HomeMy WebLinkAbout945 AZALEA DR - Building PermitsCITY OF COSTA MESA
BUILDING DIVISION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: P09-00073
PERMIT TYPE PLUM
APN: 41221302
STATUS: ISSUED
DATE ISSUED: 06116/2009
., ISSUED BY: RMD
JOB ADDRESS: 945 AZALEA DR CM Suite/Unit: ,
Vicinity: THROUGH OUT HOUSE. , "
SCOPE OF WORK: PLUMBING PERMIT�'FOR COPPER REPIPE OF SFD AND WATER HEATER CHANGE OUT, SAME
LOCATION. NO FIXTURES WILL BE CHANGED OUT.
OWNER: TOMKO, CHRISTOPHER M�' ,- �- � Address: 945 AZALEA DR .
PHONE: � � . , City/State/Zip: COSTAMESA,CA. - �
APPLICANT: ANTHONY,.PAT . - " � Address�-' �1556SANAHEIM�BLVD :STEF
PHONE: 714-758-7725 ' - � - City/State/z2ip: ANAHEIM, CA'.;. - , '
CONTRACTOR: PACIFIC GOAST COPPER REPIPE COMPANY License No: 661428 '
Address: 1556 S ANAHEIM BWD STE F � � • PHONEi 714-756•7725 ,
City/State: ANAHEIM; CA � ZipCode: � 92805 - �� � �� � � , - �� CELL: ' - ,
ARCHITECT:
ENGINEER:
' Llcense�No.
� License No.
PLUMBING PERMIT FEE SUMMARY
PLAN,CHECK FEE: $0.00
PERAAIT FEE: $45.60
TOTAL FEES: " $45.60
PHONE:
PNONE:
,
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
re9ulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work aulhorized under this pertnit to be considered legal, such work must wmply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permiL
GODER. INSPECTIONTYPE DATE INiI71RL5 COOEA MSVEClIONTYPE DATE INTITIALS
i616 Fixed System Final Fire Prevention 206 Final Mechanical �
1266 Pool Spa Final 20B Final P�umbing ZZ
200 Final Re-Roof 210 Pinal Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Flre Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final �emolition 25o Final BuiltlinglOccupancy
WORKERS' COMPENSATION DECIARATION: �
I hereby afTvm under penalty of perjury one of the following declarations:
❑ I have and will maintain a ceAificate of Consent to Self-Insure for workers'
Compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
S tion 3700 of the Labor Code, for the pertortnance of the wnrk for which this
permit is issued. My workers' compensation Insurance carner and policy
numberare: / /� �
Carriec ,SV� �c �/9.
"(Th'is secfion neetl nol be complefed d Me pe�md is valuetl af one hundretl tlollars (Ef 00J or less )
Policy�Number: �%d�+ �pi i �
❑ I cetlify that in lhe performance of the vrork for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to the vrorkers' compensation laws of California, and agree that if t should
become subject to the workers' c s ion provisions of Section 3700 of
the Labor Code, I shall h� ompl these provisions.
�-�6 -o s
App nl'sSignaWre — Date-
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENAL7IES AND CfVIL FINES UP TO ONE HUNDREO THOUSAND DOLLARS
($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirtn that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
mylicense'rs in tull (orce and effect. // /
r` / .. (=,-.�fe
Lic.-#'`- � G+ � � � �lass # `
- _ G ��'=09
'C tre r'� Ignam --�ate�
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn thal there is a construclion lending agency (or the
pertwmance of the vArk fa which this permit is issued. (Sec. 3097, Gvil Cotle).
Lender's Name:
Lender's Address:
Da�e
OWNER-BUILDER DECLARATIONS:
I hereby affirm lhat under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the lollowing reason (Sec. 7037.5,
Business and Professions Code: Any city or county which requires a permit to
construct, alter, improve, demolish, or repair any slructure, pnor to its
issuance, also requires ihe appliCant for such permit to �le a signed statement
that he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing wilh Section 7000) of Division 3 of the
Business and Professions Code) or ihat he or she is exempt therefrom and
[he basis for the alleged exemption. Any violation of SecNon 7031.5 by any
applicant for a permit subjects the applicant lo a civil penalty of no[ more than
fve hundred dollars ($500�.�:
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, antl the structure is not intendetl or
oRered for sale (Sec. 7044, Business and Professions Code: The Coniractors
License Law does not apply to an owner oi property who builds or improves
ihereon, and who does such work himself or herself or through his or her ovm
emptoyees, pmvMed that such improvements are not intended or offered (or
sale. If, however, the building or improvement is sold within one year of
completion, the ownei-builder will have the burden of proving that he or she
did not build or improve (or purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITN
LICENSED CONTRAC70RS to Construct the project (Sec. 7044, Business and
Professions Code: The contractas License Law does not apply to an ovmer of
property who builds or improves thereon, and who contracts for such project with
a contractor(s) license pursuant to the Contractas License Laws.).
