any city ot coun�y whic� requires a Dermi� �o canstruct, aller, impmve, demolish, or
re0air any stmcNre. prior lo its issuance. also requires t�e applicani for su[� Dermit b �ile a 5igne0 statemen� ��at he/she is IicenseA
pursuanl to Ihe pmvisions oi ihe Contractors State License Law (Chapter 9(commencing wit� Section 7000) ol Uivision 3 ot ihe Business
antl Pmiessions CoOe) or Iha� he/she is exemp� Iherefmm and �he hasis lo� Ihe allegetl exempiioa Any violalion ol $eciion 7031.5 6y
any apPlican� for a permi� subjects the aDDlicant to a civil penaliy ol no� more than tive hundretl dallars (5500).
I, as owner of t�e O�openy or my employees with wages as t�eir sole compensation, will Oo ihe woB, anA tlle
❑ stmc�ure is nol intentletl or otfered tor sale (Section 70a4, Business anU Pwlessional Code: TAe Coniractors' Slaie License Law
does not apPly Io an owner o� a propeny w�o 6uilds or impmves Ihereon, an0 w�o aoes such work himself/hersell or �hrough
his or �er own employees, pmviaed �hai such impmvemenis are noi inten0e0 or oflereC br sale. It, however lhe �uiltling or
impmvemen� is so10 v�ilhin one year o� complelion, �he owner will have Ihe burden oi pmving �e/S�e AiA na� 6uild ar impwve
lor ihe purpose o� sale�.
I, as ownerot Ihe pmperty. am exclusively contrac�ing wilh licensed coniracmrs m constmc� Ihe pwlecl (Section 709d, Business
❑ antl Pmfessions Coae: i�e Coniradors' State Lirense Law does noi apply �o an owner o� pmpeRy who bw105 or improve5 iher¢an
an0 wha conVacts lor such pmjects with a conVac�oqs�license pursuan�lo the Canlraciors' State License law).lam aware
Iha� pmof of �hen Worke(s Compensalion insurance shoul0 be proN0e4 to me.
� I am exemp� unaer Sec�ion: 9. 8 P. C.
lo� ihis reasan:
Oate: Ownec
I tlo here�y certily ��a� I am aviare ol an0 understantl Ne reQuiremen�s oi Calitomia Heallh an0 Safery CoEe Seciions 255Q5, 25533. antl
2553a and thai I or any �ulure �wltling acupant will/will noi (ci¢le one) nee0 to comDty with sai0 siate co0es antl �he requiremenis �or a
permit lor cons�mction or modificaiion Imm �he Air Oualiiy Management DisMci. Fesiaenlial consimetion aDPlications are exempi �wm
ihese pmvisions.
Da�e: ApPlicant:
I hereby cendy �Aat I have reatl Ihis aDDlicalion and state iha� Ihe above inbrmation is correc�. I agree lo compy wiih all ciry anA counry
ordinances and 9ale Iaws relating lo �uiltling cons�mclion antl hereby author¢e reD�esenlalives a� ��is ciry Io enier upan ��e above-mentionetl
pm � loi Inspe ion pu oases. . �� ^ /� q �
Oate: Signaiure:
�.% N Ju�%
nver's License or Social Seariiy x: �
—ApPlican�; Pink—Revenue; Goltlenrod—Asseswr
CITY OF COSTA MESA - BUILDING PERMIT PERM P70: E 070313
PERMIT NO; E 070323 PLAN CHErx DJO; N GOVT; N SUPF; N
CONSTRUCTION TYPE; PERMIT TYPE: ELE PURPOSE: P7EW
JOB DESCRIPTION ; 1119SF 2ND FL, 872SF 15T FL, 441SF GARAG SQ FT:
CLAIM C'ALUE; CALC-VALUE; GRODP OCC: P.-3 /M-1
COMMENTS: P.EF: H-69682 FOR THE GARAGE
-�t �E i� fF iF ac r�lE at i�-�lf if--�4+t'�'1� iF iF u� ac * ac iF �lt if i[� ac u ic if 3t �If x� �f aE iE+F �IP+E ih �1f iF ic ir ic iF iE * v� r ac u�7c if iF * x� �1(� �f �lE w at �R ac x m* ac iF x--�F «� �YI� aE 1� �)c a-M %�
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
------------ M1AIN HUILDING ---------- --------- ACCESSORY BUILUING ---------
FRNT: FT IPd REAR; FT IN FRNT: FT IN REAR; FT IPd
LEFT; FT IN RGHT; FT IN LEFT; FT IN RG?tT; FT IC7
PARKING REQ• PROV; PARCEL: 42519119 ZNE: REF NO;
PLAAINING NdTES>
1
i!� if # iF i! if 1f iF if if if if iR if� iF iF iF # M� if 1E 1f if # if # M�lf if fE if aF if iF1/ ih �If iF if iE 1f ir i! # if aE iE iE if iE iR iR if s M M iF 1f af �lE ib+f iF iE it iE it if it iF # if -lf �-7E �)f aE ic aF
D E V E L O P �9 E N T S E•R C' 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: G/,�2� DATE. � l.,
**s�r*+t�+r**�ir�r***+rar«x�+r**�+�sxr�*�r s�t �r, '+��+r *' ���*�r+�x�**�**x***r�+r��r r��r eaa,Far-,�a�
it�Erk*if�ttit�kit�tif+titrit�t+f*ritv�f-iEac�t*itiY�E*�riEitit+rih�Ft�c�friEiF�lEiEfF�hifr�iF�t+r+t+cifsFiFjrirkififa-iriF�tt+r+r; ia���k-iFr
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMEAIT:N
HLDG PMT FLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GP.ADING
PERMIT 6.75
50t
PLAr�
ISSUE FEE 15.00
HUILDING-DI�'-> PEP.MIT ISSUE PLAN-CHECK
TOTALS----> 6,75 15,00 Q,OQ
REVENUE DIVISION TOTALS--> COLLECTED;
BLDG FMT PLUMBING ELECTRIC MECHANIC
21.75
SMIP/NON-RES
TOTAL PAID DUE
21,75 21.75 ,00
— 21,75 OVER/SHORT: .00
FIRE SMIP/TOT GP.ADING PLAN-CHECK
##`!E iE iE Y� fE iE it le it 1E if #�# if iE �! 1f iE i�-1(-iE iF 1f iE+E 1t 1f �F iE 4 if 1E if aE �lE 1E if # if iE it i(� # if 14 K 1f iE Y� iE �1F iE fE if 9E i( it �E iF if !F if i! aE Y af i: if ff if 1f it iE iE ##
I N D I V Z D U A L F E E B R E A R D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 2 FIXTURES, LIGHTING 1 ST 20 EA. ,75 1.50
ELE 4 RECEPT/OUTLET 1 ST 20 EA. .75 3.00
ELE 3 P.ECEPT/SWITCH 1 ST 'LO EA, .75 2,25
END OF FEES
Gs fiUi�3236-00+73236 T=tT 11.75
oaTE: ?./09/44 TTME: !i:36
CONSTRUCTION AND PLANNING P��� �A �
APPROVALS Permit # Date Inspector pPpROVALS Permit # Date Inspector
l. Temporary Electrical Service or Pole 52. Pool & Equipmeoc Locacion
2. Soil Pipe-Undrgmd. 53. Steel Reinforcement
3. Elecirical Conduit Utility-Undrgrnd. ' 54. Forms
4. Elec.rical Conduit-Undrgrnd. 55. ElEctrical Bonding
5. Scee! Feinforcement 56. Rough Plumbing & Pressure Tzst
6. Electricai UfER Grnd. 57. APPftOVAL TO COVER�GUNITE
7. Footings 58. Elec.ricai Conduit�Undrgmd.
� 8. Foundation 59. Gas Pipe, O Undrgrntl., Test
9. Ulater pipe-Undrgrnd. 60. Back4vash Lines, P�7rap, C7 Undryrnd.
10. Structural Floor System 67. APPRGVAL TO DECK
t i. Property Sewer �ine & House Connection 62. Backwa;h & Recepta�-Final
i2. Sewer Cap 63. Heater & Vent-Finai
13 Roof Drains . 64. Plumbiay System � final
3d. Raugh Piumbing 65. Electrical-Final
15. Pouyh ElectricabConduit 66. Solar System-Final
16. Rough Electric Wiring J� �jr9 %U!(.1� 67. Pencing & Recess APproval
/%= .�-.�
17. Rough Wi�inq Siyn 68. APPROVED FOR PLASTEHING
18. Rough Elearical�T Bar Cei�ing 69. POOUSPA SYSTEh15 FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REOUIREMENT
20. Rougn Factory Firepiace APPROVALS Permit #
21. Duczs, �n Structure 70. Under9round Hydro
22. Ducts, Ven[ilatin4 71. Product Piping OGas �Oii
23. Gas Pipe�Rou9h & Test 72, Undzr9round Flush
24. Roof Framing 73. Underyrnd. Storaye Tank O Gas ❑ Oil
25. Root 5heathing 74. Overhead Hydro
26. T-Bar Celing (Structurail & Monocoat 75. Dry Chemicai
27. frame and Fiashing 76. DrY Standpipe
28. Lathing & Siding 77, FIXED SYSTEA9 FINAL
29. Insulaiion 7$. FIRE PREV. FINAL
30. Drywa�� Nailing HEALTH DEPT. REQUIREMENT
37. Plaster Brom�n Coat 79. FWAL INSPECTION I
32. Electriral Power Meter�Final 80. FOOQ CERTIFIGATE ISSUED I
33. Finai Electric �d��_ Notes:
34. Final Neating & Air Conditioning
35. Final Gas Pipe�Test � �
36. Hood Or CanopY
37. Final Factory Firepiace
38. Final Plumbing '
39. Water Service�Final
40. Gas Sefvice-Fi�a4
47. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape irrigation SYstem
45. Sound Aitenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING '
i
4$. PINA4 PLANNING �:� '
49. Electric Release to Edison i'
50. Gas Release to Southern California Gas Co A
5L CERTIFICATE OP OCCUPANCY
Na. Date
PflOJECT PODNE55: 3 6 S F. 1 6 TH S T UNIT: [S,
OWNEX'$NPME: ,'G9� 16TH ST ii.S�jUC
aooeess: 1936 E DEERE #215
SANTA ANA, CA 92627
263-1920
PNCN/ENGINEEfl: DON FLA 2 P, flEG.NO.: C 1 Z 9 Z U
aooeess: 17 S 7 5 VON KARMAN uxrt: 4 0 4
IRVINE CA 92179
PEPMITTEE:CROSS STATEELECTRIC (909)737-887U
noonEss: 2445 RAILROAU ST
CORUNP. CA 91720
UCENSEU CONTBACTOB OECLAflFTION: I hereby a��irm �hat I am Iicen5e0 unUer provisions oi Chapter 9(cammencinp wilA S¢ctian
7000� oi �iNsion 3 al �he Busness and Pmfessions Coae. and my li[ense is in tull brce and elfec�.
