HomeMy WebLinkAbout968 AZALEA DR - Building PermitsPfl0.1ECTADOXESS: -• 968 FiZ�iLE�: DR
OWNEH'SNFME:GURINAC, STANLEY :R
, aoo�ess:968 AZALEA DR
COSTA MESA,CA 92626
i_
� � FBCH/ENGINEEfl:
ADDNESS:
flEG.NO.:
uxir:
UNIT:
�„ PEBMITTEE:LEE ROOFING (7].4)642-727_3
nooness: Z653 SUPERIOit
COSTA MESA CA 42627
LILENSEU CON7BACTON OECLAPFTION: I hereby affirm t�at I am licensea under pmvisions oi Chapter 9(commencinA witA Section
7000) oi Divlsion 3 ot t�e Business and Pmfessions Code. and my license is in full �arce antl eflect.
CITYL/IC�.:�Oz�p} 7�1 sraTeuc.:34968 cas�s:/C-39
' 3 -.f / � Signaiure: � �V �i�"�'��
WOBREXS' COMPENSpTION �ECUIBFTION: I hereby a��irm Iha� I haVe a CehitiCaie o� Con5enl lo Seli�insufe or a certificaie o� Workers'
Compensation Insurance, or a ceni�ied copy t�ereo� (SE���on 3800. La6. C�.
roucrNo.:13009A8-93 cxr.oaTe:06/30l94
comvnxv:gTATE FOND
�❑ Ce�ifietl coOY is �ereby fumished. Q Certified copy is fileA wiih Ihe ciry Building Oivision.
fV
.��3�� qpplicant: ���� � �_
E%EMPTION FBOM WONREPS' COMPENSATION OECIAMTION: (This Sec�iOn nee0 nOl be comDle�eA if the Oefmi� is fof on¢ hunOreO (3100) ar less).
I cenify that in ihe pertormance of ihe work 1or which thi@ permit is issuetl. I shall not employ any person in any manner so as to become
subjec� m Ne Workers' Compensalion Laws o� Califomia.
�ale: Signature;
NOTICE: I�, atter making ��is declaration, you shou�tl Decome subjec� lo Ne Workers' Compensation pravisions af the Lahor
Catle. you mus� torlhwith comply wiN such provisians or [his permit shall be tleemetl �evoketl.
CONSTNUCTION LENUING FGENCY: I hereby aflirm Il+at ihere is a consimclion lending agency tor ihe pedormance of I�e work for
which (his permi� is issuetl (Section 3097, Civ. C).
LENOEfl:
AUDPESS:
OWNEP BUILOEB DECLAflFTION: I here6y aHirm �ha� I am exempi tmm �he Coniracmrs' State License Law /or t�e following reason
(Sectwn 703L5 Bu5ine55 and Protessional Cotle: Nny Ciry of wunty whith requires a permi� �o ConS�fuC�, alief, impmve, demolish, or
repair any StmcNre, prior to iis issuance. also requires �he applicani �or such permi[ ro file a signed sta[ement �hat he/she is licensed
pursuant to ihe provisions ot Ihe Contractors' S�a�e LicenSe �aw (Chap�er 9(commencing with Sec�ion 7000) o� Division 3 0� the 6usiness
antl Pmiessions Code) or that he/she is exempi �here�mm and Ihe basis �or Ihe allegetl exemp�ion. Any violation of Sec�ion 7031_5 by
any applicam for a permil sublects Ihe applicani Io a ci�il penalry al nat more than �ive huntlretl tlollars ($500�.
I, as owner of the pmDehY or my employ¢es wi�h wages as iheir sole compensa�ion, will tlo the work, antl the
❑ strucNre is not intended or offere0 for sale (Section 70da, Busness and Pm�essional Cotle: The ConVac�ors' S�ale License Law
does not apply to an owner o� a pmperty who 6uiltls or impmves [hereon, antl who tloes such wo�k himself/herselt or Ihmugh
his or her own employees, provitletl �ha[ such imPmvemen�s are not intentletl or otferetl for sale. If, Aowevei the building or
impmvement is soltl wifhin one year ol comple�ion. t�e awner wi0 have ihe burtlen of proving he/she di0 not huilA or impmve
, �or �he purpose ol sale�.
I, as owner of the propetly, am exclusively coniracting wilh licensetl caniractors to consttuct ihe pmlect (Section 7044, 6usiness
❑ antl Pmfessions Code� The Coniracmrs' State License Law tloes not apDN to an owne� o/ pmperty who GUAtls or improves Ihereon
ana who contracts lor such pmlec�s with a comracmr(s) license pursuant m lhe Contracmrs' State License Law�. I am aware
�hal pmaf oi their Worker's Compensation insurance shoultl be pmvided ro me.
� I am eeemp� untler Sec�ion: B. 8 P. C.
tor t�is reason:
�ate: bwnec
I do hereby certily Ihat I am aware o� antl untlers�antl Ihe requirements of Calitornia HeaAh anA Sa�ery Code Sections 2550.5, 25533, antl
25534 and ��a� I or any fuNre 6uilding occupani willlwill no� (circle one) need �o comply wi�h saitl sta�e cotles antl ihe feQuirements for a
permi� for conslmc�ion or modilicalion Imm the Air OuaI��Y Managemem �isVicL Resitlential conslmction applicaiions are exempt �mm
Ihese pmvisions.