❑ I am exempt untler sec.
Business and Professions Code for this reason:
309-66 (3I01)
Owner ID veri(ed by drivei`s license. ❑ Yes ❑ No
Driver's License No. Expires:
Venfication of Ownership by (type of document, i.e. - property tax bill or deed�:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five (5) or more feet in depth into which a
person is required to descentl, will be made in connection with wprk aulhonzed
by this permit, antl that no building stmcture, scalfoltling, falsewvrk, or demolition
or dismantling lhereoi, will be more than thirty-six (36) feet high (Chap. 32, Gry
2. Arl 2, Sec. 341, TUe 8, Califomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would
require a permit from the Division of Intlustrial Safety, as noted above, unless
such person has a permit to do such work from ihe division.
Applicam's SignaWre
Division of Industrial Safety Permit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will ihe applicant or present or fulure building occupant need to fle and
certify a Business Plan for emergency response to release or threatened
release o� a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health and Safety Code requires, with some
exceptions, that a Business Plan be filed wilh the Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantiry of hazardous malerials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperature antl pressure).
2. Does or will the applicant or present or future building occupant need to fle
a registralion form for acutely hazardous materials7 ❑ Yes ❑ No
(Section 25533 of Ihe California Health and Safety Code, with some
exceptions, requires regislration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
hazartlous matenals equal to or grealer than a weiqht of 560 pounds, or a
volume ot 55 gallons, or 200 cubic feet of compressed gas at standard
temperature and pressure).
3. Does or will the applicant or preseN or future building occupant need to
prepare an RMPP (Risk Management and Prevention Program for awtely
hazartlous materials)? ❑ Yes ❑ No
(Section 25534 of ihe California Health and Safaty Cotle provides that the
Costa Mesa Fire Department may require the preparation, certification and
filing with the Pire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 ot the California
Health and Safety Code been tully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or fuWre huilding occupant require for
the work which is the subject of ihis application a permit for such consUuction
or modification from ihe South Coast Air Qualiry Management District or from
any other air pollution contml district or agency? ❑ Yes � No
(Section 658502 of the Califomia Govemment Code requires that the requested
infortnation be fumished on applications for non-residential building pertnits).
6. Will any part of the faciliry [o be constructed under this permit be within
1000 feet �rom !he outer boundaries o� a school? ❑ Yes ❑ No
(I�'yes", the facility must meet the requirement of Sections 25534 and 42303
of the Califomia Health and Safely Code�.
7. If a permit from the South Coast Air Quality Management Distnct or other
air pollution control disMcl or agency is requiretl for the work which is the
subject of this application, have all o( the discbsures prescribed by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If'yes", attach certificate of compliance from Ihe appropriate air pollution
control officer). �
CERTIFICATE OF COMPLIANCE: I certify thal under penalty of perjury the
infortnation given above is covect I agree to comply with all state laws and
city ordinances regarding Hazardous Mater'�als antl Emissions. �
CERTIFICATE OF COMPLIANCE AND AU7HORIZATION OF EN7RY: I
certify under penalry of perjury that I have read this application and state that
the infortnation given is correct. I agree to comply vrith all state laws antl city
ordinances relating to building construction, and authorize representatives of
the Ciry of Costa Mesa to enter upon the above-describetl property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorizetl by this permit until fnal i p ction.
SignaWre gal r�s) Dale
' O
/AnOI �Aut�orixetlAppliWnt . —' ale � �
DNESSOFBUILqNG: 9QS AZALEA DR uxr:
swwEil�+OxN: RICHARDSON, JAMES D PLOOD: AH-38
�a+Eu RICHARDSON, JEANETTE C
945 AZALEA DR
COSTA MESA,CA 92626
pPPL. AWl1NG ADURESi
�NLXRECT OP ENtlNEEP:
ApCN.Ofl F.NO.'S ROUPE53:
CONRiACTOp'8 NAME:
cartnncToxsruwxa
�ooxess:
uc. wo.:
ue. �a.:
UNT:
unt:
LICENSED COMPpCTOHS OECLANRTION: I Mraby efl"rm unEm penelly d parjury Net I em licensed uMer prwieiona d Chepter 9
(mmmendng xi�h Seclion ]000) oi �iviaion 3 M iha Buai�wsa entl Profesaons Code. eM my 4oenae is in hll Mce arM eMea.
