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Home My WebLink About496 SHADY DR - Building PermitsoWNER COOPER, MADELINE `, GENERAL CONTRACTOR � AP No. 11%-3%1-�10 LOT INSPECTIONS � OCCUPANCY nnTr 8-8-61 BUILDING PERMIT NO 0. ROy VALUE $ 3s TRACT FIRE ZONE DESCRIPTION OF Signature DATE GROUP r TYP� SUBCONTRACTOR — 7.ON� i h na . �5y��; COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COBTA MEBA. CALIFORNIA ° For Applicanf +o Fill In Compleiely � � TYPE OR PRINT 1 MAIL MESA. �� OF LOT � � � W USE OF EXISTING BLOG. � F�E RECEIVED AUG 8 1961 FINANCE DEPT. APPLICATI�lY1f�� TMESA BUILDING For Offiee Use Only l/ ' I [ 'Gv BUILDIN a o ADDRE68 COSTA MESA. Cq OR. FIRE � ZONE TYPE GRO � APPROVED G BY DATE NING ZON NO. OF UBE OP NCW � � PlAN9 v BUILDIN6 GH6CRIPTIONI / I � L 1�� PD,\ � � I NO. OP BLDOB. B6iBACK LINC PROM � cEHTER OP 9THH6T -�� * REAR YARD �� / / iY BIDE YARD LEPT \�� RIGHT G � DESCRIPTION OF WORK $B Z LDING \�' y I�� ROOM6 n EXTERIOR WALL ROOF COVERING COVEP USE OF 1 IyG AND WORK T B a __ . / . n �% . J/7'- 37/- EVES iD ALLO1 LIN6 9TJ . i, i �i A c G • -G I HERBOY I�CKNOWlPD08 TXAT I MAV6 NGD i1118 A�GLIWTION TXE AMOUNT BHOWN UNO¢P VALUATION IB POP TH8 AND BTATE TXAT THH ABOVB 19 COpHBCT ANO AOWeB TO COM- pUliP08E OF E6TABLIBHINO A PBRMIT P88 ONLY. PLY WITM ALL CITY ORD CE8 BTAT6 LAW6 fl80ULATINO ,aUunlNa coNeixu N. ' VAWATION � SIGNATURE OF � � Q� PERMIT FEE $ � . S `� / ; D � PLAN CHEGK $ � AUTHORIZED AGENT �` (� ' �,% Q-0 TOTAL FEE �� PNOJECT PUOflESS: Q 9 E SHADY DR uxiT: � OWNEfl'S NAME: ELAINE SVEDEEN nooAess: SAME MN "' 642-2603 AflCH/ENGINEEfl: HFG.NO.: RDDflE55: IINIT: PEflMITTEE: CRANK BROTHERS ROOFING (714)548-5569 FDONESS: LZb COMMERCIAL WAY COSTA MESA CA 92627 LICENSEO CONTNRCTON OECURpT10N: I �ereUy allinn I�al I� licensed un0er pmvisions ol C�ap�er 9(commencing wil� Seciian 70D0) ot Division 3 0l Ine Busineu antl Pmlessio tle. ana y icense is in full lorte ana eff cmu : 005993 STRTELIC.: S6%% c ss: C3�� i � J Oate: � r v ignalure: — �� ` � WOBI(EHS' COMPENSR710N OECIAMTION: I �ere0yal - � I Aave a cetlifrcale of coreem to selbinwre or a anificate ol Workers' CamDensa�ion IpSWppc6�or,a4c��a covv merea� 1 ti 3eoo. �ab. ��1 / O 1/ 9 3 POLICY NO.: L°� L� exv. onTe: comrnxr: STATE FUND,.y ❑ Cenifiea coDY is �ereG fumis�etl. l'J/? �nilieE coOY �s witA ehe ry BuilUin UiNSion. � Date: �_S+� M4iiwni��i..� �� / E%EMPfI N iPDM WONI(ENS' COMPENSRTION OECIAN�tION: (ihis secuon neeC not be cOm0letM ii Ihe ce�� s �a �e Aurbre0 �StOU) or less�. I ceM1ily ��al in I�e OedormanCe ol I�e work br whiC� �his p¢rmii i5 i55Uetl. I S�ail noi emDlay any perwn in any manner 5o as lo OecOm2 subjttt Ia I�e WorkerS COmDe�sation LawS a� Califomu. Dale: Signature: NOTICE: II, atler making ihi5 detWraliOn. yrou S�oU10 beCom¢ SuEleCi lo Ihe Work¢rs' ComDensatian pmvLsions oi �he �aDor CoEe, you mustlonhvnt� wmpty vnt� suc� O�odsions ortNs permit shall be Eeemed revoked. CONSTBUCTION 1FN01NG RGENCY: I �ere�y aifirm Ihat Ihere is a constmction lentling apency for tAe Oetlarmance of t�e work for whic� ��is permii is issuetl (Seclion 3097. Civ. C�. LENOEX: nooxess: OWNEB BUIIDEfl OECUBRTION: I hereGy aflirm Itwt I am exempi �mm �he Contraciors' State Licenu Law for �ne followinq reasan (Seclion 7031.5 Business an0 Pmlessional Code: Fny ciry of county w�ich r¢quires a permit 10 consimct, alter, impwve, tlemalis4 or reoair any simcture, prior la its issuance. alm reQuires ihe applicant lor sucn Dermil to lile a sipnetl slalement Itut he/she is licensetl pur5uanl to ihe pmvi5i0n5 Oi Ihe ContratlOrs' S�aie Litense Law (Ctup�er 9(commen[inp with SetliOn 7000) Oi Oivivon 3 O7 ��e Busin¢55 anG Pmtesvons CaUe) or Iha� htJSAe i5 exempi Ih¢r¢IrOm an0 IOe UasiS lar �he alle0� e�emplion. My NOIaIiOn 0� S¢cti0n 7031.5 by any aD�licanl for a Oermit su�lecls Ihe apDlicant ta a civil penalty af not more than live huntlre0 Oollars (SSf10�. I, as owner ol t�e D�opeM or my employees witA wages as �heir sole comDensation, will Eo the work, an0 the ❑ slmciure is no� inlenEeG or o��ereA lor ule (Section 70aa, Business antl Pmleuional CaAe: The Coniractors' State License Law does noi aDO�Y �o an owner ol a proDe�y who Ouiltls or impmves �he�eon, an0 who EoeS such waA �imsell/hersell or �hmup� his or her own employees, provided that sucn imDrovements are not intenA¢0 or offerea for sale. If, Aowever ihe builaing or impmvemem is soltl within one year of complelion, ihe owner will �ave �he burtlen ol prodnp heJshe did nat bui10 or improva for 1�¢ purpose af sale�. I, as owner ol ihe pmpeny, am exclusively tomrac�ing wilh Iicense0 con�ractOrs Io consVuc� lhe prole�� (Seclion 704d, Business ❑ ane Pmfessions CoEe: T�e Coniraclars' State License Law aces nol apON to an ovmer ol DroOerty �o Dml4s or imD«s thereon ane who conbacts 10� sucn pmjecis vritA a contractoqs) license Dursuant ta tAe Comracmrs' Stale License Law�. I am aware Ihal omo� ol Ihei� Worker's Compensalion insurance should �e pmvitleG to me. � I am e�empt untler Seciion: B. 8 P. C. for Inis reasan: CITY OF COSTA MESA - BUILDING PERMIT � , PERMIT NO: 8 056868 PLAN CHECK NO: N . , CONSTRUCTION TYPE: 5-N PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION ; TEAR-OFF & REROOF 1200SF RESID W/GRANITE SQ FT: 2,975 CLAIM VALUE; 2,475.00 CALC-VALUE; 2,975.00 GROUP OCC; R-3 / COMMENTS • * �'+v/� iflFkififiFififitiEjkifififlE9EiEiF�lFaflFiE3EkikiE3fiEiFiFifiElEiEiEifiFifiEiEifiEif�Eifif�lfiEiEiElEiEiFiFafiElil3EiFifiF�� iEiEkiFifiEiFaFIFiE 2 O N I N GS ERTEBQAUCIKRSE M E N T`S�` ` �� f��-y-`�� ------------ MAIN BUILDING ---------- --------- ACCESSORY �1�`I.B1aA7��'t�-�-g a�'- FRNT; FT IN REAR; FT ZN FRNT; FT IN REAR; F�1� IN . LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN"'� PARKING RE(� • PROV; PARCEL; 00000000 ZNE; REF NO: PLANNING NiSTES� > ' 1f ik if iF iF if if IE iE It iE iE If K if 3F 3f M 3F if ik af M iF if �1k iE af if iE 1F iE iE 1E iF if 1E �lh if iF iE iE k iE if it iE 1F�ElF if 3f iF iE IE if iF if �F if iF iE iE iE iE k i! iE jF'fF 3E iF fF iE k 1t IE k iF D E V E L O P M E N T S H R V I C E S R E Q U Z R E M E N�T S r 20NZNG APPROVED BY DATE: � BUILDING APPROVED BY ; DATE: APPLICATION ISSUED BY; DATE: �� klElEifkiEiE�EifiM1iEiEiEiEififififaE�kifiE3F3fiF3FTF�FTF3F3FifiF'ifTF?F'if3F'iF3F3F'iFiFiF�iF3fTF?f'3F�if3f3f7FiEiFiEkiFiEiklFiFiE aFiE if i! 3f iE iE iE iF iE if iE if if iF iF iE if iE �)f iE iE 3f If if if iE jE it a! iE 1E iE iE 1E iF iE iE 3E if �E fE 3E �E if iE 1f iE iE iE iE iE iF iE 1E k iE iFiF iE iF iE if k iF if iF M if if # iEif iE if iE iE 1E �F iF 1F LEGALIZATION:N F E E S U M M A R Y STRUCTURAL' SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES' GRADING PERMIT 54,00 50, PL� SMIP/NON� RES ISSUE FEE ,, •� BUILDING-DIV-> PERMIT ISSUE PLAN-CHECR TOTAL PAID" , DUE TOTALS----> 59.50 0.00 0.00 54.50 54,50 .00 REVENUE DIVISION TOTALS--> COLLECTED; 54.50 OVER/SHORT: .00 BLDG PMT PLUMHING ELECTRIC MECAANZC FIRE SMIP/TOT GRADING�PLAN-CHECK 54.00 .50 .: iP iE k 1E k 1f k 1F �E iE fE�f k iF iE k k if iF if 1E iE iE if 1E if iFiE fE jE iE k iE 3E if ft 3! k if i! i! it if iE if iF±E if if if iF iE if if iE iE ik if M iF if �1(� IE IE iF iFi! iF itriE dk �f IF iF i(� �E iE iF fk 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 Z P T I O N UNIT COST ��'OTAL COST Date: �"^e�� I $FR I Eo hereUy certify Iha� I am aware o� an0 unAerS�anE t�e r¢quiremenis of Cali�ornia Heatt� anE Sately CaOe $ections 25505, 25593, and 25534 ana t�al I or any fulure buil0ing occupant will/will not (circle one) neetl to comply with saitl state coaes anA Ihe reQuiremenis far a permii lorcons�mc�ion or moUificalion Imm Ihe Air Oualiiy Managemeni �isl�ic�. ReSiAenlial cons�mclion applicaiions are exemp� imm I�ese pmvisions. Daie: pDP�icant: I �er¢Uy teriily��al I �ave rea01hi5 applital� ana Siall ordinances an0 Slatelaw5 relatingla buil�ing on5imction pmpetly lor ins0ec�ian purpo es Date: `^ SignaWre: Driver' License ar Social Securi�y a: � Canarv—AoolicenC Pink—Revenue: Galtlenrotl—Asnquxor 2975 REROOF HY VALUE RESIDENTIAL NOZONE END OF FEES 1, 1,00 �1 2,975.OU r f�j •� i DI OD1122b0-D0112261 T �o�' '.�,_� oare: a¢io�:9� TlfiFa �3:�.h CO..;�TRUCTION AND PLANNING POOI & SPA . Date Inspector Date Insp�ccor APPROVALS Permit�# � APPROVAIS Permit # � .�- 1. Temporary Electrical Service or Pole % � 52. Pool & Equipment Location 2. Soil Pipe�Undrgrnd. '� - � 53. Steel Reinforcement " .�� 3. Electrical Conduit UtilityUnBrgmd. �' . 54. Forms 1'� 4. Electricaf Conduit�Undrgrnd� 55. Eiectricai Bonding '� , 5. Steel Reinforcemen3 56. Rough Plumbing & Pressure Test � 6. Electrical UFEF Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings ' � . 58. Electrical Conduit�Undrgrnd. - 8. Foundation � ` �= ' 59. Gas Pipe, O Undrgrnd., Test i� 9. Water Pipe-Undrgrnd. � �'� 60. Backwasb Lines, P�Trap, O Undrgmd. ;:� : 10. Structural Floor SYstem �� 61. APPROVAL TO DECK � it. Property Sewer line & House �onRection 62. Backwash & fleceptor�Final � � 12. Sewer Cap ��/` , t 63. Heater & Vent-Final �� 73. Roof Orains � ^ 64. Piumbing System � Final 14. Rough Piumbing �, _- 65. Electrical-Finai � � 15. Rou h Electrical-Conduit �� _ 9 66. Solar System•Final 16. Rough Electric Wiring '� 67. Fencing & Access Approval 17. Rough Wiring $ign �..I 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINA� 19. Rough Heacing & Air Conditioning FIRE DEPT. REQUIREMENT � 20. Rough FaCtory Fireplace � ' APPROVAIS Permit # �, 21. Ducts, in 5tructu{e ., � 70. Unde�ground Hydro 22. Ducts, Ventilating ^ - 71. Product Piping OGas OOiI 23i Gas Pipe-Pough & Test . - 72. Underground Flush - 24. Root Framing � .