�ate: qpplicant
I here6y cer�ify �ha� I have reatl Ihis application antl sta�e I�at Ihe above information is correci. I agree to compry with all ciry and coun�y
orainances an0 siale laws relaiing lo building consimction anU hereby authur¢e representatives af this ci�y �o enler u0on Ihe above-men�ioned
pm0ehy Qlor inspec�ion purposes. p, n
,Oa�e: ` `3�� SignaWre�d� �`�' ��'�V"'�
Oriver's License or Social Securi�y p:
164t 46 WM1ne-Bulltlinq; Green-Cotle EnlorcemenL Canary-Applicant; Pink-Revenue; Goltlenrotl-Assessor
CITY OF COSTA MESA — BUILI�ING PERMIT PERM NO; B 063298
PERMIT NO; B 063298 PLAN CHECK NO; N GOVT; N SUPP: �U
CONSTRUCTION TYPE; V—N PERt�SIT TYPE; STR PURPOSc; ALT
JOB DESCRZPTION ; T/OFF RESHT, REROOF LJ/EAGLE LIT #4660 SQ F1'; 6,000
CLAIM VALUE: 6,000.00 CALC—VALUE: 6,000.00 GROUP OCC; R-3 /
COMMENTS; SMOKE DETECTOR RE�IIIRED PRIOR TO FINAL
�r**�**�x�**#*��c�*�cx*+�*�r�r�*� **x*******�r�*x�x-;�***�-�*x*�r+�***#�*x�**�****#*****�#��*
Z O N I N G J ER'PEBQAUCIKEiSE N E N T S
------------ MAIN BUILDING ---------- --------- ACCES50RY BUILDII3G ---------
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 RE • PROV; PARCEL; 42217109 ZNE; REF NO;
PLANNZNG N�TES>
]' r�l
!E 1E if iE iE 3E �)f 1E if if if �)f ?E fE iE iE% if iE iE !E iF iE iF iF �lf iE k iF it iF iE iE iE if !f iE iF # iF 16-Ik if X''.(� iF if iE if iE iF-1E lE dE iF k iE %!F �M� i(� i(� �%� iE iF # iE 1Elf j(-M� iE # iE �k iFlE # if
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'F• S
ZONING APPROVELI.. BY DATE: y.-
BUILDING APPftOUED HY ; DATE; '�
APPLICATIdN ZSSUED HY• � DATE; � 3`/�
iEiffP-1E#iFiFiEiE�lflEifiEi6if=KiEK�iFiFif-1F ..f . i. . . ifikM�iffElEiE�#�1fiE �irfF?Fi(•3f�
iE�lEiEiEiEifiEiFiFi(•lEifjf3FiEiF%iFifiEiE9fiE#lfiF�lEiE1Ei(��lFi(��1f#iE�lfiEi ' �IEfEiE�FiEiEiE�EiE�1fM�iE7FlF'fi1EN��k-iFiEif3Fit�lEiFif�iFiF%i(�iElEiE#�#3E3EiE�R
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEG�ENT;Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 81.00
PLAN SMIP/NON—RES
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL " PAID DUE
TOTAI.S----> 81.60 0,00 0.00 81.60 �.Q1.60 .00
REVENUE DIVISION TOTALS--> COLLECTEll: 81.60 OVER/SFiORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC -rIRE SMIP/TOT GRADING PLAN—CHECR
81.00 ,6U
iF iF ih af 1f� iE �)f-lE iE iE if 3E if if i(-iE ih ih N� iF%ik iE �1F iE iE # iE �F iE X-iF 3f df i(� �!f iF iF iEit iE �1F 3f if- iE iF iF'�f ih iE !h )f it iF k if iE X� iF 3F iFiF iE 7f 3f 3E i(-jE !E iE jFlf # 9E -1F 3F if iE 1E
I N D I V I D 0 A L F E E B R E A K D O W j�l
TYPE QTY D E S C R I P T I O N UNIT COS=� TOTAL COST
SF'R 6000 REROOF BY VALUE RESIDENTIAL NOZONE 1.00`� 6,000.00
END OF FEES
O1 QD144080—OD144C��1 T C�T 31.60
DATE: OE/03('93 TIM'c: 10:0E
�
. �
�� �
CONSTRUCTION AND PLAIVNING . (
APPROVALS Permit# ' Date (nspector
aramoorarv Electrical Service or pole
2. Sod Pipe�Undrgrnd.
3. Eiectrical Conduit Utility�Ui
4. Electrical Conduit-Undrgrnd
5. Steel Rein+orcement
6. Electrical UFER Grnd.
7. Footings
8. FoundaLon
9. Water Pipe-Undrgrnd.
� 10. SCructural Floor SYstem
11, Property Sewer Line & HouSeConnection
12. Seev@r CaP ^ �,.
13. Roof Drains � �
14. Rough Plumbing
15. Rou9h Electrical-Conduit '
16. Rough Electric Wiring ,
77. Rpugh LNiring Sign �.
18. Rough electrical�T Bar Ceiling
19. Rough Heating 8t Air Co�ditioninfj'
20: Ro�yh Factory Fireplace
21. pucts, in Strucwre I
?.2. Ducts, VeM:Iating ,
23. Gas Pip2•Rough & Test � '�
24. ftoof Framing
25, Roof Sheathing S
26. T•Bar Ceiling (Structurat) & (otonocoat
27. Framear.d Flashing
28. Lathing & Siding
29. Insulation
30. Drywall Nailing ,
31. Plaster Orown Coat
32. Electncal Power Meter�Final
33. Final Electric
3A. Final Heating � Air Conditioning
35. Final Gas Pipe�Test
36. Hood or Canopy
37. Final Factory FirepleCe
38. Final Plumbing
39. Water Service�Final
4�. Gas Serwce�final
41. Solar pomestic-Final
42. 8ackfiow Preventer
43. Backflo�v Irrigation
44, Landscape irrigation System ,
45. Sound Attenuation
46. Handicap Regulations
47.rIIVALSTRUCTUfiE&BU�LDING �
48. FINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
No. Date
I
u
'� �
POOI ,PA I .