cm uc. No.: uc. cuss: uc. No.: EXP :
oete: conveaa:
OWNEN BUILOEq DECLARAT�ON: I hemby elfirm urMer penetly d pm'ryry ihm I em e�empt Imm IM Canlrmom licenae Lew fa 1he
folbwirg reason (Seaion 1031.5 Buairess and Pmfesaiona Coda: Am/ ciy a munty whiM reyuiree a pa�mN to conswc, ellar, improw,
ldemoleh, w repair any sVudure, pior �o ils owence, ako repuirm the ep0licant fw wch pa�mB to file e aipr�ed stetemeM ihet he or ahe
�s licensed WR��� �o IM prwisiona d Me Comreeore License law �Cheplar 9(mmmeMi'q with Saction 1000) d 0'veim 3 d Ihe
6u:inexi aW Pfolasawm Gotle{ w Ih� M rn sha is aAemq thxalrom anA ihe Eeais Ior Ihe alkped axemption. My violelon of SeUon
]031.5 by eny eppliran Iw e parm� subpde �M epplicant to e eivil penelry ol �at m«e Ihen live hueMretl EWleis �8500�).
� I, ea ownar d tha O�Oar1Y m my empbyms wYh weges ea �F�eir aole mmpammion, will tlo IM wrk, eM the atrucWre o nol inlentled
a oflered Iw sele (Section ]OC<, Busne� eM ProfessionsCode: The Coniretlon Licenae Lew does �wl epptyto an owrier ol pmpaity
who budtla or enprove%ihereon. entl wfw Eoee auch work MmseM or heneM a IhrouBh he a har own amployeas, prtwitleE ihel auch
improvemenis are iwl inleMed a dlereA tor sele. X, however, ihe buiMirg a improvameM is add xithin are yeer d mmpletion, tM
�owner-builder vrill heve �he b�Nen of pmvifp he w she d'M �rot buik or improve lor the purywe oi sele�.
I. aa ow�wr d Ihe O�M. �^ exdusively wntreemg vrilh limmed conrcutois b wmArua the pmjeq (Sedian ]04C. Buaineca eM
Pmfessione CaEe: TAe ContreUors License Lew daea iwl epply to en avmer d pmpeMy who W iMa a imqoves ihereon end who
canvena lar aud� projeds wAh a mnVedor(s) Iken an� to 1M Co radors License Lew�.
q� I am eRempt unCer Senion: B. d P. . 9Y ihis (''� (� �
�....1 �n-i1,4S u L•1� ,_�l,n�NOn,�
'(Q�hereby cerlity Nal I am awere d eM uMerstenE ihe repuiram H ot Celilanie Heellh enE Sehry Cada 3ea'vre 25505.25533, end
?5534. and inet I or env �ure buildiep oeapeni will I wAI nM (d me) nead lo camvM weh aeid ata�e oodes eM tM requiremmia M
eGe�mabrmnswc�onamodficmionhanihaAi-OueilTyl�ege tDislna.ReakeniielwnsVudionnpdiretioreeramemqlmmiheee
proviaiona.
oa�e: apoi��:
WOXKEP'S COMPENSATION OECLARATION: I hereby effiim uMer penetly W peijury wn N �he Idbwirq Aetleimona:
❑ i na�e �e m� ma�men e cenRcme ot mnsem �o serc:�w,a �or vw.ken ca�w�w�on, d v�eaa �o. W somon s�oo a me iae«
eoda. e« ma rodo�� w in, �.,on� i�.�.i:cn m� w�u W �,��a.
� � n�„ �e w�e mdm� won�• �oaosm� ��s�.�. �,�wree nr sm� a�oo a me �no� cem. r« me rem,�� a m.
wmk tw which tMa peimN h inue6. My wttkefd mmpansetion Insuranca fartbr eM poliry number are:
Cemer.
Poliry Number:
(Tlris senian need �w( 6e wmple�eC! fM pelmA is lor one hunLred ddlera (,{tWJ or bn.)
� I canity thm in �he pailortn ce d �he wwk Iw which ihia pa�mn is isauetl, I shell mt empby any pneon in eny menrrer ao es to
become eubied m �M woiken comoenaetion lexs m celtl«nie, arM e9ree �hm X I ehouM become audea m iM waken'
compensetion provisions d Sa1bn 3)00 d Ihe lahor Coda, I sfiall fonhwith wmpy with thosa pew'viom.
Da1e: Aov���:
Wam/ng: Fellun to ascuro worksis'rompsnutlon cavsreps Is unHw/ul, antl �lull aub/scf en �mployer fo crlMrol pensl!lsa ena
elvl/ HMa up ro ons huntlrad Mouasntl tlollan ISt W,000/. In ed!ltlon b Ms eoat o/ mmpemafbn, demsys� aa provltlW Mr /n
Sectlon JN6 0/ fhe Labor Cotle, I�fsns( and ettemayi feea.