� � 73: Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathi�g - 7A. Overhead Hydro 26. T-Bar Ceiling (Svucturaq &,Monocoat 75. Dry Chemical 27. Frame and Flashing _ 76. Dry Standpipe 28. Lathing-& Siding • � 77. FiXED SYSTEM PINAL 29. Insulation ' '' - 78. FIRE PREV. FINAL 30. Drywall:Nailing HEALTH DEPT, REQUIREMENT 31. Plaster BroWn Coat � ,79r FINAL INSPECTION 32. Electrical Power MeterFinal . • . 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' Nojes: � . 34. Final Heating & Air Conditioning ,- � _, � , . _ 35. Final Gas Pipe�Test ' - 36. Hood or Canopy � '37. Final Factory Fireplace . • � � , . 38. Final Plumbing " _ , _ 39. Water Service�Final - � 40. Gas Service-Final �. � , � I 41. Solar pomestic-Final � • ' • 42. Backflow Preventer � 43. Backflow Irrigation . 44. Landscape Irtigation System , - _ ,� . ' � - 45.�Sound Atteouation � � � � ' 46. Handicap Regulations - ' ' . , � � 47. FINAL S7RUCTURE & BUlLDING ,_`y� �L„(L fl�y � Q�i ' ��- d 48. FINALPLANNING ' ' • � _ � 49: Electric Release to Edison �� „ � 50. Gas ReleaSe to Southern California Gas Co � �. 51. CERTIFICATEOFOCCUPANCY , No. Date �� ONMEX'SNAMEIFR�ORN:yVt.Ut.C.N GLHl �o� 496 SHA�Y DR COSTA_MESA,CA �vv�. Wu�c �ooxEss: urcxrtect oe Enr+x�x: � _ _.._ ur.r: . --- --- G "TR _ . _ _. .. 92627 . uc. xo.: uxr: � ca+m�craxsru� CRANK HROTHERS ROOFING CO ( 714 ) 548-5569 � CONiPACTORSYYIttMi 126 COMMERCIAL WY ._,.__. �ooxEEss COSTA MESA _ CA uc.No: 408677._..�_ 9Z627 uMr: __ `.ICENSED COMN�CTOPS DECU�PATION: I hereEy ellim uMer peneXy d pe�ury ihe� I em liceneed u qoviaione ot Cheper 9 �cwnme'wnp xnh Section ]OW) d Oivieun 3 d the Bud�wsa eM Pmleeeions COEe, eM my liceme'e i oRa enE ellatl. cmuc.No.:005993 uc,cuss: C 39 _�� N 408 XP: 06/98, _ offi,: ��—/�— 9'7 ��„�a OWNEH BUILOER OECL�flATION: I he�eby elfirm uMer y d perjury ihm I em exemp Irom tM ConlreUae licenne law la Ilro 'bw'vq reewn (�bn )031.5 &ni�ms eM Rofeasans Code: AnY cry a countY �� Qu'vae e pafmA to mmWtl. elix. imprare. nd'nh. a repei eny euucture. pnw to is ceuence. ebo rW�m �M apdiraM ta wch permil to fib e apred eweimnt tlal he or ehe iiceneed purwent b the powsbm d tM Coniretlon limnse Law jGMqer 9(commendiq wi�h Sedion ]OW) d Diviian 3 d ihe 8uainese eM PrMeuons Coda� a ihe� M or ehe ie a�empt Ihaelrwn end the beeis fw tha dleped ewemption. My videtbn d Sedion �aai.s M dn mWirem ��. vam�a wdaw me evqcem �o e dw roreM d na m«a inen Me hunared ddlv.155ooU. ❑ �.e.e..nera�newroa�v«mr�v�a�ea•wnwe6�%+�ne:sdemmro��.�neoinewwk.ene�naewm,n:�am�eMee - or ollered lor veb (Saclion>01d, Busirom end ProleaaianaGoda: The Comreqwe Liwnee Lew Eoee nM eppyto en owner W propeM who buids a inpavee tMreon. aM who does auM work NmaMl a MneC a Nraph he or her own amplvyeee, povided ihea euch �mawemems va �w mimwee or orcered ra sa�e. n. nowe.e.. me w�anq v inww.n.m v.da wnn� on. vw a onnWa:n. mme owner-buiMer xill heve tM burEen ot qovieq M w eM d'd na WiM a impmva la iM WN�e M xle�. - ^ ❑ l es owrer d iM MOV�v. em ozdusrvM' mnireeip wnh lioenaed conoxiws �o cmarua Me i�ol� (Seaion ]Oa. 9uai�c. ud Pmlam'vu COEe: The Com'acwa License Law dos �w eVWY m en owrcr d D�WMY who Euilda a Impw'm �hseon ud who ,. conirecb Ia ew� prqeds wiN e mmreaor�s) Icensed punuenl lo Iha Coniraqas Lim�ue Lewl. � I em azemp uMx Senion: B. 8 P.C., br No remon: .. Dete: �� I do hereby cenily tlal I am ewers d vd uMerstaM Hro rpuimnema W Cd'damb HmXh eM Selery Code Setlbre R5505, 255�3, end � Z5531. ud ihel I a vry Mure Wikinp ompam will / wil �wl (drtb an) � to compFy wih mid Me mdr ud tM rpw�amams (ar e pa�millawnniuCion a modifimtmn hom�heAi�Buit�epament Dinrid. Reeidmtiel mntl�utlion eppimliareme eaemq Imm Ihoaa „�,�om. _ .. Dete: Applicent: WORKER'S COMPENSRTION DECLAHATION: I MreEy elfi�m uMer panely W pajury ms d Ma lolloxiip detlumiona: ' � I heve eM �ril meinten e ceMctle d mimni to esMimwe br xvkai canpenWion, m provided la by SecVm J]Op d tM labar " coae, �o, �ne vanormeMa d me wwk t« wkcn �nb o�il ie iea�ee. —.� �I hew eM wil meimen xwNen' canpemmun imurerce. u reQuired by Setlbn 3]00 d iM Lebor Code. br the ps�lormence d ihe w«k lor whidi tl�b G�n c iaued. MY waken' canG�+mion mwrerce arrier vd GdKY r�umber ue: c�.: EXPIRES._ ra�yr+�mea�. 7R5—Q4f7NTT . .4 O1/OL/98 '� �nrs .:«v;m �ned,pr ee cm,deroe r me vmme o ro, a„e wne�ed eawslsiool o. �en.l � I ce�ify �hd in Ihe pMormenne d ihe wark la xhch Ihie permtl ie ieeuetl. I Mell �wl employ enY P^�^ in enY menner eo a� lo wbjed to the wakere' compenea�ion kx+ d Cdilomie. d eprea Mn il I� Eewms wbjetl to IM worlmn' prov/ie�/y ol Sedyion 3]00 N tM lebor CaEe. I e1Wl /o rilh aompy wilh p�m�moru. Deie: � � `Y � ( ' Applicenl: WemLw: Fd/u� ro aecun woitrsri comneiwtlon covsrep un/D rl. antl �hd/ w4Nct an rrWloym ro u1Mml pmeMu enC . S�ctlon 9]OS oI M� Labo�Gotle. �nlxut, nw �mm�Y � rwa CONSTtiUCTION LENUINO �GENC1: I hertEy elfirm uMx perelry d perryry ihel ihen u e owwvtlian bMi�p eperwy M Ihe peA«mence d �he wo�ic lor which Iho permi ie asued (SeGian 3091, Civ. C�. LENOEP'S NAME: LENDEfl'S ADOHE55: I ceMity ihet I hew read Nia eppliceiion md elala iMl �he abmn iMmnYion ie corred. I epies 10 mnpty with ell ary eM oounry adineMee eM emle lexs reletip to buJdig cmmumon erd heretr/ eiMarce requentetnes d iho tlty to antm upon �he ebv.e�mentunW p�apeny �Of1�19pBC110fIpYfPOHB9. � JIM CRANK � (5151-IB.WP) oma a—/G � Whne-BuiWiq 8 Selety: G�eerFla: Cenery-AOVk'ant: Pink�iarenue: 6oNenmFRsrame _. .__. ._ ____ _ ___ .___CITY_OF COSTA.MESA_ -_ BUILDING_.PERMIT� ._.. -- - - . _ ..�.. _. ... . ..---- - •- - . ..__ - - - � , _ __ .. -- - - - .PERM _NO.: H 086187._. PEAMIT NO: B__ 086187__ PLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE: V-N __. PERMIT TYPE: STR PURPOSE: REP JOH DESCAIPTION___.:_T/O REROOF AEAR PAAT OF RESID W/HUILT-UP S.Q FT: 2,565 CLAIM VALUE; __ 2,565.00 CALC-VALUE:. 2,565.00 GROUP OCC: R-3 /U-1 COMMENTS: T/00 REROOF.800SF REAR_PART W/BUILT-UP �r�e+r�r*�r***+r�*�******�e��**�t*�r�r�r**�e*******x*�e��t��r**�e**�**�e�+tx�+r+r�r�r**�r�r��c+t**�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.HUILDING ---------- -----�__-,ACCESSORY_HUILDING --------- FRNT: FT.__._IN.REAR:. FT IN FRNT: FT IN AEAR: FT IN LEFT: � FT__._IN RGHT; FT IN LEFT:._ FT IN RGHT; FT IN PARRING REQ• ,�__PROV:_. . PARCEL:_11737232.ZNE: REF NO: PLANNING NbTES>:�. ""r '1. r iF fk iF iE If iE iF k ik i4 if ff iF k k iflf if if iF ik if if M ik if if 1k iE if k if if iFi{'M k iF ik iflE ik if if if if iF iF if ik 1f if k if iklf k if 1f iE IF 1! k 1k �F iF iF ik ik iF i! if �klFlf ff IF if iF D E V E.I. O. P M E.N T r S E R V I C E S R E.Q U I R E M E N Tj� S /�f' ZONING APPROVEISR-BY_ DATE: l.�' BUZLDING APPROVED HY_: DATE: /3 n APPLICATION ISS,UED HY; DATE: �Z'I� ifiFikifiEififlFikiFifitifitifiFiFiFlElfifiE if�EiflElkiFiFi4iFik iflk .LEGALIZATION:N._..._�____ __.F E E S U M M A R Y STRUCTURAL SEGMENT:Y __.BLDG PMT.__PLUMBING ELECTRIC MECHANIC FIRE - - -74..75- --- -- --- SMIP/RSS�� GRADING SMIP/NON-RES ' .ISSUE FEE. _. _ BUZLD.ING-DIV.->__._PERMIT ISSUE PLAN-CAECK TOTAL PAID DUE TOTALS---->., -�. .. 75.25 0.00 . 0,00 75,25 75.25 .00 REVENUE DIVISZON_TOTALS--> COLLECTED: 75.25 OVER/SHORT: ,00 ._. BLDG PMT_PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK J4.75 . - ---- ._. _ . .. . . 50 1E1fiEMiFMifffMi4lfifif�kikiflEif i/ifMkMiFMlFlfifiEiE%iElf%iFNMiF�FMMKikMiEififlEiEifif if1E%N%iEiFifMKiFiEifiEiFi(�ifiElE3FiF14iF1f MiFiEif 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 SFR 2565 REROOF BY VALUE RESIDENTIAL N020NE 1.00 2,565.00 END OF FEES N ?2-16-1937/10:51 Af1/575.25 RCVT�:91 u916959 PEki"iIT:0861Fs7 �=�_ CONSTRUCTION AND PLANNING ,� P60� & SPA APPROVALS Permit # � Date Inspector qppROVALS Permit # Date Inspector 1. TemOorary Electricai Service`or Pole 52. Pooi & Equipment Location - � ,�_2L, Soil Pipe-Undrgmd. � � 53. Steel Reinforcement >^, . ..t.7.3��Flectrical Cond�it.d��ylity�Un��rgmd. 54. Forms � r � ry7A7�lectrical Cond�Y�.KSdrgrnd. 55. Electricai Bonding � ti �-�j�teel Reinforce�� 56. Rough Plumbing & Pressure Test C S v '�[�!6.<Electrical UFER��Ysfd. � 57. A7PflOVAL TO COVER•GUNITE -r -� e- !� nv. .,��,µ�'f.00tings „� � � 58. ElectricalConc��Undrgmd. ��^8. Foundation � d� � 59. Gas Pipe, O URr¢[�grnd., Test n9. Wa[er PipC�Und��d.` � 60. Backwash Line�;�Trap. C� Undrgrnd.. c�70. Structural FIoa+S�Yscem a � 67. APPROVAL V�ECK -� � . 1 i. Wroperty Sewe(.;1.ine & Hous�Connection 62. Backwash & Rec�torFinal � ' 12.�Sewer Cap � � V, � 63. Heater & Vent�F�sal " - ' 13. Roof Drains ^ ' - 64. Plumbing System � Final � � 14. Rough Plumbi g a, • X 65. Electrical-Final - �. � 15. Rough Electricetb�Ccwduit� .� 66. Solar $Ystem-Riffa'1 �, 16. Rough Electric�Viri� � 67. Fe�cing & Rcc�{bP,pproval , � 17. Rough Wif�ng $i;gn 68. APPROVED F�R'PLASTERING . 18. Rouqh Elecirit3'Y-T Bar Ceiling 69. POOL/SPA SYST�MS FINAL 79.�ktou�h Fjq�ting &rF,�yr Conditipqirag �,7 M .i m Q.�� C FifiicffiSPTtzfiEQU1REMEPF�T [u ;r ^. � G : , * �. .n 20.�iosh F'actor� F�eblace I ST a'� * S�-+ -*(' qppF(O�S"F" Permit #* � ^ i (v N :k i H=. .'CS .t: 4 �7 '7;: i ^7rC i*7 � r � a: �.... H 21.;.puqts,in�truciur�x Sr+ x C� r-� C:� 70.FL1ndergcoundFlydro � 22.�ucts, Uentil8kin}}M � ^n x O <G CJ Fx• ! ��. prod ��iPing7�'ias �`'�Oil n ..x i x r;. H.x ... r. p: u -i � ['i � x:*1 v' .. ti. � � � �, �� a: r.� 23. Gas�ipe�to�h �'�,est ..n, �jp y � p: Sx, 72. Undergr.aupd � sha = >, rn 24. floof Fraraiing 'rJX �,T�, *� 7� N* • y� Undergr(�d. St Y�e`�,�anf� � Gas ❑ Oil 25.�,Roo�She'athing M� /Z`�; �('� 7.cOverhead HydigT * 26.'3•Bar CeiNng (Str.actural) & M67�Scoat x O >' C* 7�.%Dry Ch ical `•-'� * n /�v � M S � ^ 27.;`#ramean`' F'hi�hi�?' �w" �' � � .