APPROVAIS Permit �`r �ate Inspectar
52. Pooi & Equipment Location
53. Steel Reinfqrcement
54. Forms
55. Electr'.cal Bond�ng
56. Rough Plumbing & Pressure Test
57. APPRpVFlI.TOCOVEF�GUNI7E
56. Electrical Conduit-Un�irgrnd.
59. Gas Pipe. CJ Undrgrnd., ""ett
60. BackwBsh Lines, P-Trap, � Undramd.
61. APPROVAI TO DECK
62. Backw85h & ReceWtor-Firtal
63. Heater& Vent-Final
� 64. Plumbing System � Finnf
��65. Electrical-Final
66. So�ar System•Final
�67, Fencinc� & ACcess Approvai r
68. APPROVED FQR PLASTERING
69. POOL/SPASYSTEMSFINAL
" FIRE DEPT. REQUIREMENT
APPROVAL5 Permit�}-
70. Underground Hytlro
'%1. Product Piping C7 Gas C7 Oil
72. Underground Fi�sh
73. Undergmd. Storage Tank O Gas � Oil
�,14. Overhead Hydro
75. Dry Chemical
76. Dry Star.dpipe
77. FIXED SY5TEM FINAL
78. FIRE PREV. fINAL
HEALTH DEPT. �EQUIREMENT
7J. FINAL INSPECTION
Bp. FOOD CERTI�ICATE ISSUGD
Notes: �
�--�
��
�
PflOJEGT RpUHESS: Cj 6 H AZAL EA DR
\OWNEP'SNpME:GORINAC STAidiEY TR
aaatt�ss:96$ AZA{.EA DR
� COSTA hSESA,CA 97.626
11NCH/ENGINEEH:
RODflESS:
HEG.NO.:
IINIT:
uurt:
PEBMITTEE:�INF.GARD ENTEAPRI5F_S (7141573-2$35
nooxess: ?033 SEVILLE
BP.LBOA CA 92661
LICENSED LONTflALTOfl DECIAflATION: I hereby attirm thal I am licensetl untler pmvisions oi Chap�er 9(commencing with Section
7000) of �iwsion 3 ot the Business and Pmfessions CoOe, antl my license is in full �arce an0 e�fect.
ciTr uc.: G sTnTe uc.� 6 9"/4 �` Uv� �/ ltiJ
Oate: 7(2�/ ` � Signa�ure. � �1 �-�
WONNEflS' COMPENSATION OECtANATION: I hereby attirm Na� I have a ce ic e of consent to selFins or a cehifica�e of Workers'
Compensatian Insurance, or a cenified copy thereof (Section 300Q Lab. C�.
Poucvxa.:1345674-93 E7(P.OFTE:QQIOS�9�
COMPANY:STAT�E i'UNP
� � Ceni�ied copy is hereby fumished. �]' Ce�ifietl capy is �iled wi[h the ciry Building Divisian.
oa�e: 7�a%l!1 � PPDlicant: (�( /!� �� (n-�O� ��
E%EMPTION FpOM WOPNEBS' COMGENSATION OECIABRTION: (��is seclion neetl nol be c mp teA ii �he permil is far o hundreU (5100) or lus�.
I cetlity �hal in lhe pertOrmance O7Ihe wotk for wh¢h ��is permit is issued, I shall not loy any pefson in any manner So a5 �o betome
suhlec� Io �he Workers' Compensation Laws ot Califomia.
Date: Signawre:
NOTICE: II, alter making �h�s tleclaration. you shoultl �ecome su6lect to lhe Workers' Compensalion provisions al �he Labor
Code. you mus� lorihwi�h comply w��h such pmvisions or this permit shall 6e OeemeO revoketl.
CONSTflUCTION LENDING AGENCY: I hereby attirm �hat ihere is a constmc�ion lending agency �or Ihe pedormance ot the work for
which ihis permit is f=5uetl (Section 3097. Civ. C).
�fl'THIS PERMZT REPLACES
��S$63205 CANCELLED HY CONTR
OWNEB BWLOEfl OECIAXlITION: I hereby aflirm �hat I am exempt irom ��e Con(rac�ors' S�a�e License Law fof the following feason
(Section 7031.5 Business and Pmfessional Cotle: Any ci�y ol wunry which requires a permit ro constmct, alter, impmve, demalish, or
repair any slructure. O�ior �o i�s issuance, also requires the applicant for SucA De�mi� �o file a 5igneU s�atement �ha� he/she is licensetl
pursuant ro �he pmvisions ol �he ConVactors' S�ate License Law (Chapter 9(commencing wii� Section 7000) of Oivision 3 0� Ne Business
antl Pmfessfons Cotle) or that �e/she is exempf �herefmm and �he 6asis for �he allegetl exemption. Any violation of Sec�ion 7031.5 by
any aOPlicant for a permi� sublec(s the applicant to a civil penalry of not more ihan tive huntlretl tlollars (550�).