cirvuc.:0�6j2/7��%/] $TpTELIC.:412OFi1,� � /�/��n4�ss:^C �,,0� E/�X/B 1A�0�8,/95
al _��� 5ignature: �L_�I.G�C�LY D —� J �
BREBS'LOMPENSR IONo CIAPATION: Iherebyattumtnailhaveacenilicateotconsenimself-insureoracenifica�eolwoAers'
Compensation Nsuraqcuk w q LtldieA rppy mereo� �Sectian 3800. �ao.�Cl.� � O 1/ 9 S
roucrno.:STATEaFUDJD E%P.UATE:
COMPANY:
❑ Cerlitied copy is �ereGy tumis�ed. � Certilied copy is file0 wiih IhIe�cily BuilGinA Di sian. ' //
��a � Applicant'. � Y/1/`� �• ✓' �v' —
PTION FflOM WOHREHS' COMPENSATION OECLANATION: Q�is seCiion need nol U¢ tample�etl if Ihe permit i5 �or One �UnaaA ($1W) or IesS).
I reriily that in Ihe pertormance ol Ihe work lor wAich this permit is issued. I s�all no� employ any De�son in any mannet 50 a5 io hecome
sublect lo I�e Workers' Compensation Laws ol Calilomia. .
Oate'. SignaWre: f
NOtILE: II. after making this tleclara�ion, you shoWG hecome su�le�� io i�e Worken' Compensation pmvisions al the Labor
Code. you musl loM1hwith compty wilh such provisions or ��is Oermi� s�all Ee aeemetl revokea.
CONSTPIICTION LENOING AGENCY: I AereDy allirm ��at ��ere is a COnSimdiOn lentling agenty lo( ��e petlormante ol th¢ wod lor
w�ich ihis permii is issuetl (Senion 3097. Civ. C�.
LENOEP: �
AODNESS:
OWNEP BOILOEfl OECLl�BATION: I hereby affirm ihat I am exempt Imm the Contractors' State License Law for �ne IollowinA �eason
�Section 703L5 Busmess antl Pmfessional Cotle: Any city of counry which requiies a Dermit to constmct, alier, improve, demolish, or
repair any stmcture, Orior lo its issuance. also reQuires ine applicant for sucn oarmit to file a signe0 stalemenl tnal helsne is licensea
pursuan� lo I�e O�ovisions oi the ConVactors' S�ate License Law (Chapler 9lcommencing wi�� Section 7000) ol 0ivision 9 of Ihe Busine5s
an0 Prolessions Code) or ihal ne/she is exem0� �nerelmm antl ihe hasis br Ihe alleAea eKemption. Any violaiion ol Seciion 70.31.5 by
any applican�lor a permii sublec�s Ihe aODlican�io a civil penaliy ol no� mote t�an hve hundfeU Ooilars (5500).
I, as owner of I�e prop¢ny or my employees wiih waAes as Iheir sole compensation, will tlo tAe work, antl Ihe
❑ simcmre is not imen0e0 or olierea lor sale (Section 70aa, Business anA Pmiessional COAe: The Conirac�ors' Sta�e License Law
does not apply to an ownei o� a propeny who builtls or impmves �hereon, and who does such work himselV�ersel� or Illmugll
�is or her awn employees, providea �hal suc� improvemems are noi intentletl or oflerea �or sale. II, however ��e builEing ar
impmvement is saltl wi�hin one year o� comple�ion, the owner will have �he bur0en oi proving he/she Aid noI bui10 or impwve
lor �he purpose o� sale).
I, as owner of �he prapeny, am e�clusively con�rac�ing with licensetl conlrac�ors ta constmct the pmject (Sec�ion 7044, Business
❑ and Pro�¢Ssi0n5 C00¢'. T�e COnlraClOts' Sia�e LicenSe Law OoeS noi apply lo an ownel o� O�Operty who bWltlS Of imD�o�es �heleon
antl who ConlraCis �or Suth prolecis wiih a ton�ractor�s) liCense pulsuanl ta Ihe ConlraCtOfS' Sta�e Litense Law�. I am aWafe
�hai pmai o� Iheir Worker's Compensation insurance should he pmviUetl to me.
� I am eaempt untler Se[Iion: B. 8 P. C.
lor Ni5 mawn:
�ate: Owner.
I tlo �ere�y cetli�y that I am aware oi anU unAerslantl �he requiremenls ol Calilomia Health anU Safery COEe $¢ctions 25505, 25533, antl
25534 antl Ihai I oranyfuiure building occupanlwill/will no� (circle one) neeAio comply wi�h saitl sta�e codes an0 I�ereQuiremen�s�or a
permit for conslmciion or motlilicalion Irom Ihe Air Oualiry Managemenl Di5lricL Resitlential constmction apDlications a�e exemp� trom
Ihese pmvisions.
oate�. Appiicam�.
I �ereby cer�ily Iha� I have reaa this applicalion and state ��at the above inbrmation is correcl. 1 agree to comply with all ciry antl coun�y
ordinances an0 s�aie laws relating Io Ouiltlmg Conslmciion an0 hereby aNMnie represenlatives of Nis city �o enier upOn Ihe above�mentionetl
piopenV �or ins ection urposes. ^ t A � �� �
t64L46 Wlwe—Builaing: Gmen—Coae Enlo¢ement; Canary—AO�licanl; Pink—Revenue; Goltlanmtl—Assessor
CI'TY OF COS'iA MESA — BUILUIP7G PERMtT PEP.M NO: E 07Q319
PERMIT NO; E 070319 PLAN CHECK NO; N GOVT: N SUFP: N
CONSTRUCTION TYPE; PERMIT TYPE: ELE PURPOSE: NEW
JOB DESCRIPTIOr] ; 1119SF 2ND FL, 872SF 1ST FL, 491SF GARAG SQ FT:
CLAIM VALUE;
CALC—VALUE:
GROUP OCC: R-3 /M-1
COMMENTS: REF: B-69684 FOR GARAGE
if f!1!#MVffifjf�)f#'if9f#i�V'k#'M1f1kV�'klfif#3fiftF6##if##jf1FMfFif#+t'Y1Eif7f#�If4+hitlEifMifil�#1F1ii4#iE1Eii1f{RiF4AFiR##afiFif#ifY#
Z O N I D] G R E Q U I R E M E N T S
S E T H A C K S
------------ MAZN BUZLDING ---------- --------- ACCESSORY BUZLDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
PAP.KING REQ • PROV: PARCEL: 4251°119 ZNE; REF NO:
PLAD]NING Nd'I'ES>
>
iE it it fE iE it+t if it if iE r it if i! ic i! if iE s if �lf if� # iF if it+f� M# it #�N�'1f'1F iF it it it ## iF iE iF 1E if if iE iF+f K iF iE if i!� iE i1� 1f 1f i43t iF iF if s+f �t+t it-1f if �lf 1E iE if s if iF+f
D E V E L 0 P M E N T S E�,R C� I C E S A E Q 0 I R E M E N T S
ZONING APPROVED BY .
DATE:
HUILDZNG APPROVED BY : � DATE:
APPLICATION ISSUED BY: DATE: Z Q// (�
#�*�ci�+rs*tca�lc**�t�1r**r*�c«*FiFY'3FiF;F';F'iF�ixiF. , �r +r�x,.�r3Fz�F�Fic��:hi��R'�?FitiE*��*+�krk�c�'��r ii7F"�F/').*�1
%if iF K* �c �t ic iE iE iE+i it �K iF+f if r it if iF if �c+E iF+f if if iE if if if +F if aF ic ic *{R {t iF if 1E if jc If iF if jc * M iF * a: aF iF if it k af �N� if ac if +4 iF iF if af aF ac iF�i�'if iF aE
LEGALIZATION:N F E E S U M M A R Y STAUCTUAAL SEGPIENT:P]
BLDG PMT PLUMBING ELECTRIC MECHI�NIC
PERMIT 6.75
503
nLAr�
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 6.75 15,00 0,00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECAANIC
21.75
FIAE SMIPfRES GRADING
SMIP/NON—RES
TOTAL PAID DUE
21.75 21.75 .00
— 21.75 OVER/SHORT: .00
FIRE SMIP/TOT GP.AL�ING PLAN—CHECK
dh if iF iF if-if� if iF �V� ff i1 if it !h iF 7f 1t ## 1! if if k� V af if if af if 14 iE 1f fi iF iE ia iE i4 iE iF iF if af 1h 9f # if if if iE if iF tF if 14 il+r k if M it iF iF if ir- if� # M it at+f iF #�1R a4 �.'.� iF 1R ac
I N D I V I D U A L F E E H 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
ELE 2 FIXTURES, LIGHTING
ELE 4 RECEPT/OUTLET
ELE 3 RECEPT/S[�JITCH
1 ST 20
1 ST 20
1 ST 20
END OF FEES
EA. ,75
EA, .75
EA, ,75
1.50
3,00
2.25
�? OD273?38—QD17323A 't CtT 21.75
6aTE: 12;Oil94 TIRE: 11:37
CONSTRUCTION AND PLANNING POOL ?A
APPROVAGS Permit# Date Inspector qppROVAIS Permit# Date Inspector
i. Temporary Electrfcal Service or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. 53. Steel Reinfiorcement