CONSTNUC'fION LENDINO AOENCY: I hereby etfirm uMer peneXy M{rerNrv �hq Ihere ie e oonat�uaion bMirp epazy M Ihe
peAwmence d iha xoM ror which ine Ge�mY is eaued (Sedion 309), civ. cI.
LENOEP'S NAME
LENpEfl'S AO�HE%:
I ceniy thet I heve raed ihis epplicetian eM s1a1e thet ihe ebova iMametbn is cwreq. I egree lo mmply wnh ell ary antl munty adinericea
end etete lews raleting Io build'xg consVuaion erd irereby auMa¢a repreaentalives oi ihis ary�o mter upon IM ebove-memioned properry
��`��'°�w�°�`P� JAMES RICHARDSON
�
o�,:lb•31-45
(5151de.WP) Whne-Buildig 8 Salery�, Gree�le: Cenary-Applrcanl; Pink-Ravenue; Oddanmd-hasaesor
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: B 074926
PERMIT NO: H 074926 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : T/OFF RESHEATH & REROOF W/COMP. SHINGLES SQ FT: 5,000
CLAIM �'ALUE: 5,000.00 CALC—VALUE: 5,OOQ.00 GROUP OCC: R-3 /M-1
COMMENTS: SMOKE DETECTORS ARE REt�UIRED IN EVERY BEDROOM 6 HALLWAY
**it�at�*��+�*it*�*�irit**jt�tjtttit�at*�it�* at*at*atat*+r�r�r*iE�*���+r�+�+�*+r+rie*at***at�tx��**+t*�*iE**�x*
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 BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 41221302 ZNE: REF NO:
PLANNING N6TES:>
i
, !h'N'1E'lE1E'lEiFiflElflfiElE1ElEiE3EiEiEiEfEiEf('iE9E1E'1E'k1f"1kiEif�7f�flElEiEiE1EiE'1('1EiE1E'�iEiflhdflfiE7EiE1EiE!@dh�EiFiflfiflflElflEdEiE!(��lE'1E1f1f1E1EiFiEif1l�
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 APPROVEb BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: � DATE: �1 )
+r+c�**�t*i�i�i[�i�*it�i�f�i�it*iti�+�i�*�F�F�F7f3FiEiF3FiFSi�3FiF3F�F3F3FiF3F �FiFi€iFiFiF3F3F'iF'7FiF***i�***�tt** i�i�
LEGALIZATION:N F E E S U M M A R Y STRUCTLIRAL S GME T:Y
HLDG pMT PLUMBING ELECTR'IC MECHANIC FIRE SMIP/RES GRADING
PERMIT 72.00 ' .50
SMIP/NON—RES
PLAN �
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAt�F=CHECK TOTAL PAID DUE
TOTALS----> 72.50 0.00 !� 0.00 72.5� 72.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 72.50 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
% 2. � � •. � , rJ �
if iE 3E iE fE'1E �1(�'lE fE iE 1E iE 1E if if 1f if 1E if iE 3E iE iElF iE iE fE 3E iE ff'� 1F'1(�'IE'!f iF iF if iE 1k if 1f !E �E 3f iE iE 3E iE iE 3E 1E 3f 1E 1f 1E iE IE iE iE 1E IE 3E 7E �IE iE �E 9E �E 1E if 1f ik iE iE iE i6 * fE
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 5000
REROOF HY VALUE RESIDENTIAL NOZONE 1.00 5,000.00
END„OF FEES
' ° SNiOKE DETE�TO�
r'. � !-';��Sd�1"l�'� ✓
�
� " Ol QD193s74-QOl?33?5 �"6'.pY - -
/ 3HtE: IGr=3rd� fIliv. � �• ,.
L�i:i3
�.�-•
CQNSTRUCTION AND PLANNING : , i P00. SPA
APPROVALS Permit #� Date Inspector �.�''APPROVALS Permit # Date inspector
4 t. Temporary Eiectrical Service or Pole _ ._ 52. � Pool & Equipment Location ' _
�" � _.
2. Soil Pipe•Undrgrnd. " ." 53. Steel Reinforcement . °"
.,
.�3..El�.ctricai Cunduit Utility-Undrgrnd. 3 - , 54. For�ms - . a �
`��4�;•,�IE�Crical CanduR�Undrgrnd. "'� 55. Ele'ctrical Bonding � ` � �
i _'�. i
*`:�Sjgel Reinto�cement 56. ftough Plumbing & Pressure Test - `,i:
�-�_ Electricai UFER Grnd. 57. APPROVAL TO COVER�GUNITE � _,.�
��7. Footings 58. Electrical Conduit-Undrgmd. - r�
' 8. Foundation . �� �' 59. Ga's Pipe, 0 Undrgmd., Test ��� �
. �
r '., , .