I. as owner of IDe pmpetly or my employees with wages as iheir sole campensa�ion, will tlo the work, antl [he
❑ s�mcNre is no� intended or o�fered for sale �Sec�ion 7044: Business antl Pmfessional Cotle: The Contractors' S�a[e License Law
tloes not appty to an awner ot a pmpeny who builds or impmves Ihereon, antl who tloes such work him5eif/herse�f or through
�is or her own employees. pmvitletl t�a� such impmvements are no� intentletl or oiferetl for sale. I�, however �he builtling or
impmvemen� is soltl wi�hin ane y¢ar of completion. the awner will have �he hurtlen of proving he/she tlitl not builtl or impwve
for Ihe purpose of sale�.
I, as owner oi Ihe pmperiy. am excWsivety con�raciing with Iicense0 confrac�ors �o constmct IDe pmject (Section 7044, Business
❑ ana Pmfessions Code: The Contracmrs' State License Law Uces not apply �o an owner oi property who builds or improves thereon
and who coniracis for suc� pmlects with a coniracmr�s) license pursuant to ihe Controciors' State License Law). I am aware
Ihat pmot of their Worker's Compensation insurance should he pmvidea �o me.
� I am exempt under Section: B. 6 P. C.
lor this reason:
Oa�e: Owner.
I Oo hereby certity �ha� I am aware af antl untlerstantl �he requiremems ot Califomia Heal�h and Safery Code Sec�ions 25505, 25533, antl
25534 antl ��al I or any tuture 6uildmg occuDant will/will no� (circle one) neetl [o comply wi�h sai0 s�ate cotles antl the requiremenis for a
permit lor tonslmction or moOiliCa�iOn imm �he Air Qualiry Managemenl DiSVicL Resitlen�ial ConStmt�ion applita[ions afe exemp� irom
Ihese pmvisions.
Date: Applican�:
r
I hereby cerlity �ha� I have reatl this applicalion and stale �hal the above in�orma�ion is correcL I agree Io compty with all ciry and counry
ortlinances ana 5�ale law5 relating io building consimction antl hereby aNhorize representa�ives o� this ciry �o en�er upon �he above-mentione0
pmpen�y lor inspec�ian purposes. � `� �
�ate: ry/��� -3 SignaWre: VVG�/ '"— 1l�
onver's License or Sociai Security ✓:
t6a��6 Whi�e—Bullaing: Green—Cotle EnforcemenC Canary—ApplicanC Pink—Revenue: Goiaenmtl—Assessor
CITY OF COSTA MESA - BUILDI7IG PERN�IT PERM NO; H 063248
PERMIT NO; B 063248 PLAN CHECK NO; N GOVT; N SUPP; N
CONSTRUCTION TYPE; 5-N PEkMIT TYPE: STR PURPOSE: ALT
JOH DESCRIPTION ; T/O SHAKES,RESHEATH 1/2"CDX, APPLY T'ILE SQ fiT; 1,500
CLAIM VALUE; 7,500.00 CALC-VALUE; 7,500,00 GROUP OCC; R-3 /M-1
COMMEi'dTS; APPLY NEW "EAGLELITE TII,E" (MALIBU) UNDER 600LBS, PEA S i����C�`�.0�
�*x*�r�r*�*���r�r�r*�u���t�r�r�r��***x-*�r�***�r�**��**x*�x�t�rrt*i���-*�rrt��x � �* aa�G �r
2 O N I tJ GS �RTEBQAUCZKRSE M E N T S�
gEQUIR�B
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN kEAk: FT IN FRNT': FT IN REAR; FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGH'T; F'f IN
PARKING REQ • PROV; PARCEL; 412I7109 ZNE; REF NO:
PLANNING ,�f3T'ES>
>
�t**��****�*,r�r�r�***�r�rtt��r*��r+r�rtr�rx**�r**��t�r*u�r�-*��x *�tx� �r���r*�***�-�*�*�*x �t�*�r*��-u�f��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 ,
BUILDING APPROVED BY ;
APPLICATION ISSUED BY; �������) ��
1E3tiEik�kit�lFiEiEillFiEiFkiEiFiEfE34iEiFif�Fi! iF 1t� �'3FiF3F
*x �rx x*x�*�rx��+rx���rx�r#*�r**�x*x*�t-�rx****�*�r
LEGALIZATION;N F E E o'
BLDG PMT PLUMBING ET'..C' RZC
PERMIT 99,00 � �
PLAN
ISSUE FEE
BUILDING-DIV-> PERMIT I
TOTALS----> 99,
REVENUE DIVSSION 1'OTAL - >
BLDG PMT PLUNBING �, "
99.00 ��
if if iF K� iE iE if iE iE iE if iE itlF 7E 1E iE if if iF if iE 3f !E iE
DATfi;
llATE;
IIATE; � 2- 3
it�iF#jEiF��lb#-�3F�lF� x�stit lt�f
***��****,���r*��****�*���t�*
STRUCTURAL SEGMENT;Y
FIRE SMIP/kES GRADING
75
SMIP/NON-kES
-CHri,-i,�T �'' TOTAL PA1D DUE
r.
\8
99 75 99 7
. 5 00
�j• . .