3. Electricat Conduit Utility-Undrgrnd. 54. Forms
4. Electrical G'onduit-Undrgrnd. 55. Electrica( Bonding
5. Steel Reinforcemenc 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNiTE
7. Footings 58. Electricai ConduiFUndrymd.
8. Foundation � 59. Gas Pipe, O Uodrgmd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd.
70. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Li�e & House Connectioo 62. Backwa;h & ReceptorFinal
12. Sewer Cap 63. Heater & Vent�Final
13. Roof Drains 64. Plumbiny System � Final
14. Rough Plumbing 65. Electrica6Final
15. Rough Eleancal-Conduit 66. Solar System-Final
16. Rough Electric Wiring � �e79 �%� 67. Fencing & Access Approvai
.�� v_
17. Ro�gh Wiring Sign � 68. APPROVED FOR PLASTERING
78. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE 6EPT. REQUIREMENT
20. Rough Fattory Fireplace APPROVAIS Permit #
21. Ducts, in 5tructure 70. U�derground Nydro
22. Ducts, Ventilating 77. Product Piping O Gas G On
23. Gas Pipe�Rough & Tesc 72. Underground Fiush
24. Roof Frarnin9 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathin9 74. Overhead Hvdro
26. T-Bar Ceiling (Structurall & Monocoat 75. Dry Chem�cai
27. Frame and Flashing 76. Dry Star.dpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78, fIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Pia:ter Bro�vn Coat 79. FINAL INSPECTION
32. Electricai Pow2r MeterFinal 80. FOOD CERTIFICATE ISSUED
33. Pinal Elecsric !6� Notes:
34. Pinai Heat�ng & Air Conditioning �, ,�
35. Final Gas PiPe�Test '
36. Hood or Canopy
37. Final FactorY Fireplace
38. Final Plumbing
39. Water Service-Pinal
40. Gas Service-Final
41. Solar �omestic-Final
42, Backflow Preventer
43. Backflow Irrigation
44. Landscaoe irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL S7RUCTURE & BUIIDING _
46. FINALPLANNING �
49. Electric Release to Edison .'
50. Gas Release to Southern California Gas Co �'
51. CERTIFICATE OF OCCUPANCY �'
No. Date � .
PflOJECT AOOHESS: 3 6 B E 1 6 TH ST
OWNEH'SNAME: SMITH, ROGER D
aooeess: 368 E 16TH ST
COSTA MESA,CA
92627 .
ueir:
ABCH/ENGINEEP: NEG.NO.:
RDOflESS: UNIT:
PEHMITTEE: SANTIAGO A/C INC. ( 719 ) 998-1600
aooncss: 231 W. BLU�RIDGE AVE,
ORANGE CA 92665
LICENSEO LONTNACTON OECLAflFTION: I hereby al�irm Ihal 1 am Iiren5e0 un0er provi5i0ns ol ChaD�e� 9(commencinB wit� Seciion
7000) ol �ivi ion 3 oi Ihe 9u5ine55 antl Pmlessions CoOe anG my iicens is in lull lorce A'¢�lec�.
ciTvuc.: �(��15264 srnrEuc.:269496 ss: 0 EXP: OS/95
ale' "-� �i7 S � SignaNre:
KEHS' LOMPENSATION OECIAPRTION: I �ere6y a��irm t �ave a cetlilicate of consent �o selbinsure or a certiliwte ol Workers'
ompensatia� �rqe. ar�alc�tir��c��tnereoi (Secuon . Lab. �.-� � O 1/ 9 S
eoucvNo.: CALZFORNIA COMP E%P.ORTE:
COMPpNY: �(
�rlifie0 copy is �ere�y tumi5Ae0. L( Cetlilied mpy is filed vnth �e ci uilGing Divisi0n.
.B�C� � o 'l_^ � Applicant
E%EMPTIONFBOMWOBNEFS'COMPENSATIONOECLAXRTION: (1Ti5 uanneedno�bewmpleteEifNepermitistoronehunOrea�510�arless�.
I cetlify Iha� in �he pedormance of Ue work tor which this permit is i55ue0, I 5hail no� employ any person in any manner so as �0 6ecome
subleci lo Ihe Worker5' Compensalion Laws ol Calilomia.
Oaiel Signalure:
NOTICE: Ii. aiter making this declaraiion, you shoWd �ecome suble« <o t�e Wofneri Compensation Owvisions oi Ihe La6or
Cotle, yau musi fotlhwil� tOmpry with Suc� Omvi5ion5 or INS p¢rmil shall De Aeemed revaketl.
�I CONSTPUCTION LENDING FGENCY: I hereby aflirm t�at there is a fAnSVuction lentlinq agency lor �he Oehormance o� the work �or
� which Ihis permi� is i55ue0 (Section 3097. Civ. C�.
LENOEN:
aooness:
OWNEB BWLOEP oECURATION: I here�y ailirm t�at I am exempt imm t�e Contracmri State License law lor tAe followinA �eason
(Sectian 7091.5 Business an0 Pmlessional COUe: Any cily ol county whic� requires a Dermit to constmct, alter, impmve, demolish, or
repair any slNtlure. prior to ils issuance. also repuires ine aODlicant lot sucn oermil to lile a si0ne0 stalemenl Ihat he/she is licensed
pursuam to ihe provisions of ��e Comramors' S�aie license taw �C�apter 9(commencing with Section 7000) oi Division 3 of I�e Business
h i 1 r h all xem lian. An Wola�ion 01 $lc�ion 7Q37.5 U
Pr I i n a or tllai he/She i5 eaem t i�er¢�rOm and 1 e Uas s o I e ¢ eG ¢ Y
ana o ess o s co e1 V 7 o r
any applicanl lor a permil SuUle��S the aOPlicant �o a civil Denally oi not more t�an tive �unOreO Oollars �SSOD�.
I, as awner ol I�e Dmpeny or my employees with waAes as iheir Sole compensalion, will Do �he work, anA Ihe
❑ simaure is noi intenAea ar offered for sale 15ection 70aa, Business an0 Proteuional COJe: TAe Contractars' State License Law
tloes not ap01y lo an owner ol a propeny w�o OuitOs or improves Iherean, antl who does suc� work himself/Aerselt or I�rouA�
his or her own employees, pmvided i�ai such im0�ovements are not imenUed ar offeretl lor ule. Ii, however the huiltlinp or
impmvemenl is Soltl within on¢ y¢ar ol tompleli0n, Ihe owner will have I�e Uurtl¢n ol provinp he/She GiE nol huild or improve
for ihe Ourpose of sale�.
L as owner ot �he OmDeny, am e�clusively comractinA �N licensetl coniracmrs m consimm I�e D�ole�� (Section 70a4, Business
❑ ana Prolessions Co�e: The Canlractors Staie License Law Aces not aDPN �o an owner ol DroDe�1y•�o bwlAs or Impmves thereon
antl who conVacis lor suc� pm�ens wi�0 n conVac�aqs)license pursuanllo ��e Conlraciors' Sla�e License Law),I am aware
t�at prool ol I�eir Worker'S Comp¢n5alion insurance SMNC G¢ prOvia¢G Io me.
� I am exemp� unaer Seciion: B. 8 P. C.
lor Inis reason:
Daie: Ownec
I do �erehy cenity that I am aware of antl un0erslantl I�e requiremems ol Cabbrnia Meaith and Sa�ery Code Sections 25505, 25533, and
25534 and ihat loranylulwe Guiltling occuDanlvnlUvn�lno��circle one) need Io comply vn�h saitl s�ate co4e5 anU iherepuiremen�s�ora
permil �or conslmciion or motlilica�ion Imm I�e Air Oualiiy Managemeni Distritt. Re5i0entiai constmc�ion applicaiions are eKemp� Imm
mese omvisions.