���:� Water Pipe-Undrgmd. ��; ; 60. Backwash tines, RTrap, L� Undrgrnd.
tO.+Structural �loor System 61. APPROVAL TO DECK '
'T
11. Pro�erty Sewer Line & House Connection � ; 62. Backwash & ReceptorFinal -
12. Sewer Cap += 63. Heater & Vent-Final .�
1,3. Roof Drain6 .. �' 64. Plumbinc� System - Pinal '
7A. Rough Plumbing � . 65. Electrical-Final
�
�7.5. Rough Electr4ca6Conduit � � - � 66. Solar SVstem-Final �
,L6. Rough Electric Wiring , � �67. Fencing & Access Approval "
17. Ro�gh Wiring Sign �� 68. APPROVED FOR PLASTERING f�'�
t8, ftough Electrica6T Bar Ceiling � 69. POOL/SPA 5YSTEMS FINAL
79. Rough Heat�ng & Air Condrtioning � 'p�� QEPT. REQUI(�EMENT �
'. . r- � �� x r, c^ �' '_ r . n p;
20. Rou h F` tor 1 Fice ace ! ��' � " ��-; ; �� ' � �" ` �- �� � �`
i. �? ?E � !� �� ir �'�+ 4: _ r�� c r� ,�iAPPfj,OVEIL,�'.-�., Peimit#
21. Ductis, in`Stn('cture.�?' i�.. .. s �. � -� �` "'� i 70. Untler rp crd �dro "�
� M .� r+ 1 k- L g�_. -+
22.Ducts;Vs�til�ing;;r ' ''�'' � .. -� a,��` :' r P 9 ,-
�, ; i� 77, PrtiducE�i in G�Chas OOiI
23. C�as �fpe-Rough & Test � ns �� n�� �� �' "� Y �� 7z, Undergrou�id FfT�`sfl�' ' F'
t: r �i^� /. � � '�
24. i�oof-�Fra'minq" '' "F" � 7' '� �, �. �� 73`�... Undergrnd. Storage�ank; � Gas ❑ Oil
<. r� -' . _
25. Roof�Sheathing - .� �_�p� r 74;-Overhead Hydrq *
�'w =GS ^� ..
26. F�Ba7�Ceiiing (Structi�ral) & Monocoat �� �"� ' '� � 75,�Dry Chemical . ;� ' i-y�
27. Frarr1eandFlasfiingF. �c�.a: .e� . ^.�= 76. DryStarKJpipe��� f�
- � -t
-' 2�. Lattiing $�,5ic{ing ��* �' t 7 � � `- .. ..� ••� 77 � FtXED�'�S7E�FtNA� ,- -, -
� ` ' Y � .. , ,., � �
28. Insulation � •- k � 7$:. FIRE PREV. FIN}aL -
'`30. Drywall Nailing 7 * _� � � „ ' ;{ � {�'H�ALTFkDEPj.��tEQUIR.EMENT
37. Plascer B�qwn�Coa`t � -_ � ..••• �. �: : � 79� FI �NAL [N6PECT�iDN + _
�.� � r r :,
32. Electricat�Power M`eter�Final ' � �`� � � '� `� 86.: FOOD CERTIF`FATE I,�iSUED.
' L a �
- 33. �nal Electric> �-.�:� � . . � �5 . � Notes: �m -m . G �.;,
�-- r r , _
� 34. Final�Hea''ting`& Ai%¢onditionirig � � '�' '' � ' � �+ �/.,'� ",�C�- r .x �' � �: � �
t [r � -r, [� T 5 ��' .; � r-'�l
35. Final GayPip�:Test �; " : v� ,., ' :, ` 'qr� .: � =
v _ m �
"36. Hood�orCanopy - � '"� `" ., ' ' 1 i �'�` - - ' rc �.� ����
C,
� f^ '. G rt' ' l . •� .I � ��.. '. . .
� 37. Final Factbry Fireplace i�� �, •� �� T � ,: c�
_ 3$. Final-Plupjbing � �= �' ;; '�� � Tk -`-' ' -+
+ n .� �-
39. 4Vater Ser'v.ice;final; ,. - � ��' � ' � � �" ' = '
... �1 ' i� �_ i x
_ c,
�AQ. Gas Servite-Fi-nal ", r-7 '*'t• - - r>: � 'r , ':�4+ v¢� �'
T 'l:k i-'� 1-. . ">: ' 7
'� Al. Solar poineStic�Fipaf; - ` ` �� I . ' - � � � `
r� u " x. . -�a � �:. �� _
42. Backfiew-t�reventer +' =�i - , '-" '"�� . *: , �+
a v ��.-, _.� i. 'r' r.7 �+�^ ..