�
S
T '
�
�• �_ 75 V
� O ER/SHORT•
00
� m '
IC FIRE �SMIP/_0I` GRADIfJG PI,AN-CHECK
. 7 J
# 3f lk iE iE 3E �1F iE �lE �%-iF jt iF iE * iF fF #f iF if * iE iF lE jF i( �lE i(� iE iF 1E iE ik i(� 1(� iE #',E iE :F iE �lF
I N D I V T��,� A L F' E E B R E A K D O W N
TYPE QTY D E S C R I F T I U N UNIT COST TOTAL CQST
SFR 7500 REROOF BY VALUE RESIDENTIAL N020NE 1,00 7,500,00
END OF FEES
01 00143343-00143849 Tr3 T 99.75
DATE: 07/?9/93 TII�E: 13:57
�CONSTRUGTION AND PLANNING
APPkOVALS Permit #�._;,
7� Temporary Electrica� $ervice ar,Pole ,
2., Soil Pipe•Undrgmd. :
3. Electrical Conduit UtilitY�Undrgrnd.
�4. ElectricalCond'vibUndrgmd, �
5. Steel Reinforcement �
6• Electrical UFER Grnd.
7_ Footings
8. Foundation ' "
9. Water Pipe�Undrgrnd. . �
M
10. Structurel Floor SYstem �
17. Property Sewer Line &, Houee CAnnection
12. Sewer Cap . �
13. Roof Droins
74. Rough Plumbing �
15. Rough Electrical-Conduit
76. RoughElectricWiring .
77. Rough Wiring Sign
18. Rough Electricai-T Bar Ceiling
19. Rough Heating & Air Cpnditioning
20. Rough Factory F�replace
21. Ducts,in Structure
22. Ducts, Vent�lating
23. Gas Pipe-Rough & Test �
24. Roof Framing
25. Roof Sheathi�g
26. T-Bar Ceding lStructural) & Monocoat
27. Frame and Flashing
28. Lathing & Siding •
79. Insulat�on
30. Drywail Nailing
-31. Piaster Brown Coat
32. Electrical Power Meter�Fina1'
33..Final Electric
34. Final Heating & Air Conditioning �
35. �Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fveptaca
38. Final Plumbing �
39. 4Vater Service-Final.
�40. Gas Sernce•Final .
'47. Solar pomescicFinal
42. Backflow Preventer
43. B�ckflow Irrigation.,-,
��
4G. Landscape Irrigatio�System • �
45. Sound AttenuatiorlY .�.
46. Handicap Regulatip�w_- r�=-x•��
47. FINALSTRUCT4F�f�i.�LJILDING
48. FINAL PLANNI(d� `�
,49. Electric Reledse to�dispn
•�; �
50. Gas Release to SouthA�;n',i'alifornia Gas G
51. CERTIFICATEAFOCCUPANCY
!o.__ _.__ __ "� � Date
Date Inspeitor
j
0
B
C
PpG � SPA
APPRO�'ALS Permit #
�
52. Pool & E4uipment Loc:ition
53. Steel ReinfOrcement �
54. Forms
55. Elecvical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVE 9-GUNiTE
58. Electrical Conduit Undrgind.
69. Gas Pipe, O Undrgrnd., Test
60. Backwasb Line;, P�Trap, � Ucdrgmu.
61. APPROVAL TO DECK
62. Backwasti & Receptor�F na� �
63. Heater & Vent�Finai
64. Plum6ing System � Final
65. Electrica6Final
66. Solar Systern•Final
67. Fencing & Acoess ApPiu+al
68. APPROVED FOR PLAS7ERING
69. POOUSPASYSTEMSF�NAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #-�_
70. Underground Hydro
71. Product Pipinc� L7 Gas C Oil
72. Underground Flush �
73. Undergrnd. Storcge Tank O Gas � Gil
74. Overheatl Hydro
75. Dry Chemical �
76. Dry Stand�ipe
77. FIXED SY$i'E�A FINAL
78. FIRE PREV.�FI'NAL\
HEALT,H OEPT. REnUIREMEN7
.
79. FIN.4L INSPE�iT�ON .. � '�
80. FO(�'e CEfi� FI 1'CATE ISSUED
--ra.,�a,-_
Notes: -
�' 'j' _.__._
... .v •
� ' rti;. -' _
Date � Inspector
�I
��
I �� 1
PXOJECT ADOPESS: 9 6 S AZ AL EA Dk
OWNEH'SNqME:GORTNAC, STANiEY TR
AOOflES5:968 A7,ALEA DR
COSTA MESA,CA 92626
RflCN/ENGINEEH:
ROOflESS:
flEG.NO.:
uxiT: � �
2 ,
UNIT:
v PEflMITTEE:CONSUMER SERVICES ( 714 ) 754-1533
aooxess: 1260 LOGAN :4V A-3
('OS7'� MESA CA 926�6
LICENSEO CONTNpCTOX OECLARpTION: I here6y aflirm Iha� I am litensed under pfoVisions o� hapter 9 Icommencing with Section
7000) of �ivision 3 0l Ihe Business ana Pmfessions Code. and my license is in tullforce antl eflect.
CITY LIC.: STFT IC.:
09�'33��_� 424349 C-39
Oate: SignaWre: � -o'�.
WOBREB$' COMPENSNTION OECIAfl/ITION: I her¢by aftirm Ihat I have a Cert��iCa�e 0� ConSent to 5e11-insure or a certAicate 01 WOrkerS'
Compensalion Insurance. or a certified copy Nereol �Section 3800. Lab. C).
POLICY NO.: E%P. OpTE:
COMPpNY:
�❑ Certifietl copy is hereby tulnishetl. ❑ Cetlifietl copy is file0 with ihe city euiltling �ivision.