• .k �;d � 7� �.. � m� 76. Dry Sta�WPeq� � rJ c� G F 28. Lathin & Sidin ..,:< � 'jt�H O �K ` � � +-� n f 9 9�. � � ! c{ vt FIXED`SS�ST�FIN� , i 29. Insulatio"��i rJ tuR S t?, �r S I � �. FIRE PREV, F11�F'Al. � r �� 30. DrywallSlailing T* � � � F � S NWEALTH DEP�. EQUIREMENT ( ° i ^ - �„ 31. Plaster &o�v�Co�� ! `.Y�'E; * I I � ` 79. FINAL;t,fJSPEC�N * � ,._, �� 32.�ElectricalCPower Meter�F.inal i x� , , �t � SB; FOOD CERTIFaCATE 153L1ED+ �^. T� �"1 Y r' 33.=fine�lEl^ui�' `�M '-'7 ' 'S '�' � � �`�',(2es: � ��`�' �� y � i�C7 .�. �.i' f'1, �+'^.'K .C". 6'. !. � I tX 'Y� � C*IC1 i-+S �� 34.j�in He�iing•& Air�Cs�dition g y #� � � H � T.� Y� ;,y� 35.�,�Fin�Ga PiPe'�T :t Cx� .. �"+ I � h: xo t7.�+ # i�M r. �� :� r � :� ;*� ...n K m t; r 36.d�loQ�i or'�Cano `�� ` � , � �. , . :� PY.�>c C'� �+ M � I � m zo K C'7 �-1t: �' - � ` 37. Finai'Fa'�rtory Fir`e�"p�cex !'"`; � x N � I � � � SN n+ F 1 . 1 V .: ' . .i ; 38. Final.Plumbipg ;;+�; m� t w .x � !� r+ S � �i � 39. Water Se�uic@-FinalM � t � =. � (� , r� � � � �-o * i a: � t-- � • � m m 40. Gas Ser e-F nai � t� jr,_., �,'y K � F•;vE x� 41. Solar Ddtt�es4k-Fin� u � � � � � � !T' '7N �� ^ =' . S 42. Backfiou�Prev,enterx �,; ?�'j"N � �.,, � * -� mQ1, x `� �i.".. . �.- .. 43. Backflow Irr�ation�x >+� � ct, x. r � �� Ct • t -' � Y .' F N +:s' O o (s' N 2 X J '� v w w .., •• �44.�andsca� irrigatio,e�, Systertrj�x .� � �,, �.� � g ��G * S H .» - ., . . . . _ . 45.�ound ftttesauationF "� ••�•• � ~ � m �T* ^ 7' '� � • `"� * `c' c. � S T• [*1 •�� / / N41 ••H :K �6. Tlaqdicap'Regulatio�s :.� .. x s � � � tTi.vi� CJ * !d7.�I�YALS7RUCTUR'E&BUILDING � I ' � �' � E" �.- :� �. �-� r!L L?=f7 �'� x �, c 48.�IP{l�LB�.ANNINGx" i r� * V ' � ��, !'J N S * � • cA9. Electricd3ele�e to Edison i � i � k� � � .(i k m_ � x � 7 oS .W :� ^� �50.'6as�ele�se to Sout�iern Cali%o�waGas Co � � �. � �p `�; z: iJ e "51. CE IFICATE OF OCCUPANGY " Date . w, r ::., �; e CITY OF COSTA MESA BUILDING DIVISION � v � � � DEVELOPMENT SERVICES DEPARTMENT J�— � � PERMIT PERMITNUMBER� �� B98-01907 (774) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite: Viciniry: Parcel Nunmber: 496 SHADY DR 11737232 Applicant CRANK, JIM Address: 126 COMMERCIAL WY BUILDING PERMIT Zoning: Status: ISSUED Applied: 10121/1998 Issued: 10/21/1998 , �" � ,� � Phone: "949-548-5¢69 . - : r . COSTA MESA / ;, j=! �. _ , � Zip: 92627 � _ � ' l .., i // �'� l_- � ' c-\ owner. SVEDEEN%ELAINE G TR ' % � � j , � j � _\ . � , i Address 496 SHADY DR . � � ` - � �, �- �� /\ / �� j� - -, Phone: _ -'_ .. _ =— �� j � � � � / COSTA�MESA;CA � �� ' ' Zip: 92827 A� " � - A � �� \�� n,i, - � ,- � � . b�� ,�/� - %� \, �� ii /A� VAA contractor; � CRANK.BROTHERS ROOFING CO �'��<v� �� Address: 00126 COMMERCIAL WY L� � �� \ ,; �,�� /� � i� j� Phone: �949-548-5569 �� '\ ` '., � � ..'� COSTA MESA CA Zi 92627 " , � � . , ,� P�': ':� � �' �� `, �'.�' `�.\i j�j� �� Licensei�-�408677 --- - _ „A� �� \�� Arch / En9 'i� �i � .. � � ' �' / � A A, :� ` � �`l�•� ��,�Address� -'; , �� Jr�� .. "� : . . ' r � \\ � � _ _ 't- , , ,.�j 1 r � - ,"Phone _ _ . _ s ' ��•. r � � ',� ; , .� � - ��p; _ �- .�,/,. � ��, � - " License: � - . ' ` � . _. , - % . � � ` ' � ' , � . � SCOPE OF PERMIT �, � ' � � � / i � r' /' '�TEAR OFF EXISTINGAND REPLACE W/NEW HOT-MOP AND GREY,GRAVEL ON CARPORT ROOF�ONLY; ; ;`' � ,20-YRROOF. . .�-,�.'� � ' .._�.:v � .: �. .. . ��.`,... � % *� .. �. � _ . - -_- , - ._ - - , � i ,�'�' � 'y . , y, � � P.lan Check: �, $0.00 "� � � PermiG � "$59.50 SMIP�Res.' �_�, $0.50 SMIP Com:-., '�;$0.00 ��Other ,'�, ':$0.00 Inspectiorr � $0 00 �• ;�� t :,�. �Total: _� $60.00 � �. �� ' V� �— - �=;'`:� .':� . , i �'' �, � � ,, . � % � - , `. . _ , �� . � � '�' Calc Valuation: ', ' - � Claim Valuation:/ ,�;� � �� :- ii i%�� $1,887.00 s�,eei:oo - . ,' �� ;; � :�;/ J� `�� `� �� i �' i,� � �, ' �'� A��A �� .- � �PLANNING�& ZONING , i � �j� � •1 � � �5 � � ,_ �, � _�� _ ,,: �',�� _ v�� !� SETBACKS �� 1 � �_; ,�-,_ ,�.% ��, � - �� <'��.i/'� MAIN STRUCTURE FronC� _ 0- 0�- � ,� � Rear 0- 0 � Le@ - 0- 0� . Right ;� 0- 0.-'.;'�� ACCESSORY Pront 0. 0- �� ' Rear � 0. 0� � Left . 0-0 �� , Right �-.0-�0"� PARKING Exislin : 0 Reouired:_ 0 Proposed: 0. � .. . . , ... i -. . NOTES: � � - � � EXPIRATION: This permit shall automatically ezpire and become void if work Is not commenced within 1B0 days, or it work is suspended or abandoned for a period of 180 days. INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspeetlons and flnel approval must be obtained. Failure to obtain inspections and tinal approvat will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: -, I hereby eitirtn unOer penalry ot perjury one ot the following declarations: ❑ I heva entl wlll maintein a certificete of consent to sell-Insura for workers' compensetion, es provitletl for by section 3700 ot the Lebor Cade, for ihe peAortnenca of the work for which this permit is Issuetl. ❑ I heva enA wlll maintain workers' compensetion insurence, as required by section 3700 of ihe Lebor Code, for Iha peAortnance of Ihe work for which ��is pertnit is issuetl. My workers' compenution Insurance carrier antl policy number are: Cartier: Poliry Number. (Thts section need not be completetl i! Me permit Is velued et one hunCretl tlollaro ($700) or less.) ❑ I certlty thet In perfortnance of ihe w rk whlch ihis permit is issued, I shall not employ any person In any menner so es to become subjed to the workers' compensetlon I s f Califomia, en Ih It I shoultl become sub�ect to the workers' compensetion provisions of Section 3700 of the Labor Code, I ahell fonhwith comply with thes ovisions. /�� Applicant Signeture: Date: —�— WARNING: FAILUR IX1RE WORK ' GY)MPENSATION COVERAGE IS UNUW FUL M1D SHALL SUBJECf AN EMPLAVER TO C(iIMINAL PENALTIES AND GVIL FI UP TN25 O ONE HUNDRED hKK1SlWD E 00,000),INADDRIIXJTOTHECOSTOFCOMPENSATIIXJ,DAMAGESPSPROVIDEDFORINSECilON37060FTHELABORWDE,IMEREST,ANDATTORNEV5FEE5. LICENSED CONTRACTORS DECLARATION: I hereby eftirtn that I em licensed under provislons oi Chepier 9(commencing with Sectian 7000) oi Division 3 of ihe Business antl Professions Code, and my license is in tull force entl eflect. Lic. x Clau x Contrectofs SigneWre: Date: CONSTRUCTI DING AGENCY: ❑ I hereby Irm thet ihere is e construction lending egency for the perlormance of iha work tor which this permll Is Issuetl. (Sec. 3097, Clvil Cotle). Lentlers Neme: Lender's Adtlrass: Signeture: _ OWNER-BUILDER DECLARA710N5: Deta: I hereby eXirtn that under penalry of perjury that I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Buslneu end Protessions Cotle: Any ciry or counry which requlres a pertnit ta canstruct, alter, improve, tlamolish, or repelr eny structure, prior to its iuuance, elso reQuires Ihe applican� for such pertnit lo file a signetl statemen[ that ha or she is Ilcensetl pursuant to ihe provisions ol Ihe Contractars License Law (Chapter 9(commencing with Sectlon 7000) of DlNslon 3 ai t�e Buslness and Protessions Code) or that he or sha is esempt theretrom antl Ihe basis for Ne elleged e:emption. Any violation o( Sectlon 7031.5 by any applican� for e permit suD�ects Me epplicant to e civil penalry of not more than tive hundred Aollars (5500)J: ❑ I, es owner of Ihe properry, or my employees wit� weges as their sole compensation, WILL DO THE WORK, end the structure is not intentleC or ofrered for sale (Sec. 7041, Business antl Professions Gotle: The Con�ractors License Law does not apply to en owner ot property wha builds ar improves Ihereon, end who does such work hlmseN or herselt ar through his or her own employees, provided Ihat such Impravements ere not intended or oftered tor sale. II, havever, ihe bullding or Improvement is eold within one year of completion, tha owner-bullder will have the burtlen of proving Ihat he or she did not builtl or Improve for purpose of sale.). ❑ I, as owner oi the propeny, am EXCLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS �o consiruct �he prolect (Sec. 7044, Business antl Professions Cade: The conirectors License Lew d0es not apply to an owner of property who bullds or Improves Ihereon, entl who coniracis for such projact with a coniractor(s) Ilcensa pursuant to the Contractars lJcense Lews.). ❑ I am exempt unCer sec. Business and Professions Code tor this reason: SigneWre: Date: Owner ID venfieC by Orivers license. ❑ Yes ❑ No Dnvefs License No. Expires: Vedflcatlon of Ownership by (rype of documem, I.e. - properry ta+c bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATON: ❑ I hereby certify Ihat no azcavatlon fNe (5) or more teet in deplh into which e person is requiretl to tlescenQ wlll be mede In connectian with work euthodzed by this permlt, entl thet no building stmcture, scefloldinp, telsework, or demolition ar dismaniling t�ereof, will be more ihen thirty-six (36) feet hig�. (Chep. 32, Grp 2, Ar12, Sec. 341, Title 8, Celitomia Administretive Code). ❑ As owner-bullder, I will not employ anyone to do work which would require e permit from the Division of Indusirlal Sefery, es noted ebove, unless such pereon hes a pertnit to do such work from ihe divlslon. SlpnaNre: Date: Division of Industrial Safe�y Pertnit Number: CEHTIFlCATE OF COMPLIANCE AND AUTHORQATON OF EHTRY: I certity under penalry of perjury Ihat I have read this epplica�ion end stete that �he infortnetion given is coned. I egree to comply with all stete lews end ciry ardinances relating lo bulltling constructlon, end authanze representetives af the Ciry ot Costa Mese lo anter upon ihe ebove-described property for inspection purposes. I egree not to occupy or ellow occupenq oi eny huiltling auNonzeO by Nis pertnit until iinal Inspection. CQOE �. INSPECTION TYVE 1616 Fixetl System Finel Fire Preventlon 1288 200 201 202 203 Pool Spe Final Flnal Re•Roof � Finel BIocWRe�eining WBII Final Feclory Fire Placa Final Sign 204 