43. BeckfloNl�tr�igation� v" ; a, y� � -
4A. Landscape IrrigatPoniSystem �" _. . �`� � - � a � �' `'�' '^�' .'� ' �� �
� .,:
'� 4 �:# `� � Y: ��� -.
45. 5ound Attenuatio'ri;� �'.E.. ` ; .' - {; .; �. � irr , . �y�-i ��
- -_ , � w
46. Handicap�Rzguiatlons t ' e � ,•=� �=- *
' � ' t;�s_r '� .
47. FiNRL STRUCTUflE & BUf tDfNG 6�; L� ,. '`" *
v,
48. FINAI PLANNING � t r �: '� --_ �" I � ;T ,,
:i: ra�i� �, � a
X �.F,_
49. Eiectrie Ralease to Edison ;. . '; � ''
�x � i .ry G
50. Gas Release to Southern CaliforniarGas Co W y`' - �` '" '� "� •
_ i � , ', � ^
51, CERTIFICATE OF OCGUPANCY � � �• -- r ' �' �
�%0 Dete
nooxEss or euauNc:
OWNEAS NRNE IF IQ�Ol�N: R
ADOFE55: R
<,
wr�. rwuxc �ooxess:
1HCXRECT Ofl ENC�NEEN:
RtICX.OH F1M.'S RDDNEW:
, JAMES D
, JEANETTE C
,�CA 92626
UNT:
FLOOD: AH-38
uc. ra.:
CONfppCTqYSNRYE �
CONfiIACNR5MI1L1NG
1DOflE55: ' . lJGNO.: •
UNT:
uxr:
LICENSED CONTHACTORS DECLARpTION: I hereby ellim uMm penetly d parjury ihel I am licensed under prmisioru d Chepter 9
(mmmencing wilF Sectian'1o00) of Diriabn 3 d Ihe Bueinesn end Protesaiona Coda, anE my lirenae is in full brce end effed.
cirr uc. na : uc. c�ass�. uc. No.: EXP :
Deta: Contradm:
OW NEfi BUILOEfl OECLAPATON: I hereby ��m uMerpaneXy d parjury thel I�em azempt Irom �he ConVedon Licenae Lew fw tha
followin8 reeson (Setlion ]W 1.5 Busress end Pro(essions Code: AnY cilY a�n1Y �ich mquirea e paimil lo mnshuct. a1�ar. imProva.
tlemol'sh, or rapeir any sVucWre, qbr m ns'swarke, also raquirea the applicent f« euch parmil lo file a aigred eletemant ihat he or ahe
is licamad W��^� �o Ihe prwiaiwre ol Ne Con�redors Licensa Lew �Chepter 9(mmme�ip wnh Seqon ]000) of Dirivion 3 d Ihe
Businass entl Prdessbns Code� or ihm M or aM is eaempt �herehom end �he b�a for the allepad mempl'an. My volelon of Setlon
TOat.5 by erry apphraM ioe a peim� ¢ubjMs Me eppl'eanl �o e avil penelly o1 �wt maB IAen fne hu�Mred tlollare �SSWj).
� I, as o�mar ol ihe properly or my empbyees wih wages as IMi eole mmpenselion. xill do �he work, eM IM mructure b nd in�enEeA
or ollered fa ade (Section ]OC{, Buairiess and Grofesaiana Code: Tha Convapon Licensa Lew doea nd epplylo en owner d pmpa�y
who Wida or improvea ihereon, end who doee auch work NmseM w henetl a Nrough he or her own amployem, pmvidad ihal such
improvemenis ere rd inteMed «oHared lor aele. If. Mwever, tha buikiiq or imprwemeM ia eold wilhin ma yeer d completion, the
y owner-buiNer will have the buNen of 0�'in8 he or ahe did rwl Wild or improve ta IM Wm�e d eale).
P• I. m amer N Ihe
�� propeM. ����N �Ired'mg with liceiued contreetois to wrrsUua iM pqea (Sed'on ]014. Buainroe e�W
Professions Code: Tha Contractars Licanm Lew does epplyto an ownerM properly who buika orimprovasihereon ena who
convaus fw suM projecls wAF e contraam(sl ��� eiM w �M Co atlma Liwree law).
am exempt under Sacrian: B. 8 P. .. rn ihie on: �
� a � 0-31- �i 5 �,,,. -�
nereny ceniry ma i am ewe.e d,�d ��da��a me .eQuirem �s of Cel2omie Heal�h end Setery Code Sediona 25505, 25533. end
25530, end thei I or eny Mure buiitliiq occupenl vnll / wdl na (arc one) need lo compy wih said e�me codee aM ihe requiremenb br
apemiilformns�Nqiono�modilMalionhoT�heRi�G1yF.�ensge tDis�nq.Resideniialwne�rutlionepp4celioreereexempthomiMsa
proviaions.