Daie: NOPIiCant:
EXEMPTION FPOM WONKENS' LOMPENSRTION �ECNBATION: Rhis sectian neetl not be complete0 if che permit is for one hu�WreA (5700� or less�.
t certify that'm the pedormance Pi ihe work tor which ihis shall nat employ any peraon in a manner so as ro become
Subleci Io Ih rkers' Compe SatiOn LawS of C� ia. �
Daie� ' �' �3 Signamre� �— ^ � �
N�TICE: If, atter making this declara�ion. you shoNa hecame suhlect m the Workers' Compensalion provisions of the Labor
Code, you must forthwiih comply wiih such pmvisions or this permit shall be 4eeme0 revokee.
CONSTFOCiION LEN�ING AGENCY: I hereby a�firm thai there is a cons�mc�ion lending agency �or Ihe pedormance ot Ihe work fo�
which t�is permii is issued (Section 3097. Civ. C�.
LENOEX:
p�OflESS:
OWNEB BOILOEB OECLAflFTION: I �ereby aBirm �hat i am exempi irom Ihe Contractors' S[a�e License Law br the following teason
�Section 7031.5 Business anA Pr��essional Cotle: Any city of counry w�ich requires a permit to consiruct, alter, impmve, demolish, or
repair any stmc�ure, prlor to its issuance, also requires Ihe applicant tor such permil to file a signed statemen� that he/she is licensed
pursuani lo �he pmvisions ol Ihe Coniracrors' Siate License Law (Chapter 9(commencing wi�� Sec�ion 7000) o� Division 3 of ihe Business
and Professions Code) ar Ihat hR�s�e is exempl Nereirom an0 Ihe hasis for Ihe al�eged exemptian. Fny violation o1 Seclion 7031.5 by
any applicantfor a oermit subjeG�s tne applicant to a civil penalty of not more Ihan live hundred tlollars ($500).
I, as owner of �he propetly ot my employees wi�h wages as ��eir 5ole compensation, will tlo Ne wo�k, antl �he
❑ simcture is notintentletl orotleretl torsale (Seclion 7044, Business and Protes5ionalCotle: The Confrac�ors' S�ate License Law
does not aDDN �o an owner oi a property who Ouiltls or impmves Ihereon. ana who tloes such woM1 himseli/herself or thmugh
his or her awn employe¢s, pmvitletl ihat such impmvemenis are not intenAed or afleretl Por sale. If, however the building or
improvemenl is sold witnin one year ol comple�ion, Ihe owner will have the burden of pmving he/she ditl no� huila or improve
forihe purpose of sale).
I, as owner ol t�e pmperty. am ezclusivety contrac�ing wilh licensetl contractors to constmcl the pmleci (Section 7044, Business
❑ antl Prolessions Code: Yhe Cont2ciors' S�a�e License Law tloes no[applyto an owneroipmpehy who huiltls orimprovesthe�eon
and who contrac�s for si��h pmlects with a contractor(5) license pu�suan� to ihe Conlractors' Slaie Lic¢nse Law),I am aware
t�a� pmo� af their Warkf.�'s Compensation insurance shoultl be prnvi�ed Io me.
� I am exempt untler Sectlon: B. 8 P. C.
tor �his reason:
oaie: ow�e�
I tlo hereby cenily �hat I am awale o� and un0erstand t�e reQuiremems o� Cali�omia Health antl Safely Cotle Sec�ions 25505, 25533, antl
25534 antl Ihai I ur any tWure building occupant will/will not (circle one� neetl lo comply with said staie codes antl Ihe requi�ements lor a
permi� for cansimction or moditica�ion imm �he Air Ouali�y Management DistriCL Fesiden�ial constmction applications a�e exempi �mm
Ihese provisioni
�a�e: AppliwnL
I hereby ter�ily Ihat I have r¢atl iPis applica�ion antl Sta�e �hai IAe above informa�ion is torreCL i agree �0 Comply wi�h all ciry antl tounry
or0inances ana 5(alelaw5relaiing�o builtling constmction antl here uFPe�i re0�esenlaiive5 ofthis ciryto en� r uponihep above-men�ione0
pmper�y for mspec�ion purposes.(((777 � �
�ate: �� Signalure: C.C�SAG_—
�river's license or Social Securi�Y Y:
t6at-46 Whi�e—Builamg; Grezn—Cotle EnforcemenC Canary—AOP�icant: Pink—Revenue; Goldenrotl—Assessor
CITY OF COSTA MESA - BUILDIiVG PERMIT PERM �UO; B 063205
PERMIT NO; H 063205 PLAN CHECK NO; N GOVT'; N SUPP; N
CONSTRUCTION TYPE; 5-N PERMIT TYPE; S�T�R �`i+¢t�`�/„_I;1 �\ PRRPOSE; ALT
l[�� b ) �
JOB DESCRIPTION : T/O SHAKES,RESHEATH 1/Z"CD3t, A�PL�Y TILE SQ FT: 7,500
CLAIM VALUE; 7,500,00 CALC-VALUE; 7,500,00 GROUP OCC; R-3 /M-1
COMMENTS: SMOKE DETECTORS RE�UIRED PER T'HE 1991 EDITION OF THE UBC
����.�����.����.�.��.��#�.��.*,���*� ��.����x.��**����*��*.***-.�������#�PJIOKEib°�I�CTOR
2 O N I N GS ERTEB�AUCIKRSE M E N T S
----------- MAIN BUILDING -------- --------- ACCESSORY BU�i,Z�.,��1JRED__
FRNT; FT IN REAR; FT RNT': cT IN REAR; FT IN
LEFT; FT IN RGHT; FT N EFT; FT IN AGHT; FT IN
PARKING RE • FROV; �• 17109 ZNE; REF NO;
PLANNING TES>
> `
�i IF#IfiEiEfflh iElfiktElE#3EiF1FiEil3Elf ifi1��# if iEiFiF#iF-IEiEK�iEil' il�1E9Eif3F1F#iEiE'/FiFif3FlEiFil�iFi61f-lE�lFikiE'1E14ffifihiE�7E#ifiFif
E�i/ E L �E � ��4 �t �/��•c?' � R E Q U S R E M E N T 5
20NING AP
BUILDING
IAPPLICATION ISSU�. BY
i 3fitiEikkiEiFiEitlEififiEiFjEihiF -if3EiE
� �FlFiE1liFitiEitiFiElfitif�K�iEiFit �
LEGALIZATION;N ��
1
o "' /� '+" DATE;
G' 7�ATE;
• � � L�ATE; 7 %�% �
k x. .i i' . . . . . . . . . fEiE3EitiEiFiFiFiEif 3FiF
� . ft1EiE!liEiFi4�lEkih-1EiFiF#iE�1C-�IEi "iE�1EiE�ElEiEiEiEi(-iEiFiEiF#!(�ik'1Eif#FiE�kiE7EY�iE3EiFfEiEiFlhiEiEk
F E E 5, Q M M'A' Ft �lt - STkUCTURAL SEGMENT; Y
BLDG PMT PLUMBING ELECTRIC M�CHANxG, -'FIRE SMIP/RH$ GRADING
PERMIT 99.00 . : ; .75
' , ✓,, " SMIP/NON-RES
PLAN , .