Finel Demolition 2MBde CAg U11IDAL4 K z 9- ?P "" '• /� ��= ate��/y� � � Date CODE I INSGECTION TYPE 206 Finel Mechenicel 20B Flnal Plumbing 210 Final EIBcldcal 212 Final Fire Preventlan 220 Fnal Planning Approval 222 Final Site 250 Final Building�Occupancy AOP�kant to fill in ali spaces except tnose within heavy bortler lines ana sign all aoo�oo/iate tle[larations. PE MIT NO. RA T,q�O LOT NO. UN1T NO. . ctjT„V OF COSTA�STRUCTI N ERM� � . �, 19,�2R . ��'� `�`1� � �— � �— � Project Address ApplicanYs Mail' g Add es � �9 • s/�.f�'��/_ i�)wner's Nam�e/�y�� PhonM% �� Address �Y7� �'�l � ��' � . Arch/Eng. � . License No.' ' Address Coniractor's Nam • aw� Phone � Address Imailing) ' ME Ciry License No. LICENSED CONTRACTOR OECLARATION 1'nereby aftirm that I am licensetl untlar piovisions oi Charter 9(commenclnq . with section 7000) ot �ivision 3 of the Business a/� ro essions Cotle, antl my Ilcense is in full force antl etiect � �1 License Class LlcenSe ! . Date $i9natu�e WORKERS'COMPENSHTION DECLARATION !I hereby affirm tha[ I have a certificate of consent to selhinsure or a certHiwte of Wo�ke�5' CompenSatiOn InSurdnte, o� a certifietl coOY t�ereot (Sectlon 3800."L2D. GJ � , ', � ' . Policy No. Company 8 Certifietl copy is hereby furnizhetl. Certifietl copy is filetl with the city Builtling Dlvision. I Date � APPlicdnt EXEMPTION FROM WOiiKERS' COMPENSATION DECLARATION (Shissection neetl no[ be cortipletetl if the�permit is far one huntlretl (5100)'or -' less). I certiry that �in the periorman<e of the work for wnich this permR Is Issuetl, I shall not employ any person in any manner so a5 to b come subject to Ihe workers' ompe satioAtaws ot Caiitojr �� „ _/�` Date �� S Signature-�1a..f^_�- �� 'N0T1C : If, afte making this tleUaration, you slioultl become sub�ect to lhe Workers' Compensation provisions of Ihe Labor Cotle, you must forthwith comO�Y �+'��h zuc� O�ovisions or thiy permit shall be tleemetl revoketl. CONSTRUCTION.IENDING AGENCV ' R ' , • I hereby attirm ttiat there is a construction lentling agency for Ihe pertormance of the _work for which. this permit is issuetl (Sectlon 3097 Civ._ G.) Lentler's, Name _lL.��-•� Lentler's Atltlre55 �V V/�� OWNER BUILDER DECLARATION ' I hareby a/tirm that I am exempt from the Contractor'S License Law tor the tollowin8 �eason (Section ]031:S,Businessantl Professlonal,Cotle: Any cl[y or county wnich requires a permit to construct, altei, imorove, tlemolish or repair any structure, prior to its issuance, also requires lhe appliwnt for suth permit �fo fiie a signea statement that he/she I5 licensetl pursuant to the provisions of the Gontractor'S License Law (Chapter 9(commencing with Sectlom7000) of TVPE OF CONSTRUCTION LJ NEW `U qDD L1 ALTERATION IJ REPAI R ' ❑ CONVERSION ❑ DEMOLISH ❑ OTHER _� A p �', I7 � DESCRIPTIONO W RK/USEOFB G. � ' - �� Ct�. �E/-».e ��<}QOGRi % F��i��'�'� wD P•a�..�cs s Main Building:r . TVPE OF PERMIT GRALJ DING IJ FOUNDATION LU STRUCTU�RAL 'J T Front �.O ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑'MECHANICAL � 6 Reaf � . ❑ �OTHER • . � A � C Right PROJECT DESCRIPTION 5Q. FT. oCCUPAryCv ' K � CONSTRUCTION TVPE VALUATION 5�O �: CXT 'S Left 'aFJ . ZONE GRADING CU. VDS. ' ACRES p�ng. Ref. # qemarks: - , _ . " ' Plannin9�Notes: ��q(L, i r Sink �ckflow Preventer ickflow Irrigation ithtuhs arifiers shwasher 'inking Foun�ains Floor Sinks Gas Service ' Outlets InterceptOrs - Kitchen Sink' Lavatories , . � Orains there/rom antl Ihe basis fo� the aIIC9etl e%emption. Any viOlation of 5¢ctlon .: ]031.5 by any applicant t,or a permlt subjects�tne applicant tq a clvil �enalty of not more than five nuntlretl Eollars (5500). I, as owner of [he property or my employees with wagas as thelr sole ReinspaCtion ;Fee ,mmDensalion, wili tlo the work, anG the structure iz not intentletl or otferetl for Sale (Section 7044, Business antl PrOf¢Ssional Cotle: The Conl�acto�'S '- License l.aw tloes not apply to an owner of a properry who bulltls or improves tl fi k M1I If herself o� [h�ou h hi5 or he� own � e $15 thereon, antl who oes sut wor mse / 9 . employees, p�ovitletl Ihai such ImprovGmen[5 a�e not in[entlotl o� offered fOr BOilO! sdle. If, however, the builtlin9 or Improvement is zo1C witbin one year of com- ' pietlon, the awner will have the bur0en oi provin9 he/sh¢ tlitl nOl builtl o� Im- DuCt - Und¢� G�Oulld � �rOVG tor the pwpose of sale). ' I, as owner of the properiy, am exclusively wniracting wlth Iicensetl con- Duct - Structufal Vacto�s to mn5lruct tM1e project (Sectlon ]044, Bu5ine55 antl Protesslons Cotle: , , . The Contractor's License Law does not apply [o an owne� of property who DUCt - V2�tiletiny � builtls or improves tnereon, antl who contracts tor such projecis wlth a con- � '- tractor(s9 license pursuan[ to tne Contractor's License Law). I am aware that Exhaust System ❑ Multiple proof of their Worker's Compensation insuranco shoultl be provitletl [o me. _ ❑ I am exempi unaer Section B. P. C. for [his reason Firepl/Fatt Blt. ICBO ak Date �" � Owne L.� � �✓ � Heating SyStem & Ducting - I he�e y certi�y that 1 have reatl [hii applicatioO antl slate Ihal tna above ' � 00400,000 BTU 0100,000 �1BING � FEES � Showers � Service Sink -� Sewer Cap Sewer Connection $olar Collectors Solar Piping Solar Tank � Swimming Pool w/Spa . Urinel ' - �Water Closet� • Water Heater . ' � Water Service ' ' � Auto-Wash � ' _ . � , i Issue Fee ' ' $ '3 FEE Hood or � Type I ❑ Canopy Typell � Refrigeration System � ❑aioo,000sTu ❑ioo, ystem Repair/Alteration 'Fire Dampers � Registers information is correct. I agree to comply with all city antl county ortlinances "� - antl's[ate laws relating to builaing construction ana bereby authorize repre-, sentatives of this city.to ent¢r upOn th¢ above-mentione� prop¢rty fOr. . � inspection p oses. . '/ ' Si9natur . /�c." �� Date 7 - ��.�' �-�� Reinspection Fee �$15 laue Fea Drivers' �icense or 55 $ � 7F OBfi5-46, rev. 30/84 � Wnite - Builtling; Canary - Applicant; Pink - Accountin9: Goltlenrotl - Asseszor � eT A $ 3 Automatic Wastier � Construction Pole Sub. Cooking Unit � DiSnWdSh2f Oryers��Gas DElec' Fan, � F.A.U. Fiztures � � - Device Boxes Outlet5 Switches Garbage Disposal Generator �0.5 KW C — Reinspection Fee ' �� DEVELOPMENTSERV Zo�inB APProved BY_ Building Approved By Applintian Issued Bv- 106b 4/12/85 9ba7a" T! � Zone _ , 2 O • N I N G R ied , . . � � - E _ � . Q • M 3 Dr s ELECTRICA� � --' Transformer �� 15-50 KW ' ' ❑ 50+KW . . � Meter ❑up to 100amps Sub Panel Motors�0.1 HP�iX-B � InaSolar;O9d5 HP �76-15+ �� ...___ _ _ -i_ A�. . ... . .-_ Pole Light . Range Sign �: � ; Standing.Sectfoi 5 KW Trash C'ompecta $15 �laue Fee; ,�j ' - N'CS: i� � ' � SU MARV OF FEES ' ' � ; BUILDING PERMIT $ � SMIP� $ � S� PLAN CHECK $ �'� PERMIT . � PLUMBING ' g ISSUANCE . $ PLAN CHECK 25% S ENERGV P.C. ,$ ' . . ELECTRICAL i$ GRADING 3 � PLAN CHECK 50% �S � MICROFILM $ • ' � MECHANICAL' ��$ TOTALFEE $ �13.73 s � PLAN CHECK 25% � $ � , , � ' ' �: ,�� CON�7RUCTION AND PLANNING � POOL & SPA Date Inspector Date Insper.tnr APPROVALS Permit # APPROVALS Permit # 1. Temporary Electriral Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. S[eel Reinforcement 3.�Electcical Conduit Utility-Undrgrnd. 54. Forms , 4. Electrical ConduirUndrgrnd. 55. �lectrical Bonding 5. Steel Reinforcement 56. Ro�gh Plumbing & Pressure Test 6� Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7..Footings � �. � ` �t/ �S � 58. Electrical ConduirUndrgrnd. S. �Foundation 59. Gas Pipe, � Undrgmd., Test 9. WateMPipe-Undrgrnd. • 60. Backwash Lines, P-Trap, � Undrgrnd. F,• � - 70. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains ' 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final • 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17.� Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVAIS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23: Gas Pipe-Rough & Test 72. Underground Flush 24? Roof Freming 73. Undergrnd.StorageTank OGas ❑Oil ' �.� 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Geiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe " ? • rr • 28. Lathing & Siding 77. FIXED SYSTEM FINAL ',� i; � 29. Insulation 78. FIRE PREV. FINAL �A - + 30. Drywall�Nailing HEALTH DEPT. REQUIREMENT '' -� 31. Plaster Brown Coat � 79. FINAL INSPECTION ' 32. Electricaf Power Meter-Final 80. FOOD CERTIFICATE ISSUED � � 33. Final Electric Notes: � ' 34. Final Heating & Air Conditioning `�" . 35. Final Gas Pipe-Test ,i 36. Hoo'd or Canopy � `r - �� < 37. Final Factory Fireplace �r 38. Final.�Plumbing� , ', � � . , - 39. Water 5ervice-Fina1 ^ '�� x '- ,.. 40. Gas Service-Final ' '=� � 41. Solar pomestic-Final � � � 42. Backflow Preventer - � -' �� ` � > ,•t � I•' _ 43. BackflaW Irrigation . 44. .Landscape Irrigation System � Incomplete Inspections 45. Sound Attenuation '�� ..,: 46. Handic2p Regulations � ''" - 47. FINALSTRUCTURE&BUILDING .� 48. Special Requirements Completed , � , 49. Electria Release to Edison �� '' /':� �� 50. Gas.Release to Southern Califdinia Gas Co ,- �' ' 57. CERTIFICATE OF OCCUPANCY '=, Nn. Date , PflOJECT pODPESS: 4 9 6 $}i�Y DR � owxeesearne: ELAINE SVEDEEN � PDONESS: SAME " 642-2603 FflCHIENGINEEP: NEG.NO.: UNI7: R�OPESS: UNIT: PENMIiTEE: CRANK BROTHERS ROOFING ( 714 ) 548-5569 aooaess: 126 COMMERCIAL WAY COSTA MESA CA 92627 LICENSEO CONTNACTOfl DECIANRTION: I here�y aflum Iha� I litensetl wUer pmvisi0n5 0� ChaD�er 9(COmmencing wi�t1 Setiion ]000) ol Division 3 of Ihe Business anG Vrolessio ne, ana y icense is in lull force and eii ciTru : 005993 STATELIC.: SG%% c ss: C3i� � v �Oale: � � ignaNre: _ y �� WOBNENS'COMPENSRTIONOECIABR710N: I�ere�yaf' atlhaveacenificaieolconsemtosel6insureoracenificateofWarkers' Compensaiion Ia5y�ypca,a, a,cp� tl copY �hereo� � �i 3800, LaD. POLICY NO.: L D 7 L L 4 7� E%P. DATE: S I O i I 9 3 con+rnxr: STATE FUND,�/ ❑ Cetlifietl copy is here0y fumis�ed. L'1 rtilieU w0Y �5 4 wilA Ihe ily Builtling Oivision�� Dale'. ApDlicant�N'�C//C/�� T E%EMPTI N FBOM WOPNEflS' COMPENSATION OECtAflATION: (i�is seclion neeG not be completM ii Ne permil b lor one huMreC (51 W) or kss�. 