�ate: ApDlicanl:
I hereby cerlify Ihai I have rea0 ��is apP6cation antl s�a�e ��at ihe abopppve infaJJJrmeeea666i���ieeeon i5 correcL I agree �o comply wi�h all city anE caunry
orAinances and sta�e laws retaling �o builaing conSlmciion an0 �ere6y a thorize sznlatives of t�is ciry lo enter upon ihe above�mentioneA
Or tly lOr ms0edion purp05e5. /1 /
,(�`, ���
E _ � � �ti`1 T $igndlUfe: ��
Drivers �¢ense or Sociai Securiiy a�
1641�06 Whlte—Bmltling; Green—Gotle Eniorcemem: Canary—Applicant: Pink—Revenue: Goltlenrotl—Awassor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO; M 069421 PLAN CHECK NO: N
CONSTRUCTION TYPE; V—N PERMIT TYPE: MEC
JOB DESCRIPTION ; REPLACE A/C UNZT
CLAIM VALUE:
CALC—VALUE:
P RM NO; M 06942
GOVT: N SUPP: N
PURPOSE; NEW
SQ FT:
GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK AUTHORI2ED BY THZS PERMIT
***�r*�rr*�r**�e�r*w***�r�r**x�r�e�r****i�*r+t�**w��r�r+t�r�r�e***�rw�r�r�e*�rx�r*ir�t�e*�rw�r*****r�**�t*�rr*
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 ----------
FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN
--------- ACCESSORY BUILDING --------
FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV; PARCEL: 42519119 ZNE; REF NO;
PLANNING N�STES>
7
1EMIEMiEif if if 1f 1litklfiflf ilfFftilikiFMiF1lff ffkif7F%%Mifif iFiffffFfEff kfF�f it%if ltifilM!lifilif ff ifffif if itiElf iEff if %if f!illfif 1kMiFiE1F1f if 1F
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:
BIIILDING APPROVED BY ; DATE;
APPLICATION ISSUED BY; DATE�� � ly
1t iF ikif 1f iF ltit k iFif 1f iF M if% MM 1E % if if % �f kiEif If ifjE 1f jF if
1flFifMltitMifMifMlFMif1liFitiFlfklfiflfifMlfafMifMiflfMlflfillfMMikM1lifikifitiFififiEifMiflhiFMififaflEjfiEifMif�ffFiF MffiFiFMitiFikiFiF
LEGALIZATION;N F E E S.0 M M A R Y STRUCTURA SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT
PLAN
ISSUE FEE
BUILDING—DIV—>
TOTALS---->
18 00
15t SMIP/NON—RES
15.00
PERMIT ISSUE P N—
LA CHECK TOTA PAID DUE
18,00 15,00 0,00 33.0 33.00 ,00
�
\
33.00 OVER/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN—CHECK
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLOMBZNG ELECTRIC MECHANIC
33.00
1tilifMlfifMlt4MkffMMififif4llMMMkMikMifkM1lMkMM1F1FlfifififlFkMiFiflfilMlflfik�fltMMMlflfMifihMlfMlf4MM1f1fifMMltMMMMif
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 1
MEC 2 INST FORC—AIR/GRAV FURN <= 100 K BTU 9.00 18.00J
END'OF FEES
t31 OOY7C�0�0—OQ170030 T�] T 3�.�0
OATE: i0/21/94 T1hlc'; 15:19
CONSTRUCTION ANDPLANNING POOL PA
APPROVAL5 Permit#'� �Date Inspector pppROVALS Permit?k Date Inspector
i. Temporary Electrical Servkce or Po�e • 52. Pooi & Equipment Location
2. Soii Pipe-Undrqrnd. - 53. Sieel Reinforcemen2
-3.'ElectricalCondi�i;�tility`-iJndrgmd.- 54. Forms -
J;�4.�E�ectrical COnduii-Undrgmd. „- 55. Electrical Bonding
' 5; Sieel Reinforcerdenc .`, 56. Rough Plumhing & Pressure Test "
�'6,�.Electrical UFER•Gmd. �r - 57. APPflOVAL TO COVER�GUNITE ,
�� 7.'Footings = ' S8. Electrical Condwt�Undrgrnd. �
.;
,.8. Foundation �. i 59. Gas Pipe, 0 Undrgrnd., Test
9. Water PIpe�Uniirgrnd. 60. Backwash Lines, P�Trap, C Undrgrnd.
19. Structural Floor SYstem " 61. APPROVAL TO DECK
11. Qr. Perty Sewer Line & House Connection 62. Backwash & Recepror�Final
12. SAwer Cap � " 63. Heacer & Vent-Final
13. F�of Drains 64. Piumbing System - final
14. Rough Plumbing �' - 65. Electrical-Final
15. Rough ElectriFal-Condurt 66. Solar SVstem-Pinal
16. Rough Electria Wiring � 67. Fencing & Access A�Proval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING .
78. Rough Elect�ical-T Bar Ceiliog 69. POOU'SPA SYSTE,:1S FINAL � �
19. Rough Heat�ng & Air Conditionin5 �z.���� PIRE DEPT. REQUIREMENT
20. RoU h� actvry Fire lace � ;-. . - _. ' '=' „"'�'�" I; , _ s
..9 .5 P . -APPROV/xL'S� r. Parmit # � *+
_ _ „ � i, �. �� _
2L,Dui,ks, in Steuct�e; � J .. .� � ' .. . 70. �7nderg'��ry v �.' H} Iro �� � I
22. Ducts, VentilatiCgr � �_ " 77. Produat'Piping �`iias �Od
23�iGas'Pipe". Rough & Test ! '�; ; �., ' - , 72. Underg�oq�ld F(I��Y ;. _
24�-Roof F�am(Hg , - - •� � - " ':73? Undergrd�ti.Stor��'Tank'OGas �Oil
n
25. Roof Sj)patNing - - ' T� � ' " :
� , �, � 74.�pverhead�Hydro�
26:,T�Bar Ceiling (Steuetural) &�fvionocoat � i n� � 75,^ Dry Chemical ^7 �-�7
- �.
275•Frameand F�ashipJ °'r�, . ' 78- Dry Stantip�pe ��a'. + -' `�' ���
.:28.� �athing& Siding � „� .. " . .. 77�: FIXED SY�TETs rl AL _. ?'
^29. InsulaYron � „ �' -""� � , `' � i . 7�^,'FIRE PREV. FIN,AL ^
;�30. Drywali Nailing � � `� � � - •HEALTN;OEP7a.REQ1ilIREMENT
.'31. Piaster Brown Coat .. ' i�,., �, 79�FINAL I't�;'SP.ECTEON � =" :
, :r-r-ti-
�.32,,�Electri�l Power Meter-Pina� r• , -80o;FOOD CERTIF(�ATE ISSUED �r
.« r
�33�Finai Elactric ' - � �' �� Notes: � ,_,7�- ` '
- i . nt �� '.n
' 34: �Firial Heatiog & Qii Condttioniny' '-. �_2� �- `� � ' ' ' � 'i
• ! ?- l�-�t�- � = ��_l1-IL�c�ri�+.3- -
35:"Firtal Gas Pipe-Test� _ - � ' � I � .:�,�=�� 4�' :; � ry: .� �' • _
�36. Hooii or Canopy � _ ` , �. � �' �?�- 7 c3 Gl„S �--G1�<S-C�.,,
•37.-'Fin�l FactorY Fireplace _ ' - ' � k . • I
I � _ 4
� �.
'38. FinalPlumbing . ' .... '. � �� _ �. ��, f �
i
39. Water Service�Finah � � � ' ;M " �4• �� �. ^i . �
.�
,40. Gas Service-Final � _ , . ��". • . . ' `
• r r. �' � -
-41. Solar pomeStiaFina�. � �• ' 4= - ' '
r . "
42.--8ackflow Preventer ,i � � , - ' � { -� _ �
43. Backflow trfigation� -. , � ' �� �-' � � _ 1
i' I � •
��A4. Landscave I�iigation System.`�. , � .c • ,: ,� � � �i ...
� 45. Sound AiteouatioFl - �: � • - - - r �
n (.0 '
-.46."Handicap Regulations - - ' � '. �, �; . . ; ,
�47. FINAL STRUCTURE & BUtLDING • � �� ^ �
i . �.
48. FINALPLANNWG �,� ' � � ' , ,,
49. Eleetric Release to Edison � � .
,
`50. Gas Release to Souihem CaliTornia Gas Co � , ."� . ".
.m
51. CERTIFICATE OF OCCUPANCY - ", _ - , .. ,.
No. Dace
�I
��
mon�ssaew�ano: 368 E 16TH ST
awwexsru�eiviwowx: j;,Irt,Tt�r)??t liCf'�i7
��+Eu: 1�J36 £ LSEE�t� �Cr #2? 6
SANTA ANA,CA 92627
i
�vr�.iuuuxc �oox�sx
u
YiCNRECi OR FNC�NHA: 11C NO.:
YMH OP F1M.'4100RESS:
mN�narara nua:
COHfN1CTOR'BYYl01G
�DDRF.iS:
P[#:iF
UNT:
uxr:
UNT:
LICENSED COHfRACTOFS OECLAP�TON: I Meby ellim wMx peea�y W pamvy Na I em Iies�wA under prw'noru d Cheqar 9
(oomma�M xilh Senion )000) d DHnion J d Ihe Buvnen end Vrdasawu Code, eM mY 4ronw is in hA tacs eM efled.
cm uc. No.: uc. cuss: uc. r+o.: E X P:
od.: co��.a«:
OWNEH BUILDEP DECL�R�TION: I hereby dfi�m uMm penely d periny ihet I em e�mmq Imm iM CaNreeon Licenee lew la Ihe
Idlow'uip reeeon �Serfion ]031.5 &n'wwae end PMawiona Cab: Rny cAy or muny which �epuiree e permn �o omeWct, ellx, impraro,
Jemd'oh, p rpei vry aVucluro, pv w ea uweiae, e6o repuiisa �M epplirenl ta wch paimil lo fib a eipmE �telemeN IIW he a eM
licen�d punuent lo �M povivms d tM Conireaaa Licenee law ICheqx 9lmmmen'iiq wn� Sedian ]000) d Orv'aion � d tM
�aineee enE PrWeeabne Codo� or Ihel M or ehe ia eRemq ihselran arW Ihe beaia lw Ihe dbped exemqion. My vbletbn M Setlian
/W t.5 by eny applira�t I« e permn eubptla �M epqceM lo e dvil peraly d not maa then INe hurdred Edlen �5500��.
Q+ I. ea evmar d ihe O��Y or my mmpbyees wih wepes d �Mi aob oompeneetun. will Eo IM work. eM IM Hrucluro u rwl inleMed
a olleraE Im eab �Sec�ion l0«. Bupnev end Vrolnaions Code: TM Comrecion Licer�sa lewdoea � appyto en ownord O�M
wM bulAe or inpovm tlwism. xd vRa Eme suM waklimaetl ar Mrsel a Waqh he a Mr own amplv�ee�. pv+ided ihtl ach
'mCwemmu ere nd inlentled aWxeE lar eeb. p.lwwe�er. �M EuiHiM u inP�'�eM is wld wil�in ona Yeer d comdMian. ihs
anrier�Wi4ler vnll M1eve tM buMen d provin0 he or eha did nd build w impmve la Ihe WTae d eeb�.