ISSOE FEE ..'�_ � ' '
BUILDING-DIV-> PERMIT Z55UE FLAN-CHECA '�" ".TOT'AL PAID DUE
TOTALS----> 99,75 0,00 ', 0,00 � 99..75 99.75 ,00
9 w �r i ,
REVENUB DIVISION TOTALS--> COLI,-EC ED; ��'tl'= 99,7:5 OVER/SHOkT: 00
BLDG PMT PLU,yBING ELECTkIC M$CH�NIC -• ^F'3'I2E- .�,'MTP/TOT GRAUII�G PLAN-CHECK
99 . 00 4. ti l .. , 75
ff jf 1E iE ih ik iE if it iE iF iF iF iE �E fElf iE fF if 1E if �E %ik 1E iF if �f iE iF iE it iE 3E iklE9E iFiF iF iF iF 1f iE iF iP iEiEif�iE if i4 iE if 1E ff dF iE iE �E iE iFif� 3f if �3E iE iE iE 3E iE �3E iE if 16 fE if iE
I N U I V I D U A L F E E'' B"R°E,�P: K D O W N
r n x( �- • /
TYPE QTY D E S C R I P T I 0'N,: �; .�-;,UNIT COST TOTAL COST
SFR 7500 REROOF BY VALUE RES'ZD,'ENTIALr NOZONB %,=� 1,00 7,500.00
END� OF FEES - - � �,
�� �
- ' 'I� (M�.1� b�� . �Q� :��oJ`� �� Q
� A �I E �. ��:- �o ,��
i�er C�7r5zzc7�i-s /2�u.�s . . �,
��� �' � Q1 OD143645-pDi43646 T C�T 99.75
�Di;T F ��93 $I�'i.1c��G���'"�_-.�� ' DATE: 07/27/93 7If4E: l3:17
CONSTRUGTPuN ANDPLANNING
APPROVALS Permit #
1. Temporary Electrical 5ervice or Pole
2. Soil Pipe-Undrgrnd. �� I,
3. Electrical Conduit Ut�liry�Undrgmd.
4. Electrical Condurt�Un�;rgrnd. ,
r
5. Steel Reinforcement �
�• Elecvical L'FER Gmd,
7. Footings
6, Foundation „
9. Wate� Pipe•Urtdrgmd. '
10. Structual Floor SYstem
'�
11. Property Sewer Line & Hous�Co�nection
12. Sewer Cap � '
13. Roof Drains ,
14. Rough Plumbing ,
15 Rough Elactrical•Conduit '
16. Rough Electric Wiring
17. Rouah 6Vring Sign
18. Rough Electrical-T Bar Ceil�ng
�9. Rough Heating & Air Cunditioning
20. Ro�gh Factory Fireplac:
21. Ducts, in St�ucture
22. Ducts, Ventilating
23. Gas Pipa-Rough & Test
24, Roof Framing
25. Foof Sheathing �
26. T-Bar Ceiling (Structurall & ivtonpcoat
27. Frameand Flashing
28. Lathing & Sid�ng
29. Insulat�an
30. Drywall Nailing
31. Pixster Bro�vn Coat `
32. Electncai Power MeterFinal �.
33. Final Electric i' ;
> i�
34. Final Heating � Air Conditioni�y.,
35. Final Gas Pipe-Test ` r
36. Hood or Canopy ' �
37. Final Fsctory Fireptace �
38. Final P-tumbing
39. tVater Service•Fina�
40. Gas Seh�ce-Final
41. Solar pamestic-Final
42. Back'flow Preventer
43. Backflow Irri9ation
44. tandscape Irrigation $ystem
45. Sound Attenuation ' ' .
46. HandicaP Regulations'. . ;'
•'-
47. FINAL'STRUCTURE'& Bt11LDING
4E. FINA�-PLANNING �
49. Electric Release to Edhon",,
50. Gas Release to Southem Callfomia Gas C
51. CERTIFICATEOFOCCUPANCY
Jo. �. _ - Date
Date
P00� �PA
Inspector APPROVALS Permit #
52. Pool $r Equipment Loc�tipn
53. Steef Reinfarcement
54. Forms
55. Electrical Bnnding
56. Rough Plumbing & Pres,ure Test
57. APPROVAI. TO COVER-GUNITE
58. Electrical CondUii-Undrgrnd.
59. Gas Pipe, � Undrgrnd., Test
� 60. 6ackwash l.ines, P-Trap, Q Undrgrnd.