1 cerlify I�at in ihe pedorman[e ol ��e work for whic� ��is permit is issuea, I shall noi emDloy any perwn in any manner so as to �ecome Subjett l0 Ihe WorkerY Campensalion Laws ol Cablamia. Oate: Signaiure: NOTICE: II, after making this tleclaration, you Shou10 Uecome sublect b IAe Workers Compensation pmvisions ol I�e Labor CaAe. yoV musi forthvnl� cOmpty w�t� Such O�o'^5ion5 or INS permii 5�all �e AeemeA feuoketl. CONSTflUCTION LEN�ING RGENCV: I hereby at�irm Ihai IAere is a conslmction lenaing apency lot I�e pedorman[e ol t�e woB �or wNcA I�is Oermn is issuetl (Section 3097. Gv. C�. LENOEN: nooxess: OWNEB BUILOEP UECLAflRTION: I here�y a��irm I�at I am exemp� Irom Ihe Contraclors' State License Law for tne �oilowing reason (Setlion 7031.5 Business anC Pmlessional Cotle: My ciiy oi county whic� repuires a permii Io con5truct, at�er, improve, Oemalb�, ar reoair any slmcture. prior lo ils issuance. also reQuires ihe apo�icanl for sucA permit ta file a signe0 statement Ihal nelsAe is licensetl pursuanl Io �he pmvisions of Ihe Cantraclors' State License Law (Chap�er 9( Wmmenung vni� $epion 7000) of Divi9on 3 0� I�e Busine55 and Pmlessions CoOe) or ihat he/s�e is exempi Iherefrom antl t�e EaSis �or IAe allege0 exempiion. Any Nolaiian ol Seciion 7031.5 by any applicant for a permit SuUl��S Ihe aOD�icant �a a cidl p¢nally ol not mo�e Itwn INe huntlre0 GOIlarS (55110�. I, as owner of ihe D�oOeny or my employees vnih wages as tAeir sole fAmpensation, vnll tlo tAe work, antl lhe ❑ slruciure ¢ no� intenGed or o��ereE �or sale (SeCtion 70a4, Bus�ness and Pmteuional CoAe: T�e Contractors State Liunse Law does no� aDD�Y �o an awner al a O�aperty w�o huilds ar impmves t�ereon, anA who Ooes such work himsell/�ersell or t�muqh �is ar her own emDlaye¢5, pwviEeG �hat such imDmvem¢nts are nOt intenAeU a� olfe�e0 fo� sale. I�, Mwev¢r I�! GuilEing or imD�ovemenl is soitl wit�in one year o� complelion, ��e owner will have I�e UurJen ol pmving �e/s�e tlitl nol Gui10 or impmve tor Ine ourpose of Sale). I.as ownerofihe pmpetly. am exclusively contracting with licensetl contracbrsto wnsimct the O�olect (Seclion 7044, Business ❑ ane Professims CaEe: TAe Comractors' SIaIe Litense Law Oces noi aODN �o an owner ot pmpeM `� hml0s or improves Nereon antl who conlrads lar suth vroiecls with a conlractor(s) license Dursuani to ine Conlractor5' State License Law). I am aware �� 0�� of lheir Worker's Compen5ation insurance sMu10 Oe OmviOeA ro me. � I am eeempl un0ei Section: 8. 8 P_ C. CITY OF COSTA MESA - HUILDING PERMIT � ; u � PERMIT NO: H 056868 PLAN CHECFt NO: N ��VT�-SU1Tf�l� CONSTRUCTION TYPE: 5-N PERMZT TYPE: STR PURPOSE: ALT JOB DESCRIPTION ; TEAR-OFF 6 REROOF 1200SF RESID W/GRANITE SQ FT: 2,975 CLAIM VALUE; 2,475.00 CALC-VALUE; 2,975.00 GROUP OCC; R-3 / COMMENTS• * � **�r�r*x�*x�i�*+r�t**�r***+�x�**x��r*�t**�ex�*�t**�r*+�*+�*+t�r*�r+r***��r��r**�t*�h�*��x�i �.r�r ***+�*�+r*** 2 O N I N G R E Q U I R E M E N T°Sr� `?�' �� : � ��' S E T B A C K S FRNT; FT MAZINBREARING FT IN FRNT; FTCESSONYR��;��1'"� IN LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN"'� PARKING REQ� PROV; PARCEL; 00000000 2NE; REF NO: PLANNING NtSTES> � ' if iF ik ik ik ik if iE if iP iE iE k�lk �E 1E if 1! iE M k�! 3k IF iF iF iE �f If 1f iE If if �E iF if �F 1E aF iF iF iE k jf iF iF 1E iE1f if ik iElf if iE iE if if �F �f if iE k iE if iF �F 3E iE iE iE iE IE iF 3E iF iE k 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: HUILDING APPROVED BY : DATE: APPLICATION ISSIJED BY; DATE; �` (�� M�ilikifkififfFifiFiEifiEaFiPiFifiFiEiEifiF7F�iF�if3Fifif7FTF�iFiFii�3FiF'�'a€iF"3f'iFiFiFiE3flhiffFiE*ifiE 1E3E iF �k k�i 1E iE �1F iF M iF if if iE iF iE 1F 1E k jf iE iE iF k iE IE iE 1E iP IF 1E if if if �lEif �E 1E M if if ik aE 3f iF if iE if if if iE k if �E iE 1E iE iE if If ik if iE iF iF iF iE if iF 14,1EiE iE IE ik fk iF 3f iE 3E LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES' GRADING PERMIT 54,00 50, PL� SMIP/NONj RES ISSUE FEE BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID''� DUE TOTALS----> 54,50 0.00 0,00 59.50 59.50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 59,50 OVER/SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADZNG-PLAN-CHECK 54,00 ,50 - iP iE k if 7F if !f 1E IE iE iE 1f 1E IE it k if ik if iF if iE iF k!E iE iE iE iF �F iE if if iE iF iE i! k iF iE iF iF �F k iF 1E iE iE 1F iF iE k 1E if iE:F iE if iF IE k 3E iE iE �E iF �)f it iF iE if iE if iF �1E ak 3E iE 1E I N D I V I D U A L F E E B R E A K D O W N rormareasar TYPE QTY D E S C R Z P T I O N UNIT COST ��'OTAL COST oa�e: �""ef SFR 2975 REROOF HY VALUE RESIDENTIAL NOZONE I Oo hereby cenity ina� I am aware o1 an0 uneerstan0 me requiremenu of Californu Heallh an0 Salety Coae Sectans 25505. 25533, an0 $ND OF FEES 25534 anat�al lo� any�uture buil0ing occuDanlwilUwillnoi�circle one�neeElo tomply wilA Said s�aie c04e5 anU lhei4quiremen�5�ora pe�mil br construction ar moGifiwtion imm Ine Air Ouabty Managemenl Uisirict. FeAEential constmction apDlications are eKempl Irom i�¢se provisions. Dai¢: AppliCani:, I �ereGy cetlily Ihai 1 have rea0 �N5 applica�� an0 Slate or0inances ana s�aielawsrelatingio buil0ing onstmciion; pmperiy fai inspection Durpo�es. Oa�e: Signa�ure: Orivef License o� Social Securi�y M: � Canary—AoolicanL Pink—Revenue: GolEenrotl—Assnssor 1,00 2,475.00 ��, i� AI DDiI°::SG-"�ii?iGi S'c�`r UNT�: f4/Ri.'9? 7�PIF. �-�•,}, ,�'I CO..;�TRUCTION AND PLANNING POOI & SPA APPROVALS Permit�` Date Inspector qpPROVAIS Permii# Date Inspector 1. Temporery Electrical Service or Pole • 52. Pool & Equipment Location 2. Soil Pipe-Undrqrnd. � �� 53. Steel Reinforcement ', � 3. Electrical Conduit Utility-Undrgmd. � 54. Forms 4. Electrical Cohduit�Undrgrnd.• 55. E�ectrical 8onding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings � ` - 58. Electrica� Conduit•Undrgrnd. 8. Foundation � � 59. Gas Pipe, O Undrgrnd., Test � i• 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgmd. ' 70. Structural Floor SYstem � 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final - - 72. Sewer Cap - i 63. Heater & Vent-Final �' 13. Roof Orai�s ' 64. Plumbing Syscem - Finat 14. Rough Plumbing - 65. Electrical�Finai 15. Rough Electrical-Conduit � � 66. Solar System-Final 76. Rough Eleciric Wiring • 67. Fencing & Access ApProval 17. Rough Wiring Sign -� 68. APPROVED FOR P�ASTERING 18. Rough Electrical�T Bar Ceiling 69. POO VSPA SYSTEMS FINAL 19. Rough Heating & Air Conditionin9 FIRE DEPT. REQUIREMENT 20. Rough FactorY Fireplace . � APPROVALS Permit # 21. Ducts, in StrUctu�e 70. UndergroUnd Hydro 22. Ducts, Ventilating 77. Product PiPing OGas ❑Oil 23i�Gas Pipe•Rough & Test � 72, Underground Flush 24. Roof Framing • � � 73r Undergmd. Storaye Tank � Gas ❑ Oil 25. Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structuraq & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Sid�ng 77. FIXED SYSTEM FINAL 29. Insulation 78, FIRE PflEV. FINAL 30. Drywall.Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � 79. FINAL INSPECTION 32. Electrical Power Meter-Final . 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning �, , 35. Final Gas Pipe-Test 36. Hood or CanopY 37. Final Factory Fireplace • - , 38. Final Plumbing ' . . 39. Water Service-Final 40. Gas Service-Final � 41. Solar pomesC�cFinal ' � 42. 8ackflow Preventer 43. Backflow Irrigation - 44. landscape Irriqation SYstem � 45.�Sound Attenuation - • 46. Handicap Regulations � � . � 47. F�NAL STRUCTURE & BU�LDING , `f� �L„� fl�,�� ,e �� D�i � ��- 48. FINALP�ANNING '. �. ' 49.- Electric Release to Edison „ 50. Gas Release to Southern California Gas Co � � 51. CERTIFICATE Of OCCUPANCY No. Date � 7 ADDF650GBUILdHO: q9 SHADY__DR o.mexsrure�Faa,�x:SVED N ELAINE G'TR aooniss qg6 SHA�Y DR ` COSTA MESA,CA �w�. �uiwc �oo�ss 1PCXRECT OpENtlNFEA: MCX. OX FNO: S INONE55: 92627 uc. xo: u�: _._ _ CITY OF COSTA MESA -_BUZLDING PERMIT PERMIT NO: H 086187 PLAN CHECK NO: N CONSTRUCTION TYPE: V-N PERMIT TYPE: STR uxr: � carm�crarsxu� CRANK BROTHERS ROOFING CO ( 714 ) 548-5569 cwm�crorcs�uia�+ 126 COMMERCIAL WY . wo�ss:COSTA MESA CA ucw: 408677 92627 �r�: - - ti10EN5ED COMP�RORS UECLAXATION: 1 MreDy dlim uder perely W pmjury tl� I em Icpued � pavbm d Cheqx B (mmmend�q wilh Sacibn 1oa0) d Diviaion 9 W Ne 8uainem uq PMeaeons Code, end my &ame u i o�ca uk eMed. cmuc.No.:00599/3 uacuss:C 3g uc.N.: q08 •XP: 06/98 Dme:,�`/�.0� / � GonbeCor OWNEN BUILUEfl DEClAFA710N: I hreby alfirm undor d perjury ihm I em aump hom IM CaMrapws Ua�ue law lar Ne bw*q imsm (Seaion ]W t.5 &nnen ud Fdmom COJe: AMW a cauM' whidi nVu'vas a G�n �o mnmcl. etler.'unpm+. �d'oh, a rapei eny aVunuro: qiar b u ce�ariw. ebo reQuirae tM epplimM Iw wch permn lo fiM a epneE Wtement Oat M a eM .kenaaE pumunt Io ihe pvm'vu d Un Camrmon Licema law �Cheqa 9(aommentinp xvh Swion A00) d D'w'aian J d Ilr Bu�irwa ard PrWeniaro COMI a thm M n ehe u vmmp �Asahan eM tM hse fa IM e0e0� e�emqian. Mrv violetion W Sedion 1031.5 Ey enY aGV�� tw a Pormil wbptls IM eppliceM �o e dvJ perelly d iwl mora Ihen fxa huMred ddlen �SSOOn. � I.moxmdthepopenyamyamdqwwihweqemlheidecampensetian.YiOdoNewak.eMtMmununenol'vtleMed «MareE br aele (:nctian laa. Buai�roae eiM Prdeae'vnCada: The Contrmon Licenee lew Eom M eppy ben owrierd propary wln ddEa a inpwes iAsean. end w1n doee ewh nak FBnaetl a Mnd a Wa9h he a Mr mm emNoY+a. p�b ihr exA ;,,,wo.emmns m. �a im.