❑ I. ro ovmx d iM V WMY. em azduavaN mmretlM xilh 4oenxE can4Mon m oonmutl IM pMa (Sedion IOM. &nm�� and
Pmfenian+ Code: The Canlratlon L�aroa lew Aom na eOMY ro en oMner M O�W�Y wM Wike a impwo ihaaon W Mc
convazta lor wM wM�� � e ooMrodmle) Icenead punuem to ihe GaNretlas Littnaa Law).
� I un manq urdw Section: B. 8 P.C.. tar Nu ieeaon:
Dete: Oc+ier
I do Ir�abY undY Nu I em ewer� d vd u�denuM the iapuiremeM W arrie HeeM end Se1W Coda Setliom 25505.255JJ. md
25.Ua. uq tM1m 1 a eny Mura WiMirp oowpent will / wll mi (tlrcb wn to wih vaid uma end tM npu anb br
apammlammbuctianamoddwionkam�MAi�iaSi�iy anpmwv �amA en Nre
pwuotu.
Dale: /�pa�:
WOPKEH'S CO PplSAT N DKL�PATION: I heraby dfirm wder psnMy d psjay me d �hs to0orriiq iom:
❑ �nm..newNmvm.n.cansw.donneN�o.w;vu�.rorMOM1en�om,ro��.a+wo�eea�«Msm�s)ooa�n.lebor
coe.. �« �n. wnmrerc. d N..m �« »tid, �N. v� a a.�a.
❑ i n....�w �:� nwmen �.on.n� w�v��, ���. m�a��a M sm� a�oo a ue ien« cm.. �« m. ro��m+nca w �n.
wak Ia xfiidi Ih'v G�� b 6�iwE. My waMn' mmP�ion iiuwerca wrier end W�Y riumber ers:
Cemec
Pd'eyNumber.
iis eeaian rie�M rwt M canWMed l IM 0�1 is b aro hurMrM ddlers (J�001 a bea.J
❑ I cerlEy Nel in Ihs perlomunce d the wwk la xAch thn permd ie ivuad, I ehell iM emdW �Y Ge� �� Ny menner eo m to
beiwne wbjrf �o tM v.arFers' mnWanWion le�+v d CeGlmiie, enE eprea Ntl p I kiwW berome wEjed �o IM xohre'
�c«i.mion w�on. a swion a�oo a ine leno. coa, � awi �ortmwn w�W ..w ino.. pwi.ion..
De�e: ApqcenL
W�minp: Ftl/un ro�wun xroikeri romWwXon cmx�p� b unbw/u/, anJ �MII �ubpcf m�mplopr ro ctlMrpl pmalHa nb
clvll flrwa yv N on� hu�GM fMuurd dolbn (SfOq000A ��Itlon b M� cwt o/ rortp�wtbM1 Wm�q� u provltlM br In
Sectlon J�G6 0/ fM IaborCob, Inf�nat. �nE �ttomry'a /w.
CONSTAUCl10N LENDINO �OENCY: I haroby elfirm under psnelty d parN�Y �� ��n m e wn��uabn bnEiip epency br IM
p,n«�,�, a in. w�m m..nKn me o«m� a:�»a ts«,� soe�. cw. cl.
LENDEfl'S NAME:
LENOEH'S AOUHE34:
I cenih �het I hew reeE No eVWiWion ud nels �Mt Me ebova iMwmeton u c«rea. I qpee lo canWY xilA M dlf' uM oou�nY ordim�s
erM eiete bws ralm'rp io buJdmp cmX�uCian md Mreby eulhor¢e �epmanletivea d �Iw dry ro enlx upon tM ebo.a�membneE piapMy
���'�'"u'�' DANIEL HOWAAD
vNvr
� � Dme: 2
5 un /�A�r
(SISIJB.WP) W�Ns�BiuM�qBSelery:GerorFb:CuwyAppiraiu:Rnk�iw�xnn:Oddmvod-Atrom
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: B 072479
PLAN CHECK C70: 01940-95 S
f�F,RM M1iC�� p ij7_!�7+i
GOVT: N SUPn: N
CONSTRUCTIUAI TYPE; PERMZT TYPE: S2R PURFOSE: UTH
JOb LHSCRIP7IUN ; CITY STANDARD BLOCK. WALL SQ FT: E7
CLAIM VALUE: 1,900.00 CALC-PALUE: 1,340.00 GROUP OCC: R-3 /
COMMENTS: 67LF CZTY STANDARD BLOCK IdALL
iF iF M �F i4 iF M'R'JF'lE i'� iF iF'� 1f iF 1f iF'iF iL iE'IF if i�' if iF i4 Y')t i� Y i4 i4 iF Y{L iR iL Y if iF i4 i'� iF i4 # ri� iE �k #! iF if if ii dk �F iF iM jF Y' i! iF T iF }. i�' if'1F X� i4 if X if �F 1F iF'X' if
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
------------ MAZDI HUILUING ---------- --------- ACCESSORY BUILUING ---------
FRD7T; FT IN REAR; FT IC7 FRNT; 20 FT IN P.EAR: FT 6 IN
LEFT; FT IN RCHT: FT It1 LEFT: FT IN RG?iT: FT IP]
FARKING REQ: PROV; PARCEL; 42519119 ZNE; R2 REF NO:
PLANNING NUTES> 67 LF OF 6 FOUT HIGA BLOCK WALL ALONG (BUT 6" INSIDE) REAP.
> PROPEATY LINE OF 2-UNIT CONDO PROJECT,
if dEif 7�'iE iE�Y 1I-+f'lE i4�IE 1f iF ii�af i! af Y 1E ii iE Y if i��)i-tif iFiF if iE it i(�if �E iF aF if if-lE iF�R'lE�li af 1E iF iF K iFif iR ik aF �:j4 iF ii�iEi! lf IF iF-1F af if i4 ii�ir df i!�f(�ii i�'if ]E Yf-)f if�
D E V E L O P A1 E N T S E R V I C E S R E Q U T A E M E N T S
20rlIP7G ALPROVED BY GQ DATE: Z�SI�I�
BUILDIPIG APPROL'ED HY ; DATE;
APPLICATIODI ISSUED BY: � DATE; � 23 �`U
�ltuaFv.��c*�u*+t�t*r>*rir-M�tir�t�F�iF�TriFriz���i�e.��T�+rx++r,-�+++x��r.Z+��+�L.r+�r.ra��r�xx .3 ��.. �,r.-+w�s�.r+
LEGALZZATIQN;N F E E S U M M A R Y STAUCTURAL ScGMENT:Y
bLDG PMT FLUMBING ELECTRIC MECAANIC FZRE SMZP/RES GP.AD7NG
PERMIT 33,00
PLAP7 21.45
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAP]-CHECY.
TOTALS----> 33,50 0,00 21.45
REVENUE UIC�ISION TOTALS--> CULLECTEL;
BLUG PMT PLUMHIDIG ELECTRIC MECHANIC
33,00
50
SMIF/NON-RES
TOTAL PAIL� UUE
54.95 54.95 .OU
54,95 OLTER/SHORT; .QO
FIRc SMIP/TOT GP.AD2NG FLATI-CHECf:
.50 21.95
'If ii< �f4 JM1jf'K"M'{EifL 'vf jc 3f 1f ic 1f�iF'4 1F'V'�F 1f if V if if'�f if i't 1f'M'1f } 11'IFaF if'�l'�('al'< Y'N b tf Y i4 T'1f iM1Y ii�'Y iFi("1f ii'if'11 1M1 M 1f �f iF M tif iF M' M M'j1- Y�iF �L {f
I Dl D I �' I U U A L F E E B R E A K U O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL CUST
SFR 67 RES-COPICRETE HLOCK WALL ; FT. 20.00 1,390,00
ENU OF FEES
O1 00183551-ODIE2553 Ta7 T 54.S5
DATE: OS/23/95 [ItiE: I1:1`
-CONSTRUCTION AN� PLANNING POOI '.PA
qPPROVALS Permit # Date Inspector APPqOVALS Permit # Date Inspector
1. Terr�Porary Electrica� Service or Pole 52. Poo� & Equipment Location :
2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement
3. Elettrical Conduit Uiility�Undrgrnd. 54. Form"s
4. Electrica4 Conduit�Undrgrnd. 55. Electcicai 8onding �;
5. Steei Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE �
7. Footings � 2�{��� C{.� 58. Electrica� Conduit-Undrgmd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd.
10. Structural Floor System 67. APPROVAL TO OECK
11. Prpperty Sewer Line & House ConnecYion 62. 8ackwash & Receptor�Finat
72. Sewer Cap 63. He�ter & Vent-Final
13. Roof Drains 64: Plumbing System - Final
74. Rough Plumbing 65. Electrical�Finai
�
15. Rough Electrica6Conduit 66. Solar SYstem�Pinai �
16. Rou9h Electric Wiring 67. Fe�cing & Access ApProval �
1�. Rough Wiring Sign 68. APPROVED FOfl PLAS7EflING .,
78. Rough Electrical-T Bar Ceiling 69. PQOUSPA SYSTEMS FINAL
19. Rough Heatinq & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough factory Pireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & 7est 72. Underground Flush
24. Roof Framing 73. Undergmd. Siorage Tank � Gas ❑ Oil
25. Roof Sheathing � 74, Overhead Hydro �� .-� �
26. T•Bar Ceiling (Structura0 & Monocoat 75. Dry Chemicai
27. Frame and Flashing 76. Dry StandpiPe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. InsU�ation 78. FIRE PREV. FINAL
30. Drywall Nailing HEAITH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electricai Power Meter�Pinal 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Fina� Gas Pipe�Test
36. Hood or Canopy �
37. Final Factory Fireplace
38. Final Plumbing ^
39. WatB� Service�Final . , .
40. Gas Service-Final
41. Sola� Domestic-Final
42. Backflow Preventer
43. Backf{ow trri9ation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING -� ,y�S �(y��
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Retease to Southern Cafifornia Gas Co .-
51. CERTIFICATE OF OCCUPANCY
No. Oate
i � '�
DECLARATION OF AUTHORIZATION FOR AGENTS OF
CONTRACTOR TO APPLY FOR PERMITS
Ralph E�erson
person(s) to obtain permits on behalf:
�
IGNAIUR
Daniel B. Howard
PRINT NAME
SIGNANRE
SIGNATUflE
PRINT NAME
declare that I hereby authorize the folbwing
DRIVER'S LICENSE Ofl SOCIAL SECUFITY •
DFIVEF'S UCENSE OP SOCIPL SECUFITY ♦
ORIVEflS LICENSE OF SOCIQ SECUflITV �
2. I will also file a Workers Compensation Insurance Cert'rficate, issued by my insurance agent,
covering ail persons employed by myseH, my company or corporation prior to the issuance
of any pertnits in accordance with Sedion 3800 of the State of Cal'rfomia Labor Code.