Dete: APW��t:
WOFKEfl'S COMPENSATION DKUIHATION: 1 Aareby elfirm uMar penehy d pmjury ane d �ha Idbvn'p AeWrelims:
❑ I heva enE witl meiniein e ce�Rcme d cansem to aeH-inaure fa wwkara' compenWian, es provideE (o� by Sedion 3]00 N �M Laba
Code, im ihe perlortnance ot �he wpk ta which �hia parm0 is isaued.
� I M1ava enE witl meintan woAfera' cvmpenaelon irraurance, es requiretl by Setlion 3'l00 d �M1e Lebar COEe, ibthe perbrmence d tM
wak lor which thie parmil ia imuetl. My wakers compensation insurence cerrier anE poliq number ue:
c�.
Polcy Number:
(This section need iwf be complefeC % fhe ps�mX is /w are hundreE Collars (S�OaJ or less.)
❑ I cenEy ihm m the peNormence o/ ihe wak for v.fikh �his Po�it is issuatl, I ahell �rot empby eny pemon in eny manner ev eg to
become aub�eci lo Iha worken' compensetion lews d GalHomia, end epree Mat il I aMuld becomo eubl� �e �he workeis'
compensatbn O���a d Seqion 3)00 d Ihe Lebor Coda, I ahell fMhwith mmOH �h Nme provisioem. '
oa�e: Ana�n: ' .
Weming: Fallun b axuro wo�lrwi mmpensetlon rovenpe I� vnlewlul, and shsll su61Kt �n employx fo cNMiul pe1ultls, e�M
NNI flina W ro om hu�tlreO tho�send do/Mn (5��,000), In etlG/tlon ro Ns ewf ol rompsnutbry Mmeges es proHCeG bi In
Sxtlon J]OS o/ Ns Labor COW, Intaiasf, antl attomeys /esa.
CONSTHUCTION LENOING AGENCY: 1 �ereby elfirm under panaly al parjury ihm �M�e ia e mnstrudion lerdifg epenry M �he
perlortnance d �M wark t« which ihe parmi ia awad (Sepon 309]: cir. Cl.
�LENDEN'S NAME:
LENOER'S AD�PE53:
I cerliN ihal I heva reaE Ihis applkelbn end reie thm tha ebove intammion ia coned. I egree �o comply with ell ary and muMy ortli�nce�
end atete laxs rolaling to building mmtr�qion eM hareby eutMr¢a representetivea Mihis tlry lo enter upon Ihe above-maMoned prope�ty
r«��s�aro�p�,��s. JAMES RICHARD50N
�
o�,: ) � � 3 l- 45
(5151de.WP) While-Build'uq 8 Sefay; Greeo-Fle; Cenery-AOPficenC Pink-Revenue; Ookemotl-0.^.sessor
CITY OF COSTA MESA — HUTLDING PERMIT
PERM NO: B 074926
P£AMIT NO: H 474926 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : T/OFF RESHEATH 6 REROOF W/COMP. SHINGLES SQ FT: 5,000
CLAIM VALUE: 5,000.00 CALC—VALUE: S,OQQ.OQ' GROUP OCC: R-3 f44-1
COMMENTS: SMOKE DETECTORS ARE RE�UIRED IN EVERY BEDROOM 6 HALLWAY
ifiliFiFiPiElklEiflkiFiEiElFiEiE7kiElE#1E#i(�#lF1E1FiE#1ElF1f lkifiElEiEiE##1E�lEiEif�lEiFlfiflEif�iElEikifiEiElE#iE�1FiEiE1F�I(�1Fdf-if�iFiE�1E1E1E�lE1E�ElE#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
------------ Mt1IN HUILDII3G ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT ZN REAR: FT IN FRNT: FT' IN RHAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT ZN AGHT:. FT IN
PARKING REQ• PROV; PARCEL: 41221302 ZNE: REF NO:
PLANNING Ni7TES>
�
ik'IElEiE �lf 1f 161E'lE iE 1f 1('1E # If if 1E'1F 1E 1f 1f if 1F if �h �F' 1E 9(' 7f'IE �F #!i 1E if if 1E iElE 1E �E iEif #�h if iE if dF'If ### iE iEif if if 1f 9f af # �f # iF 1f iF �lE #')i' iE ##1F if itr # ikik
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:
HUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE: J �)
#'lEiElPif1(�iE1E1E#if'1I'iEiki('1Ff('ifififiE# iflEliiElE�1EiF1fif1F iE#
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL S GME T:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 72.00 .SO
PLAN
ISSUE FEE
HUILAING—DIV—> PEAMIT ISSUE PLAN—CHECK
TOTALS----> 72.50 0.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
%2.��
��4:�i.r.���y
TOTAL PAID DUE
72.5� 72.50 .00
72.S0r OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
.50
!f 1f 1F'If if 1E'lF #'1F#1f iE 1E iE iF# # 1E iF�IE �IE #i(' #'�F'IF 1E #'lE iF 1Pif if iE�lf� if 1E * If 1E if 1E # iE 1f IE iE ikiE 1F # dF# iF if i41k iE if IE �lE iE iE 1i # 1f' iF1E if #'!k iE #�F ###1Eif
I N.D I V I D U A L F E E B R E A K D O W N
TYP'E. QTY D E S C R 2 P T I O N UNIT COST TOTAL COST
SFR 5000 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 5,000.00
ENA OF FEES
i
�
�
D1 00193374-00293375 "�s� � 72,5p
DATE: iD/31/95 TSt9E: fl8;F3
309��
COSTA MESA BUILDING-SAFETY DEPARTMENT
301 AR P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
BUILDING
ADDHESS
OWNER LARWIN SOUTHE$'1G CALIFORNIA, INC.