�dea or on«.d �ar.e�e. n. no..«.. m. wad�ro a mw��«a u.da xiinm m. r.•� a ownpmvn. �ne owror-buikx xill M1m+iM Wrdan d G�+irq M rc Me AiE nol buk a imP� Iv tM WPaa d sebl. � 1, m oxw d �te pW^�Y. em eidnirW wu�aei9 x'nh Ycemad cWrectm lo mviM iM V�9� (Swion ]ON. &e'vr� aM v�a.�,. coes: rn. cam,mon �K�.a �. ao« m eodr m� owo« a ww.nr .no w�d. � ��w« m� �a .no mn�reeu br erh D�G�+ wh e mmretla(o) Icomed Rnuvu w �M Cauemae licwna leM. � I em uemq wdr Secwn: B. 8 P.C.. br Nb reeaon: i do n.�nv �r mu i�,..�,�. d.d waa.�.�d me na��m a cwome �v, w s.bn cod. s.a�. aws. asv. �a � 25v�a, ud Met I a vry Mun dnM'vq omipem. wiA / wil rwl (acb'me) roed b canply xth eeiA tlels oode� uq IM �epinananb br epaimutamnvunianamoddrsaionhamlMM�y empemeNDinntl.Re�iCmtilm�a�uqioneppfutiomeneRemdlmmUwse pwsmn' . Data: MG�� WOflKEF'S COMVENS�TION DK4NATION: I hereby elfirm under psiMy d pxyoy me d Ns Idbv.'vp Esduel'wm: ❑ in.�m.newm.un,n.wiW�w.ameeanio..e;mwea..M.:wmpraeim...a��«Mswianalaoatn.leba � coe.. �« �n. v�a�. a �n. v.w �or W:cn mm va�ma s muea. — I j� IMvseMNme'voanwkrs'mnW�ion'vm�uw.onV�vadMSed'vi])UOdCrlaEarCaM.briMD��d�M wark lor whidi Mb G�n e i�aued. My wakms' comV��ion mwrarce rarier eM V�Y mimbm ma: c.�« STATE FUND EXPIRES PofryNumber. 9as-aanNr��i . .� O1/O1/98 '� !� sen:n mednw e. mnWarod r m. v�� u ro. ons �wdrsd ecdu.ls�ool n wn.) � I oer11Y Uxt in Uw P�wiwica d �he wak M whc� Ihu Germd h u�ued. I WY na amWW enY Va� in �nY menrw o n lo wbjetl to tM xakmY mmparuaion Nr.s d CeHame. C eyas tlW ! 1�ho baronr ad'ptl to IM wvlw+' Dw�� s� �� 31W d �he lebar Code. I ehe0lo ' h mmW 'nh Pwirim^. �wnrUm: W�m4p: F�Yun ro ucun woA'en'ronpwu�tlon roverpq/ unl . uW ilWl al!/�c1 �n wmplqw ro er/MiW pwltlp �IW cMl nnp �q ro ms nWrH fhowW Aolhn lSiPO,OWA tlon ro lM cmt ol rortpw�ufbn ��p� u proHdM ror In Sxtlon J105 a/ tlro LeGor Co6. Intrut ��m�Y'� /� CONSTIIUCIION LENMNO �GENCY: I IweW dfi�m ueW penalry d par''vy tlw tMn u e ampiutlion bMvp epeM.y br tM �no�� a m. wax i« wnw� iw o�� o�a �sea� �. c:. c�. LENDEN'S NAYE: IENDEH'S ADDNE%: I cently iM1et I here read N'v appl"ratbn eM pete Ihal iM ebow iniwmation u conen. I ep�es to canply vm� M uy W coumy adinenoae eed ateie lew �elelM ro Wtld^0 oonstn�mon eed hereby eiMn¢e ieppmietivea d Ihe tilYto eNr uV� �M ebovs.rtwYionetl pWMY la impecion prpwea. � JIM CRANK n Dms� ��/('� � (5151-ae.WP) Whps6uiknp 8 Selery; GreamFb; Ceiaiy-AppiraM: %nk�immus:Oddenmd-Mamv PERM NO: H 086187 GOVT: N SUPP: N PURPOSE: REP JOH DESCRIPTION :_.T/O REROOF REAA PART OF RESID W/BUILT-UP SQ FT: 2,565 CLAIM VALUE; 2,565.00 CALC-VALUE: 2,565,00 GROUP OCC: R-3 /U-1 COMMENTS: T/00 REROOF 800SF REAR.PART W/BUILT-UP **�rw�***��r+r*x **r**r*�r**�r********�r******+r*+r+�+�*�r****�r*�r*****��r**�t*+r**��c*�*�*�*x� .... 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 BUILDZNG --------- FANT: FT _ IN REAR: FT IN FANT: FT IN REAR: FT IN LEFT: FT _. IN AGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING REQ• _ PROV: PARCEL: 11737232 ZNE: REF NO: PLANNING N(7TE5>_: i ifMkifikifkMMMkitkkffklklF�fkiEiFlFNfFkitlflllfltffikfFfkkMikMNfkiEikkMikiFffkfFif'lfkiF�Fiflfif�flFlfkiflffFiFiFikifif'1klfikkifiFiFMik D E V E I, 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 i/ � ZONING APPROVE�•BY _ DATE: l• HUILDING APPROVED HY_: DATE: :, APPLICATION ISSUED BY: �� nn�rc. 1>''ll Cp �ti7 MkffifiEifikMkMkMikiEkiFiFikIEMiFk�iF LEGALIZATION;N ____ . BLDG PMT _PLUMBING PERMIT_ 74 .75 _. _ _ F E E S U M M A R Y ELECTRIC MECHANIC STRUCTURAL SEGMENT:Y FIRE SMIP/R50. GRADING SMZP/NON-RES PLAN ISSUE FEE BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE TOTALS---->. 75.25 0.00 0.00 75.25 75.25 .00 REVENUE DIVISION TOTALS--> COLLECTED: 75.25 OVER/SHORT: .00 HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK 74 . 75 --- . 50 iFMififKkkMkMiEflifkMMifMMMifNiFMMikkMMMM1fMiFiFkikMkikiflk%MMMiFMKMifMifiFMiEMiEMKiEikiEiFMfFMiFM1FiFikifiEitiFiEiflf I N D I V Z D U A L F E E H R E A K D O W N iTYPE QTY D E S C R 2 P T I O N UNIT COST SFR 2565 REROOF HY VALUE RESIDENTIAL NOZONE 1.00 END OF FEES F TOTAL COST 2,565.00 ?2-16-1997/10:5i Rn/515.2� FCGTN:flI-5�315539 PERI'iI�:086187 ` t;�Y OF COST Project Address Applicant's Maili X x AVG�icant to fill in alt spacez except ehose within heavy porEer lines ane sign aIl apP/ooriate aeclarations. ER`M� PEgMI � N��R .Tw GT�O` LOT NO. UNIT NO. L� �� Pr es ! Address �y� ��%`'�'�� l�� ArcMEng. � , License No. , � � Address Contractor's Name� dw� Phone Address (mailing) � �E � Ciry License Na. LICENSED CONTRACTOR DECLARATION ' ' I hereby affirm that I am licensetl untler provision5 of Citarte� 9(comm¢ncing � with iection 7000) of �ivision 3 of the Business a� ro essions Cotle, antl my license is in full force antl elf¢Ct. License Qass � - Licen e Date $ignature WORKERS'COMPENSATION DECLARATION � hereby affirm that I have a certificate ot consent to sGlf-insure or a certificate �f Workers' Compensation Insuran<e, or a certifietl <opY ihereot (Section 3800,'Lab. C.) � ', � ' � Policy No. Comqany ❑ Certifietl mpy Is hereby turnishetl. ' � ❑ Ce�tifietl copy is filetl with the city Builtling D�viSion. � Date ' Applicant - EXEMPTION FROM WORKEHS' COMPENSATION DECLARATION (This section neetl not be completetl if the�permit is tor One huntlretl ($100)'0� �- less). I tertify tM1at in Ihe performance Of the wo�k tOr whiCh [his perm�t is issuetl, I shall not empioy any person in any manner so as to b come suEject to the Worker^' ompe satio(LLawS of CdlitOr i' �, � / Date �519nalur �. "fL(.G Fivl ' ' 'NOT1C :If,afte making this tleUaration, you slioultl bewme subject to the Workers' Compensation provisions of the Labor Cotle, you must forthwitn cOmply with such p�ovisions or thi,5 p¢rmlt shall be tleemetl rewketl. CONSTRUCTION LENDING AGENCV ' R. ' � I hereby affi�m [hat there is a tonstruclion lending agency fo� the perfOrmance of the work for which. this pe�mit is issuetl (Section 3097 Civ. C.) Lentler'S Name —[_�....a_i� . LenCer's Atltlress �V �"�~� OWNER BUILDER DECLARATION ' 1 he�eby affirm that I am exCmOt irom the Cont�acto�'S License �.aw tor the foilowing reason (Section �031.S,Businesz antl Professional, Cotle: Any city or county wnich requires a permit to construct, altei, improve, tlemoiish or repair any structure, prio� to its issuance, also requires the applicant for sucn permie `SO f112 d SIJ02tl SLdlCff12f1[ IhdL IlE/ShC IT IIC205Ed pO1511d�1L LO Ib2 plOV1510l15 Oi [he Contractor's License Law (Chapter 9(commen<ing with SectionO000) of Division 3 of the Busine55 antl Profesvons Cotle) or thaLhe/she is exempt the�efrom antl the basis for the allegetl exemption. Any violation ot Section ]031.5 by any applicant tor a permit sub�ects the applicant to a civll penalty of not more than five huntlretl tlollars (5500). ' . ❑ I, as owner ot tM1e Oroperty or my employees with wages as their sole .compensation, wi11 tlo the work, antl the structure is not intentletl or offeretl Tor sale (Section 7044, Busine55 antl Piof¢SSional Cotle: The Cont�actor'S Licenie Law tloes not apply [o an owner Of a O�operty wno builtl5 or improves thereon,' antl who tloes sucN work hlmselt/herself or tnrough his or her own employces, provitletl [hat such improvemen[s are not intentletl or ofteretl tor , sdle. If, howeve�, the builtling or Improvement I55oltl within one year o( com- pletion, the owner will have the burtlen of provin9 he/she ditl mt builtl o� im- prove for the purpose of sale). � '- . '. ❑ I, as owner of lhe property, am exclusively contracting with lic¢nsetl con- tractorsto construGt the project (Section 7044, BuSinesSand Professions Cotle: The Contrattor'S License Law tloes m[ apply to dn owner ot property who builtls or improves thereon, and who contracts for such projects witn a con- tractor(55 license pursuant to the Cantractor's LicenSe Law). I am aware Ihat proot oi their Worker's Compensation Insurance snoultl be providetl io me. ❑ I am exempt untler Sectimt B.$� P. C. for this reason /i // / oatel�%'' %�%�� R.-e�.�.e� . /L`�-f -C�..�v�� . I her�y that I have read this appiication ana state that the above ' information is correct. I agree lo comply with all city antl county ortlinances' antl'state laws relatin9 to bulltling construction, and hereby authorize repre-. senta[ives of tM1is city to enter upOn the above-mentionetl property for. inspection p�1'J��ses. . , ,/ x I Si9natur .e-�yyti�c ¢ � � �CMF 0865-46, rev. 10/84 White - Builtling: Canary - Applicant; Pink - Accountinq; TVPE OF CONSTRUCTION LVJ NEW''LJ ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTIONO5 Wq RK/USEOFB G. � ' R nCCG $' (/ENFE�2 �.4�2OE.�1 F6�L"� G.�D, 3 TVPEOFPERMIT GRAOING ❑ FOUNOATION STRUCTVRAL ' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL � . ❑ OTHER PROJECT DESCRIPTION 5t3. FT. oCCUPA�Cv�p. ' CONSTRUCTIONTVPE VAIUATION$ vU/•� GRADING CU. VOS. A( Remarks: � - , _ Bar Sink �� Backflow-Preventer - � Backflow Irrigation � Bathtubs Clarifiers . Dishwasher . Orinking Fountains ' Roof,Drains � • Floor Sinks Gas Service ' Outlets Interceptors - Kitchen Sink P-Trap Roof Drains - . Reinspection ,Fee� $75 Boiler Duct - Under Ground � Duct-Structurel ' Duct-Ventilating ' � Exhaust System ❑ Multiple ❑ Fi�epl/Fact. Blt. ICBO # Heating SYstem & Ducting� � ❑0-100,000 BTU 0100,OOOBT peinspec[ion Fee ' I � $15 nrotl - Asse55or u PLUMBING Showers - Service Sink ` Sewer Cap . Sewer Connection Solar Collectors Solar Piping Solar Tank ' � Swimming Pool w/Spa Urinal �Water Closet' Water Heater Water Service Auto-W85h • � • Issue Fee ' � FEES Hood or � Type I ❑ Canopy Type I I ❑ � Refrigeration System � ❑0.700,OOOBTU ❑100,000 ystem Repair/Alteretion Pire Dampers � _,-,-�-g Registers R r � '� �!, Iwue Fee $ 3 A.P. � I I — S Main Building:� TFront �('� A Rear � C Right 3 � K _ _ ' _ _ ' Ping. Ref. # Planning Notes: Automatic Washer � Construction Pole Sub. Cookin9 Unit D ishwasher Dryers-❑Gas ❑Elec' Fan, F.A.U. Fixtures � ' - Device Boxes Outlets Switches Garbage Disposal Generecor �65 KW C � Reinspection Fee ' DEVELOPMENTSERVIC Zoning Approved By— Building APProved 8y Appliption laued By— ID64 4/12/d� ;,,7'� ;i� — a - za�e Accessory Building: Parking Req./ProvideJ .rn�.M ..n� . �_'_' Z O N I N G , R E Q M T 5. �+� iec.. , ELECTRICAL FEES � - Trensformer �' 15-50 KW � � � � ❑50+KW . Meter ❑up to 100 amps � Meter ❑bver 100amps ' Sub Panel Motors�0-1HP�1'/:-B � Inc.Solar�09-15 HP �16-75+ 'nn�,....,.,�„a . ?