3. I understand that my signature below acts as a continuous authorization until a written
document cancelling such authorization oi any or ail of the persons listed above is rece'rved
by the Buildi�g Division. Any additions or mod'rfications will require a new fortn.
4. I agres to indemnity and hold fhe City of Costa Mesa and 'Rs employees or ofiicers hartnless
from any claim resutting in damage or personal injury to myseli or any other parties as a resutt
of work authorized by the permits from the Ciry of Costa Mesa.
5. I have read and understand the above statements as they pertain to the issuance of pertnils
by the City ot Costa Mesa and the Califomia State Contractors License Board.
6. I declare under ihe penatty oi perjury that the fore�ing is true anc�orrect. Executed this
Eighteenth (18�h�f
Y
May
May 18, 1995
oarE
WESTPORT GROOP, INC.
COMPANYNAME
9 95 at ��nge County, Cal'rfomia.
x�,l.ph Emerson
NAME (PRINTEO OR TYPED)
Chief Executive Officer
1936 L. Deere J1ve. , @216 --
COMPANY �DORE55 STATE OF CAUFOqNIA CONTiUCTOF5 NUMBEfl
Santa Ana, CA 92705 _,
CAMPrWY PMONE NUMBEF CUSSIFICaTION
AN ACKNOWLEDGEMENT BY A NOTARY PUBLIC OF
CONTRACTOR'S SIGNATUfiE fS REQUIRED. �
ATTACH COPY OF STATE CONTRACTOR'S UCENSE.
�eca-acwW ITV.sreaJ
� i�� �
�
�
CALIFORNIA AL4PURP ACKNOWLEDGMENT
_
State of CALIFORNIA =
County of o�N�E
No.590]
Qn May 18, 1995 before me, RObecca S McGahp� Notarv Pnhlic,
DATE NAME. TITLE OF OFFICER - E.G.,'JANE DOE, NOTARY PUBLIC
personally appeared Ralph I�erson ------------------------------
NAME($) OF SIGNER(S� ,
C� personally known to me - OR -❑ ' ' �
to be the person(s�' whose name(.aj"�ere-
subscribed to the within instrument and ac-
knowledged to me that�sk�efi#�ey executed
the same in �/k�er-Lt#eir authorized
capacity(iesj, and that by ii /Fie�/-t+rei'r
signature�sj' on the instrument the person(sj,
or the entity upon behalf of which the
person(s� acted, executed the instrument.
REBECCA S. MC CABE
Q � COMM. i10E4173 Z
z•-� , Notarv P�Oc — CaOfaNa �
Z '�' ORANGECOUMY
AAy Comm. E�tree OEC 23.iG98
WITNESS my hand and official seal.
OPTIONAL
11'iQ , � !yL�'� '.�.
$IGNATURE OF NOTARY
Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
(raudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT
❑ INDIVIDUAL Decla=ation of Authorization
� CORPORATEOFFICER for Aqents of Contractor to
Chief Executive Officer —'�`
I E OR TYPE OF D UMENT
TIRE(S�
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
❑ ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
SIGNER IS REPRESENTING:
NAME OF PEflSON(S) OR EMIN(IES)
Westport Group��nE,
One (1%)
NUMBER OF PAGES
May 18, 1995
DATE OF DOCUMENT
Daniel B. Howard
SIGNER(S) OTHER THAN NAMED ABOVE
�7993 NATIONAL NOTARV ASSOCIATION • 8236 Remmet Ave., P.O. Box 7184 • Canoga Park, CA 97309�7784
PNOJECT PDOflESS: 3 6 B E 1 6 TH $T UNIT: �
OWNEP'SNFME: z9O 16TH ST ASSOC
aooREss: 1936 E DEEAE N215
SANTA ANA, CA 92627
• 263-1920
.+ FflCH/ENGINEER: DON FLAI R flEG.NO.: C S 2 9 2 O
aooness: 17 8 7 5 VON KARMAN uxiT: q a q
IRVINE CA 92174
PEflMITTEE: zjO 16TH ST ASSOC LP (719)833-5047
nooxess: 1936 E DEAR AV 215
S,A. CA 92735
❑CENSEO CONTNACTOP OECIANRTION: I �ereby ai�irm lha� I am licensed unaer pmvision5 0l C�apter 9 �commencinp wit� Se[tion
]000� oi Division 7 al I�e Busine5s and Pmiessions Code. anE my license is in full lorce anG e��eci.
ciTr uc.: srare uc.: cuss: EXP :
�ate: Signalure:
WOPREHS' COMPENSpT10N OECLAHATION: I �ereUy atfirm t�at I �ave a certilicate oi consem ro sel6insure or a certifiwte ol Warkers'
Compensaiion Insurance. or a ceniliea copy t�ereof (Section 3800. La�. C�.
POLICV NO.: E%P. OATE:
COMPIINY:
❑ CerlilieU tOpy is hereby �umished. ❑ Cenifie0 copy is filed with t�e city Building Oivision.
Jate: Applicant:
E%EMPTION FNDM WOBREBS'COM7ENSRTION OECIANAiION: QAissecuon M notbecomp@�eCiftAe permilisiaane�uMrM�S10U)orless�,
I certily ��a� in I�e pedorm ce o� I�e work for which �his rmit is issu I shall no� employ any Derson in any manner so as �o �ecome
su�jectlo Ine 4° rkers' C pen tion laws ol Califomia �„ ��
<�.
Oate: �� � � Signa�ure: �
NO71LE: Ii. aite makin Nis Oeclara�ion, you s�ou hecame su01�� ro tAe Workers' Compenution provisions ot tAe LaUor
Code. you musi forl�wiih compty wil� suth pmvi ns or Nis permit 5�all �e tleemeU revokeG.
CONSTBOCTION LENDINC AGENCY: I h¢re6y a�firm t�at I�ere i5 a canSlruCiion I¢ndinq apenty lor Ih¢ petlormante 01 Ihe wo�k fOr
w�ic� ��is permit is i<sued �Seclion 3097. Civ. C�.
LENDEP:
aooeess:
OWNEfl BUIIOEfl OECLABATION: I hereby allirm �hal l am eeempl irom Ihe Conlraciors' State License Law �or I�e lollovnnp reason
�Section 7031.5 Business antl Pmfeuianal Coae: Any city of coumy whic� repuires a permi� to constmcL alter, imprwe, GemoliSR or
repair any 9mcture, D�ior lo ils issuance. also requires Ihe apDlicant for sucA permit to file a sipne0 statement ihat APlshe is IicenseU
pursuant io Ihe provisions oi ihe Coniractors' Sta�e License Law �ChaO�e� 91�ommencing vnl� Sectian 7000) oi Division 3 of t�e Busine5s
ana Pmlessions CoOe) or ihat helsne is eKempt tAertlmm an0 �he basis br the altepe0 ecemptian. Any violation of Section 7031.5 by
any aDDlicanl br a oe�mi� subiecis ine aDPlicant to a civii oenalty ol not more tAan live hunOreO �ollars 135001.
I, as owner ol Ihe pmpertY or rtry employees vnih wages as their mle wmpenu�ion, will Eo tAe work, antl IAe
❑ stmcmre is not inlenaeA or oilereU foi sale (Secuon 7044. Business ana Pmlessional Code: The Coniracrors' Staie License �aw
tloes not ap01y ro an owner ol a property who �uilds or impmves t�ereon, anG wlw Aow such woA �imseli/�erseli or e�mup�
his or A¢r Own employees, pmNOetl Itu� suc� impmvemeni5 ar¢ no� in�¢nG¢E Or OfleaO fOf Sale. Ii, however I�e EuilCinq Or
impwvemenl is 5010 wittlin one year ol compl¢�ion. I�e owne� vnll have the burG¢n o� pmving he/ihe ditl no� Euiltl or impmva
for ihe outpose ot sale).
I. as owner of Ihe O�operty. am exclusively conirac�inp wilh IicenSeU contraclors la conslmq Ihe pmleci 45ec�ion 7044, Business
� antl Pmfessions CaEe: the Contracmrs' Stale license Law Eoes not apDN �o an owner of pmperty wtro Emlas or imDroves thereon
anU who camracis lor sucn omlens with a coniracmqs� license vursuant m the Contracmri Stale License Law�. I am awam
that prool oi �heir Worker'S ComOensalion insurance 5�ou10 be D�ovidetl lo me
� I am e: emp� u er Seciion: B. 8 P. C.
tor tl reaso �
L
Dare' � f Owner
I tlo nere ; ceniy inat I am aware oi ana understan0 ine requirements ai Califomia Healih an0 Satery CoEe Sections 25:A5, 25533, anU
255Ja ane thai I or any fulure OuilOing occupanl will/wiil not (circte onel neea m comply with saiE state cotles an0 ine reQuirements for a
permit for con9mction or rtwailicatian imm ihe Fit Ouahry Management psiritl. fle9Geniial cOnSimction aDP�iWiions are eaemp� irom
��ese pmNsions.
Dale: Ap0licanl: _
I hereby wr�ity �hat I have reaa Ihis applicatian antl slate ��al
o�tlina�n ands9a�elawsr �atingio uil0ing consimtlion an0
pmpetly lo�ion p Doses.