67. APPROVALTODECK
62. Backwash & Receptor�Final
63. Heater & Vent�Final
6Q. Plumhing System - Final
65. Electrical-Finai
66. Salar SVstem-Fins!
67. Fencing & Access Appro��ai
68. APPROVEO FOR PLAS-fERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APpROVAIS Permit#
Date � fnspector
70. Underground HyUro f
71. Product Pipinc� �Gas ❑Oii i
72. Under9round Flush `"� -. �i
73 Undergrntl. Srorage Tank O Gas ❑ O�i t
74. Overhead Hydro :�
4. u+� eS
' ._ 75. Dry Chemical �T� '�� .
a
£. •.�
�7$. Dry Standpipe i a_ -
i' 77. FIXED SYSTEM FiNAL !
�, , , ;,,��..; ,_.
,;, 78. FIRE PREV. FINAL r% ' A'
� •
��,,� NEALTH DEPT. REQUIREMENT. - - �••
�� 79. FINAL INSPECTION ,''� I � '�
--#-
80, FOOD CERTIf ICATE ISSUED i_
, Notes: 5 ta �O /�(� L✓oy/�( .
' �Yor� o � tva�/1�� �snr/� - ?/?Y��/
i ..
0
3590�
201 C COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
BUILDING
ADDRESS
�
OWNEF LA IN SOUT N CALIFORN7A INC.
MAIL
Z nooRess16255 Ventura Blvd.
a c"'i CITV Encino California No� 986-889
F Z
� N �Noea��oNLARWIN SOUTHERN CALIFORNIA, I
�� BRANCH 16255 Ventura Blvd.
J N
m � ADDRESS Encino_ California 91316
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ADDFESS 9100 Wilshire Blvd., B. A.
CONTRACTOR Larwin Southern California,
nooaess16255 Ventura Blvd.
ciTv Encino, Califomia No� 986-8890
L C No. 191311 LICVNO. B�l
OF LOT 6O XLOO NO.OF BLDGS.
NOW ON LOT O
USE OF
EXISfING BLIX'i.
SIZE OF NO. OF
_RIOfl WALL ROOF
EFING SY.l1CC0 COVEFi1NG WOOd I
OF BUILDING AND WORK TO BE PERFORMED
1 heraby acknowletlge that I have raed this application and sSate
that the above information is correct antl agree to comply with
all laws regulating builtling construction, antl I shall not employ
any person in violatlon of the workman's compensetion laws of
the State of California.
I hereby certify that I am properly licensatl as a contractor under
the State of California Business anA Protassions Cotla, Divisicn 3,
Chapter 9, and that sucM1 licenses are in full force antl etfect, or I
am ezempt from ttie provisions of the Stat¢ of California Business
antl Professions Cnc/le, D'�ivision 3, Chapter 9.
Signatura o�l:�ae�E�� N �/
Permittee t �//l,/6��"' � ���
Authorized Agent
JUl -5-73PAIo00 2��# **� 139.04
CMSk
APPLICATION FOR BUILDING PERMIT
BUILDING
AD�RESS
TRACT
OWNE
��C/'
VAWE
FIRE
20NE T E GFOUP
APPROVED � i
B.V DATE �.J�
20N NO.OF USE OF NE �
� PLAf�S Z BUILDING
VAROSAPPFOVED VARDSAPPROV D
MAIN BUILDING ACCESSORV BUILDING
(FROMC/LS EET)
FflONT ��FT. FT.
/� F � FT.
L. SIDE S FT. FT.
FEAR �S FT. FL .,
DISTANCE BET. BET. MAIN &
VAR. #`
C.V.P.#
FOR SPECIAL
DATE
APPROVED
�
�� �
� SQ. FT. o
HE AMOUNT SHOWN UNDER VALUATION IS FOR j
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: Q
VALUATION �i✓'�O � m
j PERMIT FEE� $ �
$ J�.�!��� O PLAN CHECK $ �' � E
�QI�3YYNT //� p
T TAL"FE�� � LL
CITY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT N0. / V J'� /
L07' N0. �'7` D
ADDRESS ��,%y ���/
DATE�f� /97 5�
�
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 agreement, acknowledges that (he-she-they)
(was or were) ,C.tJ-Pii,2/ advised that this tract has
not been given final inspection nor has it been accepted by the City of Costa
Mesa as having complied with the conditions of approval which were imposed by
the city at the time the final tract map was approved.
The city assumes no liability for the enforcement of the conditions necessary
fo�' approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the city harmless from any claim
resulting in damage or personal injury to the undersigned by reason of the
afOrementioned uncompleted condition.
RECEIVED
CITY OF COSTA MESA
u� np�n���i.. ...�T
JUL 1 G 1974
AM PM
7i8i9il0illi12ili2i3�4i5i6
�
BY 7��� �/?/ x-.�-tJ
� Purchaser
BY �G� C1�J .
D veloper andfor authorized
representative
m
Lender