- � . Pole Light . Range Si9n �� ; StandingSee�fon! 15 KW Trash Co'mpacror $15 � ��Issue Fee a $ 3 � � � SU MARV OF FEES ' , �� BUILDING PERMIT $ � SMIP $ PLAN CHECK $ _i� PERMIT . PLUMBING ' $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ � ELECTRICAL ,$ GRADING S � . PLANCHECK 50k $ - MICROFILM $ � ' MECHANICAC -� $ TOTAL FEE $ �/3. 73 z � PLAN CHECK 25% � $ ' ' ' � CON�TRUCTION AND PLANNING � POOL & SPA qPPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspecror 7. TemPorery Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. �Electrical Conduit Utility-Undrgmd. 54, Forms , 4. Electrical Conduit=Undrgrnd. 55. �lectrical BOnding 5..Steel Reinforcement 56. Rough Plumbing & Pressure Test 6� Elsctrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings � �_ � ` � �S � 58. Electrical Conduit-Undrgmd. 8. �Foundation 59. Gas Pipe, O Undrgrnd., Test 9. WatewPipe-Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgmd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. RoUf Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rou9h Electrical-Conduit 66. Solar System�Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17.�Rough Wiring Sign 68. APPROVED FOR PLASTERING 1S. Rough Electriral-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. RoUgh Factory Fireplace APPROVALS Permit # 21. DuGis, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23:�Gas Pipe-Rough & Test 72. Underground Flush 24: Roof Framing 73. Undergrnd. Storage Tank [7 Gas ❑ Oil � �• 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. FrameapdFlashing 76. DryStandpipe � r,• - 28. Lathing & Siding 77. FIXED SYSTEM FINAL ,: :; � r 29. Insulation 78. FIRE PREV. FINAL �;, - � 30. DrY"�'aIl�Nailing HEALTH DEPT. REQUIREMENT ', - 37. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrica�'Power Meter-Final 80. FOOD CERTIFICATE ISSUED ' � 33. Final Electric Notes: (� ' 34. Final Heating & Air Conditioning "'" , 35. Final Gas Pipe-Test ;i 36. Hooci or Canopy ' . � �- 37. Final Factory Fireplace - � 38. Final.�Plumbing�� , � � . - ` - - 39. Water Service-Final ;� - 40. Gas Service-Final ' - 41. Solar, Domestic-Final � ' 42. Backflow Preventer � " -� ' _ -� - 43. Backflow Irrigation. , � ' � 44. .Landscape Irrigation System �- Incomplete Inspections 45. Sound Attenuation • ; , ' , 46. Handicap Regulations ' • ' -- 47. FINAL STRUCTURE & BUILDING •s 48. Special Requirements Completed �'i 49. Electric Release to Edison � `-'� i� , i �.. : 50. Gas_Release to Southern Califoinia Gas Co i' ' 51. CERTIFICATE OF OCCUPANCY ; � Nn. Date , � �. 6� �,- e CITY OF COSTA MESA BI/ILD/NG DIVISION �� _ � DEVELOPMENT SERVICES DEPARTMENT J •,w � PERMIT PERMIT NUMBER / '*�am+m 698-01907 1% (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 496 SHADYDR Suite: Vicinity: � Parcel Nunmber: 11737232 App�icant CRANK, JIM Address: 126 COMMERCIAL WY BUILDING PERMIT Zoning: Phone: 949-548-5569 . COSTA MESA , i _ Zip: 92627 Owner: SVEDEEN,'ELAINE G TR Address 496 SHADY DR �'`:' - " �. ' Phone: . COSTA MESA;CA � Zip: 92627 Contracror: � CRANK BROTHERS ROOFING CO Address: 00126 CONIMERCIAL WY �.. `� ' Phone: 949-548-5569 � . ` _ - COSTA MESA CA Zip:'� 92827 � • ,. License:i-.408677 '. , l� , iv. Arch/Eng: ,� _ �;�- �. � � , � . . f .. • I. • � Address:� � i� � ' - � - � � Status: ISSUED Applied: 10/21/1998 Issued: 10/21/1998 Plan Check: Permit: SMIP Res: SMIP Com: OtFier: Inspection: Total r . 1 ' � � �� . `- . . , "Phone>._ .. . � \ ' ' . . , Zip: - . - .� ' a � License: ' � - SCOPE OF PERMIT .TEAR OFF EXISTING AND REPLACE W/NEW HOT-MOP AND GREY GRAVEL ON CARPORT ROOF ONLY; 20-YR ROOF. � �. - � � " ' � $0.00 $59.50 $0.50 $D.00 $0.00 $0.00 $60.00 FEE-SUMMARY ,'J , - " _ -. _ • � Calc Valuation: " ,d % Claim Valuation: SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Exlstina: o NOTES: Rear 0- 0 Rear 0- 0 Reouired: 0 PLANNING�& ZONING Left 0- 0 Left . 0- 0 - Pr000sed: 0 - ,� Right 0- 0 Right 0-0 5i,sa�.00 $1,887.00 EXPIRATION: This permit shall automatically expire and become vold if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapections and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: I hereby aftirm under penelty of parjury one of the tollowing tleclaretions: ❑ I have entl will maintain a certificate of consent to self-Insure for workers' compensation, es provided for by section 3700 ot the Lebor Cotle, for the pertortnence of the work for which this permit is issued. ❑ I have antl will meintain workers' compensaGon insurance, es required by section 3700 of the Labor Cotle, for Ihe pertortnance ot the work tor which Ihis pertnit is issued. My workers' compensation Insurance carner end policy number ere: Cartier: (71iis section o�less.J Policy Number: ❑ I certity thet In pertortnance of t�e w rk which this pertnit is issued, I shell not employ any person in any manner so as to become subject to t�e workers' compensation I��f Celifomia, an Ih ii I should become subject to the workers' compensation provisions of Sectlon 3700 of the Labor Cotle, I shell forthwi[h comply with Ihes fovisions. ��j Applicant Signature: Date:i�L�� X — WARNING FAILUR CURE WORK ' CAMPENSATIIXJ CAVERAGE IS UNLAWFl1L AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FI UP TNES p ONE HUNDRED TI-IOUSAND RE 00,000), IN ADDITION TO THE COST OF COMPENSATIIXJ, DANAGES AS PROVIDED FOR IN SECTIIXJ 3]OG OF THE LABOR CODE, IMEREST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: I hereby atFirm ihat I am licensed undar provisions of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Code, and my license is in full force antl eNecc Lic. # Class q Conirectors Signeture: � Data: /i. .... �/— Q i'i CONSTRUCTIOJ7yENDING AGENCY: ❑ I hereby � irm that there is a consiruction lending agency tor the pertortnance of the work for which ihis parmit is issuetl. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: SignaNre: Date: OWNER-BUILDER DECLARA710N5: I hereby aHirm that untler penalry of perjury ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Business and Professions Code: Any ciry or county which requires a permit to consimct, alter, improve, demolish, or repair eny siructure, pnor to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of ihe Contractors License Lew (Chapter 9(commencinq wlth Section 7000) of Divislon 3 af the Business and Prolessions Code) or thet he or she is exempt tharefrom antl t�e basis tor I�e alleged exemption. Any violation ot Saction 7037.5 by eny apDlicant tor a pertnit sublects ihe applicent to a civil penelry of not more ihen five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wa9es as their sole compensation, WILL DO 7HE WORK, end Ihe siructure is not intentletl or oNeretl for sale (Sec. 7044, Business and Protessions Cotle: The Contractors Licanse Law does not apply to an owner ai property who builtls or improves thereon, and who does such work himself or herself or through his or har own employees, provitled that such improvemenis are not intentletl or oNeretl for sale. If, however, Ihe builtling or improvement is sald within one year of completion, the ownerbuiltler will have the burtlen oi pmving that he or she did no� build or improve tor purpase oi sale.J. ❑ I, as owner of the proparty, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business and Professions Code: The contrectors License Law does not apply to an owner of pwpeny who builtls or improves thereon, antl who contrects tor such pmject with a wntrector(s) license pursuant to ihe Coniractors License Laws.). ❑ I am exempt under sec. Business and Professions Code tor this reason: Signeture: Date: Owner ID ventietl by dnvers license. ❑ Yes ❑ No Dnver's License No. Venfication of Ownership by (rype of tlocument, i.e. - properry tex bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Expires: ❑ I �ereby certity that no excavation tive (5) or more leat in depth into which e person is requiretl to tlescentl, will be made in connection with work euthorized by this permit, and that no building siructure, scaffolding, talsework, or demolition or dismantlinq thereof, will be mora then thirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Tille 8, Calitomia Adminislretive Code). ❑ As owner-builtler, I will not employ anyone to do work which would require a pertnit irom the Division oi Indusiriel Safery, as no�ed above, unless such person hes a pertnit to do such work trom the division. Signeture: Date: Division of Intlus�rial Safery Permit Numbar: CERTIPICATE OF COMPLIANCE AND AUTHORVA710N OF EMAY: I certify under penalty of perjury ihat I have read this applicetion and ste�e ihat �he infortnation given is correcL I egree to comply with all state laws and ciry ordinences relating to building consimction, end authorize representetives ot the City of Costa Mesa to enter upon the ebove-descnbeA proparty for inspection purposes. I agree not to occupy or allow occupancy ot any building authorized by this permit until tinal inspection. CO�E �. INSVECf10NtVPE 1616 Fixed System Final Fira Prevention 1266 200 Pool Spe Final Final Re-Rooi 207 Finel Block/Rataining Wall 202 Finel Fedory Fire Plece 203 Final Sign 204 Finel Demolitian zane-ae �ff 1�� ! L 9- 4� "" " �� Deta� r � /� X � Date � Cooer ixsveenoxTrae 206 Finel Mechanical 208 Finel Plumhing 210 Finel Electrical 212 Finel Fire Prevention 220 Finel Planning Approvel 222 Final Site 250 Finel Building/Occupancy -t:r� � y�► ; •�•. ; : �• . CITY OF COSTA MESA BU/LDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT _�✓ PERMIT NUMBER P98-00731 (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: 618 SHASTA LN 93405183 NOCK, RON HEINLEIN, JOHN JR Address HEINLEIN,�MARILYN COSTA MESA,CA 618 SHASTA Contractor: NOCK PLUMBING . Address: 11612 KNOTT ST ArchlEng: Address: GARDEN GROVE , CA � INST WATER HEATER. ISSUE FEE Backflow irrigation Backflow Preventer � Bathtub Clarifer System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas EaAhquake Valve Gas (L4 ouHets) Gas (Over 4 outlels) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT $22.