.
Daie: Signalure:
Driver s License or Social Security •: �
—Applican�: Pink—Revenue; GolEenrotl—Assesaor
�� CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 06968_
PERMIT NO: E 069685 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE; ELE PURPOSE; NEW
JOB DESCRIPTION ; 1119SF 2ND FL, 872SF iST FL, 441SF GARAG SQ FT:
CLAZM VALIIE; CALC—VALUE; GROUP OCC: R-3 /M-1
COMMENTS; REF; B-69684
w*xxwrxx*�r�r�r�rr�rr**�+r+rxxir+r�r*�r�r�r***+t**�r***�t*�*x*r+��r*+e*�***r*�r�r*�r**+r�r�r�r*********x��r
2 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 HUILDING ---------- --------- AC[ESSORY 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; 42519119 ZNE: REF NO;
PLANNING N6TE5>
i
�r�r*�r�r***�r***xir*wr+rw�r**�r*�r�r*****r�rr�r*****rr**x*�r�**rr*+*+r*r*�r+r**�rr�+r**�r*******�r*�r
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 HY: DATE; ��
if�lfifif aFk if if if iFif i! if itif k 1fM if ifif 1f jf iPif if if if it it iE if if
if KM ikiFif if if if if if fE if 1f i! Mif i� M j! iF if if M �f�Mafff if �Fif 1l%1f ilif 1f iFif if MitM 1f M if jtlf iF k%if flif ifjt jf if K11 if�f iFif jEjf jf af �f if aFif af af if 1f if ifif
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 15.00
50�
PLAN
ISSUE FEE 15.00
FIRE SMIP/AES GRADING
SMIP/NON—RES
BUILDZNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 15.00 15.00 0.00 30.00 30.00 ,00
AEVENUE DIVISZON TOTALS--> COLLECTED; 30.00 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANZC FIRE SMIP/TOT GRADING PLAN—CHECK
30,00
if il1F M �Fr it 1f 1fili! % it if ilif it k M if 1f1f Mk r if if ifMifif k �t 1f if !f iFM if if if if if iF if Mif iEff if if M ifit i! ikif kif if iF if if if M 1f af it itif it if 1f ifififif itif
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
ELE 1 TEMP SERV PWR POLE W/OUTLETS EA. 15.00
END OF FEES
01 00170803-00170E03 TO T
DATE: ±0/31/4; TICIE: 11:24
15,00
30.0�
CONSTRUCTION ANDPLANNING POOI 'A
APPROVALS Permft�` Date Inspector I qppROVAGS Permit# Date Inspecior
t. Temporary Electrical Service or Pote �/ y9 �2, Pool & Equipment Location , ' .,
.�
2. Soil Pipe-Undrgrnd. 53. Steei Reinforcement '
3. Electrical Conduit Utility-Undrgrnd. "� � 54. Forms '
4. Electrical Condui;-Undrgmd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. �Electrica� UFER Grnd. 57. APPROVAI TO COVER�GUNITE
7. Footings 58. Electrical Conduit�UndrgrnA. ,,,/ �
8. Foundat�on 59. Gas Pipe, � Undrgrnd., Test . '
9. 4Vater Pipe-Undrgrnd. �-� 60. Backwash Lines, P�Trap, O Undrgmd.
10. Structural Floor System 67. APPfiOVAL TO DECK � �;
17. Proper.y Sewer Line & House Connection � 62. Backwash & Recepmr�Final �- �. - i
12. Sewer Cap 63. Heater & Vent�Final �
13. Roof DrBins • �. 64, Plumbing Sysiem - Final �
1
14. Rough Plumbing � 65. Electrical�Finai
15. Rough Electrical-Condu�t 66. Solar System�Final ���
16. Rough Electric Wiring 67. Fencing & Access AnP�oval '
77. Rough W��ing Siyn' 68. APPROVED FOR PLASTERING �
18. Rough Electrical-7 Bar Ceit{ng 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEP7. REQUIREMENT I
20. Rough Factory Firepiace • � � APPROVAtS 'Permit # �
21. Ducts, in Structure „„ . 70. Underyiound_ Hydro
22. Ducts, Ventilating � ' 71. Product Pipin9 L� Gas L] Oii
23. Gas Pipe•Rough & Test �: .. . 72. Underground Flush
24. Roof Framing- . � .� � . 73. Underymd. Storaye Tank � Gas � Oil (
25. Roo` Sheathinq ' 74. Overhead Flydro
i
26. T�Ba� Ce�ling (Structural) & Monocoai • • 75. Dry Chemicat
27. Frame and Plashin9 ., - 76. bry Standpipe � �
28. La.hing & Siding �• � 77. FIXED SYSTEM FINAL
29. Insulatien . ' �. � , 78. FIRE PREV. FINAL
30. DrywaO Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ��� , PINAI INSP.ECTION � �
32. Electrical Power Meter�Final �//�/L I/�'� �`�0. FOOD CERTIFICATE ISSUED
C 7�
33. Final Electric 11/�/ry� �Notes: . � '
( �(�
34. Final Heating & Air Conditioning , . . �
35. Ffnal Gas Pipe-Test , � , '
36. Hood or Canopy _ , �
37. Finai FactorY Firepiace ' �
38. Final Plumbing .. ' . j
39. Waier $ervice�Final • �
40. Gas Serv�ce-Final � . , - �
41. Solar pomesticFinal � • '
42. Backfiow Preventer �
43. Backflow Irrigation !
44. landscape irrigation System � - , � �
45. Sound Attenuation ' � - � � �
46. Handicap Regulations ' ��. I
47. f INAL $TRUCTUAE & 8UILDING "
46. FINAL PLANNING � - �
49. Electric Release to Edison . - �
50. Gas Reiease to Southern California Gas Co . �
5t. CERTlFICATE OF pCCUPANCY
No. Date
COUNTY OF ORANGE
- BUILDING DEPT.
636 No. Broadway
San[a Ma, CdG(omia '
Phone: KI 2-6211
1. OWNER'S
MAILING
Namc ............
Address __..___.
City ------._..
State
Lic IQo.----.....
PROPOSED
3E
2. J013 LOCA"I
�
�
Application for Building Permit
AND FOR A
Certificate oF Use and Occupancy
. � 't' �
a
Permit No�� `5-------•------�---�;
Date.... . ...... .. � - �..../....--.....---.....----..
HONE:- ----�--------- --------�
-�..-�.��l.._�.--....
Name ._...������kl� ....�-�"--"---- ......................
/ (Concractor) �
Address -�--`--`�-------- --...�-'-1""""'•"""'-"..
City.-�--- .. ........ . . .'_........---"-----'-"'_-'.....------
State
Lic. No.---�L�/1�---- ................... Phone�.�A._�6_�-_�'iJ�
(Amhitect or Engineer)
Phonc...-------.....-------..........
, (Name of Strcet)
�_
3. LEGAL DLSCRIPTION: Lot..._.,.��2..:.._......_ ....................Block
(Metes and Bounds Deacript�on—Use rcverse e�de o( form)
(Town or School District) � .
- -------......._._ Tract��.%/"c!� U
4. CO2NER LOT ( ) INTERIOR LOT (✓) THRI�UGH LOT ( ) SLOPE OF. LOT ( )
i. SIZE OF BLDG.:.�o?:X-v?:-�.--.-----AREA:----��._8 ..............SIZE OF LOT:�.S�. X.�_a a..-_-.---.AREA:.l�..��.a.....---...
G. HEIGHT OF BLDG.:........L.O....._.......___...__..CEILING HEICHT:......R.'....______....._....NO. OF STORIES....._..L .....................
7. NO. FAMILIES......._......_..�/ ...................Si4e of Smallest Bedroom:..l�X_1.1�.._._...__....__ Size of Kitchen�a__�1�?r.:...............
fi. EXTERIOR WALL CONSTRUCTION:_..__ ....��.....ti...4a ............._INTERIOR WALL
(Frame, Scucco, Ecc.) (P:
9. SETBACKS: Front Yard From Center Line of Sveet...n�7S�...lA.(�-kr�2a�i�....�C
v -
Nearest Side Yard...__._.. .I.�.-..-Rear Yard.. .�tr�.....yL._.......Distancc in Fcet Between Bldgs. on Same
E[c.)
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
Il. For
Acce�sory
Bldgs. and
Similar
Structures:
(a) Footing: Width____......__.�'�.
----_---------------Depth in Ground.--_�-?2----..........Wi�thaf
O Size of Swds:... . X. . �b "CC Material of Floor ....... ...... .
b a�. .........5 acin �
% P g-.. ---- - -- -.... . ........._ ........... ..�
(c) Sizc of Floor Joists:.�'----- .............---.Spacing------------.........._...------.....:'CC
(d) 5ize of 2aftcrs:e�Xii `4_...��J.C.Y�........-......Spacing---��-•..�.��...'�_ 4---...._..:'CC
12. VALUATION OF PRnT �'P SED I�RK: Induding all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage dispo_=al 5....----1P-J..�.---------....----�
13. I HEREBY CERTIFY THAT TO THE BEST OF MY KI�'O,WLEDGE AND BELIEF THE INFORMATION IN THIS
' APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OP
THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APP�E TH E� •
O�
/� Signed
Plans Filcd:...._.....�5. �' 7/� /
. _ _.......... _f -----' --------- ------------............. B Y
FOR DEPARTMENTAL USE OIv'LY
' FEES: / /' � CHEGwK�/NG BY
Bldg. Permit • $.------.--�� r Cf(Y) GROUP--•-- ---. �J..---._.. APPLICATION.��"L1 l�HEALTH----_ .............'--_....
Pl:m Check • $...---•-'�-.r_CiP�.,; TYPE ........ ................- ..