ADDRESS 16255 Ventura Blvd.
CITV Encino, Calif. No�:�986-8890
LOENDER�ION LAHI�IIN SOUTHERN CALIFORNIA, I',
BRANCH 16255 Ventura Blvd.
ADDRESS Encino, California 91316
ARCHITECT ��IN S0. CALIF, rE'-.273-4484
OR ENGINEER NO.
ADORESS 910� Wilshire B�.Vd. B.H.
CONTRACTOR
ADORESS 16255 Ventura B1vd.
TEL.
C17v F.ncinn� Cal;f_ No. qg6
L C No. 191311 LICVNO. [;-
OP COT E1Z X LOL NOW ON LO
USE OF
SIZE OF 1987 $f NO. OF 1
NEW BLOG. ROOMS STOflIES
EXTERIOR WALL ROOF
COVERING pt11CC0 COVERING WpOd shingL
USE OF BUILDING AND WORK TO BE PERFORMED
I hereby acknowledge that 1 have read this application antl stete
Mat the ebuve i�formation is correct end agrea ta comply wiM
all laws repuletinp builaing constr�ction, end I shell not employ
any pe�son in violation of the workman's compensation laws of
the S[ate of CalitOmia.
I hereby certify thet I am properly licensetl as a cantracior untler
the State ot Calitornia Business antl Professions Cotla, �ivisicn 3,
Chapter 9, and thet such licanses ara ln full force antl affect, or I
am 0xempt from the p�ovisiOns of the $taie of Calitornia Business
antl Professions Coue, ivision 3, Chapier 9.
Slgnaiura of ��
Fermittee D. DOW[1
Auffiorizetl Agent .
1UL -5-73�H��OO 296� �**173.40
APPLICATION FOR BUILDING PERMIT
E VE BY D TE RECENED DATE ISSU,
�o� 7-h-
BUILDING
ADORESS
FIRE
APP
DA
NO.OF�7 USE OF NF
PIANS ( ,., BUILDING
APPROVED VARDS
FOR
THEAMOUNTS
THE PURPOSE OF
VAI.0 TION �
����-
$
FT
MAIN &
ER VALUATION IS FOR
yG A PERMIT FEE ONLv:
,FE� �
7,�.p �
iECK $
I �f �..++-++.r-
FEE $
m
0
i
¢
m
N
7
m
E
0
LL
�.. ... .... � .uu�.�.r��. �w �w. �� _` �.ur':Av��....
CIT. OF COSTA MESA REQUEST FOR OCCU�...JCY
.�
.,.�_�� � .
DATE piC � r �'
The developer of.the above entitled tract desires to sell the above set
forth lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreemen:, acknowledges that
.
...(he�-they lstae•sr were)� advised that this tract has
not been given ina inspection nor has it been accepted by the City of Costa Mesa
as having complied with the conditions of approval which were impoaed by the City
at the time the final tract map was approved.
The City assinnes no liability for the enforcement of the coaditions
necessary for approval other than those conditions.protected by surety bond.
The undersigned agrees to'indemnify and hold the City haLmless from
any claim resulting in damage or personal injury to the undersigned by reason
of the aforementioned uncompleted condition
' RECEIVED
CITY OF COSTA MESA
. p� � �i.i,n,,. n-aT.
DEC 2� 1973
AM PM
7�g�gil0illi]2i�i2i3i4i5i6
R
N
BY
7 ��
,�—
/' / J7 �
Bi / �--?' E-�.L<_�� (�� �'>f—[��t� l
Developer and/or authorized
representacive
aY �."" l� �
.�/2�/_.c.,L�fi� l l_� K
Lender '