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PLUMBING PERMIT Phone: Zip: Phone: Zip: 92626 �� Phone: 714�895-1246 "2ip: 92841 License: � 707775 Phone: Zip: LicenSe: SCOPE OF PERMIT FEE SUMMARY - AMT Laundry Tub / Washer . $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors •. 50.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect 80.00 Sewer Private Line 80.00 Shower $0.00 Sink, bar $0.00 Sink, wmmercial $0.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, servicefmop 50.00 Spa (private) $0.00 Spa (public) $0.00 CdTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS I SPECIAL CONDITIONS Status: ISSUED Applied: 0924/1998 Issued: 09/24/1998 Sump Pump Swimming Pool Trap Primer Urinal Vacuum BrkrBkflow(1-0) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (foileQ Water Heater I vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION TOTAL CALCULATED FEES: AMT $0.00 $0.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $11.00 $0.00 $0.00 $0.00 $0.00 ao.00 $0.00 $0.00 $0.00 $33.00 QTY 0 0 0 0 0 0 0 0 0 0 t 0 0 0 0 EXPIRATION: This permit shall automatirally expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a penod of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inapectione and final approval must be obtained. Failure to obtain inspections and final epproval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545826 WORKEHS' COMPENSATION DECLARATION: I hereby aKrtn under penaly of pe�ury one Ot the following declaretions: ❑ I ha entl will meintain a certificate oi consent to selt-Insure for workers' campensation, es providetl for by sectlon 3700 af Ihe Lehor Code, lor the peAormance of the rk for which ihis pertnit is iuued. I have entl will maintain workers' compensation�insurance, as required by section 3700 of tha Labor Cotle, far the peAormance ot Ne work tp which Nis pertnit is issuetl. My workers' compensetiqr9f��r� c�rfiqr entl policy number are: /�l, / f� l� Cartier l/C (//l<f% PolicyNumber. /�v`�� 'J� l� (This section neetl no! be canp/efed il the permi( is ve/uetl ef one hundred dollars (5100) oi le55J ❑ I certily that in the peAormence of iha work tor which this permit is issued, I shall not employ eny person in any manner so as to become subjact ro t�e workers' compensatian laws at Celifornla, end egree that If I should become subject to ihe workers' compensetion proWslons oi Sectlon 3700 of the Lebor Cotle, I shell tort�with comply with thesa provision5 c �5./ ApplicantSigneiure: �� Date: �'— �C —/U WAFNING: FAILURE TO SECURE WORNERS' CUAIPENSATIqJ COVEPAGE IS UNLAWFUL AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TO IXJE HUNDRE� TFIOUSAND OOLLARE (5100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED f-0R IN SECrION 37060F THE LABOR CODE, IMEREST, AND ATTORNEYS FEES. LIGENSED CON7RACTORS DECLARATION: I hereby ettirm thet I em licensetl undar provis� forca end eflect. Lic. # Contrectors Signeture: with Section 7000) of Divislon 3 of the Business entl Professions Cotle, en0 my license is in tull Ciass a G — oate: �9 � � CONSTRUCTION LENDING AGENCV: ❑ I hareby eMirtn tha� there is a consiructlon lending agency for the pertortnance oi Ihe work lor whic� this permit Is issued. (Sec. 3097, Civll Code). Lendefs Name: Lender's Address: Signature: Date: OWNER-BUILDEH DECLARATIONS: . I hereby ettirm ihat untler penalty of perjury Ihet I em EXEMP7 FROM TME CONTRAC70RS LICENSE LAW tor the following reeson (Sac. 7031.5, Business antl Professlons Cotle: Any ciry or counry w�ic� raqulres e permit to construct, alter, improve, demolish, or repair any siructure, prior to Iis issuance, elso requires the applicant for such partnit to Tile a signed statement Ihet he or sha is Iicensetl pursuani to the provisions of tha Contrectors License Law (Chepter 9(rnmmencing wiN Sec�ion 7000) of �ivislon 3 of the Business antl Professions Code) or Ihet he or she is exempt iherefrom and the basis tor Ihe alleged ezempiion. Any vloletion ol5ection 7031.5 by any applicant for a permit subjecLs the epplicant to e civil penalry ot not more than five hundred dollars �5500).): ❑ I, es owner ot the proDerty, or my employees with weges as their sole wmpensation, WILL DO TME WORK, antl the structura is not intentled or oHered For sale (Sac. 7044, Business antl Professions Cotle: The Contractors License Lew does not apply to en owner ot properry who builtls or improves thereon, end who tloes such work hlmselt or hersell or through his or her own employees, proNAetl that such improvemenis ere not intendetl or otteretl for sele. II, however, the bulltlinq or improvement is sold within one year of completion, Ihe owner-builtler will have ihe burden of proving Ihat ha or she tlitl not bulld or Improve far purpose of sale.). ❑ I, as owner at the property, em E%CLUSIVELY CON7RAC71NG WITH LICENSED CONTRACTORS to consiruct Ihe projad (Sec. 7044, Business and Professions Catle: The contrectors Llcense Law Coes not appty to an owner of pmpeny who builds or improves ihereon, and who contrecis for such project with a contracbr(s) Iicense pursuant to the Contrectors License Laws.). ❑ I am exempt untler sec. Siqnature: Owner ID venfied by tlrivefs license. ❑ Yes ❑ No Business and Professions Code tor this reason: Verification of Owners�ip by (rype oi tlocument, i.e. - property taz Dill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Dnvefs License No. Date: Expires: ❑ 1 hereby cenily ihat no eacavatlon five (5) or more teet in depth Into which a person is reduired ro descend, wlll be mede in conneMlan wlih wark euthonzed by ihis pertnit, end that no bullding structure, scafloltling, talsework, or tlemolition or dismantlinq thereof, wiil be more than thirtpsi: (36) teef high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Celitornie AdminlsireNve Cotle). ❑ As ownervbuilder, I will not employ anyone to do work which would require a pertnit from the Divislon of Industnel Sefery, as noted ebove, unless such person hes a permit to do such work from ihe division. Signature: Date: Division ot Industnal Sefery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATON OF EHTAV: I certify untler penalry of perjury that I heve reatl t�is epplica�ion and stete thet the infortnation given is correct I egree to comply with ell stete laws and city ordinances relating to building consWction, and au�honze representetives of Ihe City ol Gosta Mese �o enter upon iha ebove-descnbed property for inspection purposes. I egree not to occupy or allow occupanry of any building authodzad by this pertnit until final inspection. � $�pnetu Ot Le9al Owner(s) _ /! _ De_ te� � ��(.` �J 7/?s AnO/Or�ithodzed Appliwnt Date eooe �. ir+svernoxtvre 1816 Fixetl Syslem Finel Fire Prevention 1268 Pool Spe Final 200 Fnal Re-Rooi 201 Finel BIocWRetaining Wall 202 Final Fectory Fire Pleca 203 Final Sign 204 Final Demolition 2C4Bd8 peg J�E{$ GQpE1 INSiECTONTYVE 2os Flnal Mechanicel 208 Finel Plumbing 210 Finel ElectAcal 212 Final Fire Preventlon 220 Final Planning Apprmel 222 Final Site 250 Finel Building/Occupancy GAiE II�ALS oWNER COOPER, MADELINE `f{'l �/ npTE 8-8-61 JOB ADDRESS GENERAL CONTRACTOR Patrick 0. Roy VALUE $ 360 00 AP No. 117-i71-)i0 LOT TRACT FIRG ZONE DESCRiPTION OF WORK7.,+ �i+ +,. .... INSPECTIONS �5ignature� DATE � GROUP T TYPL; v ZONE SUBCONTRACTOR m — � 61 i Ki nr, : � .�5.1€3�; COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 C08TA MEBA. CALIFORNIA ' For Applicanf to Fill In Complefiely � � � TYPE OR PRINT BUILOING ///7 G/J. C'��/ n �. . �Q MESA. � MAIL TEL. IARCHITECI' � � /�M OR ENfINFFR \' II � SrpiE �S.y O 'NO. � ^"(J LIC. NO. SIZE �; [ �'� /� / �I NO. OP BLD09. OF LOT � V J NOW oN �OT EJCIGTING BLDG. � ��L��y� 6ETBACK LINB FNOM Jq �� ] �/ CENTER OF BTiHHT ��' REAR YARD ,r-O " SIDE YARD I LEPT �-�� / I RIGHT Gl�� DESCRIPTION OF WORK BUILDING �/ y NO. OF 81ZE �S'^ ?" ROOM6 EXTERIOR WALL ROOP COVERING COVEF USE OF BUIIDING AND H'ORK Tp E FIRE LewL F�E RECEIVED AUG a 196) FINANCE DEPT. APPLICATI@�I1f�� '��TMESA BUILDING For Offiee Use Only COSTA MESA. CAN�ORNIA TYPE GROUP ED / DATE V / NING q� I NO. OP 7 /I U8E OP NCW � PUN9 v BUII.�INO � ,o��)� l�l�l� Pbf?SGI��' .� 1 /7 - 3 7/- �o «T, EVES ED ALLOWEO ' uN68TJ .�• � � 0 7e� 1 HEPEBV �CKNOWLHDO6 TNAT 1 HAVE itlAD iN19 A�PLIWTION THE AMOUNT 9HOWN UNDEH VALVATION IB POR THE /WU BTATE TNAT THE A60VH 18 COPNCCT ANO AGRC¢ TO COM- pU11POBE OP EBTABLIBHIN6 • P6RMIT FEE ONLY. PLY WITX �LL CITY ORO CEB 6TAT8 IAWB IiE�UTATINO bU1LO1N0 CON9iRu N� ' Q VALUATION � SIGNATURE OF � PERMIT FEE $ � . $ `� % � D , � PLAN CHEGK $ � AUTHORIZED AGENT �� (� �J a-Q TOTAL FEH �