- ZONING � ...---.....� FIRE
Total , , , $.........- ' .�._�..... DIST. P� d MARSHAL- ------.........._
` ry PLANS AND v
Recci c No. . .� Zi MAP .................. ...... ....... ....
p ..... - -.... � �i ' SPEC'5 ........... .. ............... STATE. ---- --......... - .......---
Paicl to • • .......,_ ' l:r�' SHEET NO...._�^? ................. CORRECTIONS ENGINEER
-
--�� �
Date .....----------------------� .�-��t--- ---. . _..__._ _ . _ . . VFRTFTFTI (lA7
' r1�f:tit�l:i�i�.��' ' • -�
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V
OWNER wrr.r.RnwF r.nnrs��, r.nnranTav, rnTr oA'I'E ��[A _
JOB ADDRESS 368 East 16th Place BUILDING PERMIT NO. '733'1
GENERAL CONTRACTOR T_ p_ �rpgg _ VALUE $ 13�7C�7.00
AP. No. LOT �n TRACT'�q��[', FIRE ZONE DESCRIPTION OF WORK ���
' �UP I TYPE V ZONE R.I� PLAN NO. 'I�Z1
INSPECTIONS I DATE I SUBCONTRACTOR (
DATE NUMBER
7'rcnches Forms Stecl 2'�—d'',.� O`,�Q'$� -
coat
r..,di
'il
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�COSTA MESA BUILDING DEPARTMENT
P.O.80X 31�
' COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
368 � 16th Place
COSTA MESA, CALIFORNIA
OWNER �LGRO[�E CONSTRUCTION CO.� INC.
RE55 11933 Stanton Blvd.
ADDnc55
. ,, _ , . R .
-.s. r�."v�:.: J,��_
� z1y C� s��Y6/�Y s�Y o0
� FI�",NCE DEPT,
^_ �ncTa r;��
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
FECEIPT NO.
0 iJ� t�
RECEIVEO BV OnTE RECEIVEO O4TE ISSUEO
.�..,./ A_ �c`..,.� SEP 419�
California TNo: T1'1 3-3135 InooRE�ss .
:�n' COSTA MESA. CA�IFORNIA
GIqE
CITV LIC. 20NE PLO�1N5 TVPE �
CONTRACTOR T.P. GTegg No.
ADORE55 11933 Stanton B1Vd.� TNo: na 3-3135 BYP OV D DATE
"`"` �} CORRECTIONS
OESCRIPTION ryOT lO BLOCK TRACT J�S
A.P. NO.
' `i2�"S x 135��• Il�IOW ON LOTS
USE OF
EXISTING BLOG
SEIOACK LINE FROM
CErvTEN OF STREET �Or iEAR YARD ��T
SIDE YARD Y� ftIGHT 1`� LEFT Ll
DESCRIPTION OF WORK
X
NEN' ALTERATION ADDITION
REPAirE MOVING DEMOLISH
SIZIE DING 'ZS x S'r ROOMS � STORIES �
EXTERIOR WALL �uCCO ROOF �__
� /
STATE TMtT TXE RBOVE IS COflNECT 4N0 iG O COMPLY WITM ALL .
CITV ORDINANCES AND ST TE LLW EGUI BUILOING CONSTRUC�
T�o�. VALUNTION
SIGNATURE OF
PERMiT FEE S �� —
PERMITTEE
g /� �� � _ PLAN CHECK 5 �L �
AUTHORIZED AGENT TOTAL FEE $ �� � ����
OWNER KLEVEN, EDITH DATE 10
]OB ADDRESS jb8 E. lbth StT�Bet � BUILDING PERMIT NO. 7']�j7
GENERAL CONTRACTOR �'�R12P VALUE $ 500.00 �
1� P. o. LOT S6 TRACT FIRE ZONE DESCRIPTION OP WORK ?�`ire-nlar.e
INSPECTIONS I DATE I 8UBCONTRACTOR I
DATE NU
coa[
I '�inq Fix[u
6__. Gas Test
I I ��/
.�
�OSTA MESA BUILDING DEPARTMENT
P.0.90X 31]
COSTA MESA. CALIFORNIA
F^OR APPqLIC NT O F LL IN
BUILDING ''h �/� (� / �
nDDRE55 � 1% (/
COSTA MESA. CALIFORNIA
c.i.v.��:i
/n� l7 /]�/ V � TEL.
��T� u����c � �o.
ARCHITECT LIC.
OR ENGINEER NO.
QTY �IC.
CONTRACTOq NO.
TEL.
ADDRE55 NO.
�[cnt LOT
DESCaIPTiOrv NO. BLOCK T
A.P. NO. ��
SRE j� No. ov e�ocs. ,
OF LOT �/ MOW ON LOT
USE OF �
EXISTING BLDG. �)
SETB�CN LINE FROM y /
CENTEA OF STnEEi REAR YARD �-/
/
SIDE YARD RIGHT I, LEFT
- DESCRIPTION OF WORK
� NEW ALTERATION AOOITION
�REPn . MOVING DEMOLISH
BUILDING NO.OF
SIZE ROOMS STORIES
E%TERIOR WALL i T ROOF
COVERING �'FJ COVERING
USE OF NEW � /1 /� /I
BUILDING � u.,�x
��� R���Vf��
/�� /o -S�F
� ��
AP .L�CA�TI.�'"O�N�ItrO�.,R, PERMIT
BUILDING
FOR OFFICE USE ONLY
3 6 �'' � /G t�
COSTA MESA. GALIFORNIA
'�� �L/ �(Y'/R f J (� [
O
�/ DATE / %
CORREGTIONS
CITY OF STA MESA
� r .
SUBJECT TO DG. DEPT. REi
sY ' na,r d-
GI AN T-�
f� _ i � . ._. _'� r� LF ��
$TRTE TN4T THE RBOVE IS COXRECT 4N� �GREE TO COMPLY WITM PLL
CITV ONOINnNCES /.NO ST<TE L<WS REGUL�TING 9VILOING CONSTflUC�
T�O�. VALUATION '
SIGNATURE OF � � PERM�T FEE S
PERMITTEE ��
O U P�AN CHECK 5 �'�
AIITHORVFO Af.FNT ~� TOTAL FEE 8 �_ �,
r
�, JOB ADDRE�SSCE3 E.Rl th St. BUILDING PERMIT N0.�38545
uwntK
�GENERAL CON7RACTOR O�rrier-Bldr• DESCRIPTION of WORK Add Fam.I�. & Bedrm. to Res.
w 0^ Vo. ].17-271-32 LOT TRACT fIRE ZONE VALLIE S 3_000_00
SUBCONTRACTOR
PLUMBING
SWR. LINE I-I MOUSE CON.
MISCELLANEOUS
ROUGN HEATING AND AIR CONOITIONING
UNOERGROUH� U POWER
ROUGH WIRING
TRENCHES FORMS
FLOOR SYSTEM
SMEATHING
FRAME AND FLASHING
5' T
H. F
GLOMBI
FL, FINAL
VENT., REFRIG. ANO A.
, FIN/.L AND GFS TEST
ELECTRIC, FINAL
BUILOING. FIN4L �.2 i_ �
�- :;a5 s
�
. COSTA MESA BUILDING-SAFETY DEPARTMENT
P.o. BOX 72a0 COS7A MESA. CALIFORNIA 92626
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m�.,z-����,.—�.or,�zs� 35.�0
PP ICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
R V D DATE RECEIVED DATE ISSUED
_BUILDING � �, ���� n�I, C.•'�1 !� �,_��
XADDRESS �T ��
'OWNER � QQC A.P.NO. II " " P S
MAIL BUILDING . / �
ADDRE55 ADDRE55 �
TEL. � P
CITV NO. TRACT LOT BLOCK
CANSTRUCTION W A D A P
LENDER �/'
�
BRANCH
OWNER I �Ge�
AODRESS ALUE �/�yj�
ARCHITECT TEL. S $ d`V�/
OR ENGINEER N
FIRE �
ADORESS ZONE PE GROVP
APPROVE
CONTFACTOR Q — BV DATE �
ADOFESS
TEI. ZON NO.OF USE OF NEW
FLANS UILDING
CITV NO.
STATE CITV 1'ARDSAPPROVED VARDSAPPROVED
�IC. NO. LIC. NO. MAIN BUILDING ACCESSOpV BVILDING
SIZE NO.OF BLDGS. (FROM C/L ST T)
OF LOT NOW ON LOT RONT FT.
USE OF
EXISTING BLDG. T FT.
SIZE OF / � NO. OF
NEWBLDG. �� b� FOOMS STOFIES L.SIDE C FT.
EXTERIOR WALL qOOF /
COVERING +VCCO COVERING COW1- REAR �`PFT. FT.
USE OF BUILOING AND WOfiK YO BE PERFORMED DISTANCE BET. BET. MAIN &
MAIN BLDGS. ACCESS. BLDGS.
A � /// . C VRP # /� AOPqOVED
. APPROVED � ���7 �/3_7. /
Y
I hereby acknowletlea thet I have reatl this aDP���ation entl state $�
thet ffie above information is corYact antl aBree to comply wIN
all lows regula[ing builtlinB consttV���on, entl I s�all not employ N
any person in violation ot the workmon's tompensation laws of �
the $tate ot California. �+L
2 b $ ��.-
1 hereby certify thet I am propeAy licensetl as a contractor untler SQ. FT.
Me Stato ot California Bvsiness and Professions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, entl thac such licenses ara in full torca antl attect, ar I THE PURPp6E OF ESTABLISHING A PERMIT FEE ONLV:
am exempt iron the provisions ot the Sta[e ot Cel(fornia Business VALUATION 01,—
entl Professions Cncie, Division 3, CPapter 9, r
� PERMIT FEE $
Signetura ot %� % P I'J_ � ,
P¢rmltteeC[ W � \ — �_ $ �l/lOO PLAN CHECK $
v� ^ 5
AUMorizetl Agent TOTAL FEE 5 �/
J