HomeMy WebLinkAbout329 RIVIERA DR - Building PermitsCITY OF COSTA MESA � ,
yTpMf BI/ILDING DIVISION
4 9 �
> ,., � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.wsta-mesa.ca.us
°. � FOR INSPECTIONS CALL: (714) 754-5626
'`°°�4°'� PERMIT NUMBER: B10-00361
PERMIT TYPE B`ROOF2
APN: TPN00580
JOB ADDRESS: 329 RIVIERA DR CM
Vicinity: 329 - 335 RIVIERA DR
Squares: 4600 „ " ,
STATUS:
DATEISSUED:
ISSUED BY:
Suite/Unit:
Valuation:
ISSUED
11/2912010
KJB
$18,000.00 • r
SCOPE OF WORK: TEqR OFF EXISTING BUR SYSTEM AND INSTALL NEW BUR SYSTEM ON 36 S�UARES OF FLAT ROOF AND
INSTALL 2 LAYERS OF 15# FELT AND 1 LAYER OF 30# WITH 40 YEAR COMP SHINGLES ON A BARREL ROOF,
APPROX 10 S�UARES. CONDOMINIUM BLDG: INCLUDES ADDRESS 329 THRU 335 RIVIERA (4 UNITS). �,
COMPLIANCE FORMS ATTqHCED TO JOB CARD AND CITY PERMIT. � -
OWNER: BACK BAY �qRDENS ASSOC - Address: � � ' Unit:
PHONE: . - _ - Ciry/State/Zip: , � --
APPLICANT: HIRSCHMAN, ROBERT '
PHONE: 714-744�'i577 ,..
CONTRACTOR: JORDqN ROOF COMPANY
Address: 915 W COLLINS AVUnik �
Ciry/State/Zip: ORANGE, Cq 92867
ARCHITECT: �.
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
$o.00
$293.28 -
$0.00
$1.00
Address: 915 W COLLINS AV �
City/Sfate/Zip: ORANGE, CA -
PHONE:
License No.
License No.
TOTAL FEES $294.25
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 -
Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibiti
New Years Dav. Memorial Dav. Indeoendence Dav. Labor Dav. Thanksoi�
Unit: :
License No. . .406783
714-744E577 ' �
CELL:
PHONE:
PHONE:
Sundays and the following Federal
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulalions. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permil to be considered legal, such work must comply wilh all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
COOE k. INSPECTONTYPE DATE INIITRLS CODEN INSPEC110NTVPE DATE INPTIALS
1616 Fixed System Final Fire prevention 206 Final Mechanital
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof .��' �� ��� 1�1 _� 210 Final ElecVical
201 Final BIOCk/Re�aining Wgll 212 Final Fire Preven�ion
202 Final FactOry Fire Place 220 Final Planning Approval
203 Final Sign 222 Fina15ite
204 Final Demolition 250 Final Buiiding/Occupancy
WORKERS' COMPENSATION DECLARATION:
I hereby aHirm untler peqalry of perjury one of the following dedaretions: �
❑ I have and will maintain a certificate of conseN to self-Insure,for workers'
compensation, as providetl for by section 3700 of Ihe Latior Code. (or the
performance of the work for which this permit is isSueO. �
❑ I have and will maintain v✓orkers' compensation insurance, as required by
section 3700 of Ihe Labor Code, for Ihe peAortnance of the wurk4or which Ihis
permit is issued. My workers' compensation Insurance cartier antl policy
number are:
�QZIf18f: �L �.�
(T�is SeGiwr neetl irot Oe mmplefed A the peimR is valuetl a1 me �untlietl cl�llars (5100� orless )
P y Number. Q�_� (9 S( �
❑ I certify that in the performance of the work for which ihis permit is
issuetl, I shall not employ any person in any manner so as lo become subjeci
to the vrorkers' compensation laws of California, and agree that if I should
become subject to lhe workers' compensation provisions of Section 3700 of
t��e, I shall forthwith comply wi�h [hese provisions.
_J ( -2_S- eo
�rmmre �
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLL4RS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions o( Chapter 9(commencing
with Section 7000) of Division 3 of the Business antl Professions Code, antl
my license is in full torce and effect.
Qio�-� l al�"-ss�.fF�C-i5
_(1-L4-`o
raCW-Soialwe' ate
CONSTRUCTION LENDING AGENCY:
❑ I hereby atfvm that ihere is a constructbn lentling agency for the
peAwmance of the v.ork ta wfiich this permil is issued. (Sec 3097, Civil Code).
Lender's Name:
Lender's Address:
SignaWre
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMP7 FROM THE
CONTRACTORS LICENSE I.AW for lhe following reason (Sec. 703L5,
Business antl Prolessions Cotle: Any ciry or county which requires a permit to
construct, alter, improve, demolish, or repair any strucWre, prior to its
issuance, also requires the applicant for such permit to fle a signetl statemen[
Ihat he or she is licensed pursuant to the provisions of the Contractors
license Law (Chapter 9(commencing wilh Section 7000) of Division 3 of the
Business and Pro(essions Code) or ihat he or she is exempt theretrom an0
the basis (or the alleged exemption. Any violation of Section 703L5 by any
applicant for a permit subjecls the applicant to a civil penalty of not more than
fve hundred tlollars (5500).):
❑ I, as ovmer of Ihe property, or my employees vrith wages as their sole
compensation, WILL DO 7HE WORK, and the sWcture is not intendea or
oflered for sale (Sec. 7044. Business antl Professions Code: 7he Contractors
License Law does not apply to an owner ot property who builds or improves
thereon, and who does such vrork himself or hersel( or thmugh his or her own
employees, provided that such improvements are not intended or offered for
sale. If, however, the builtling or improvement is sold within one year of
completioq the owner-6uilder will have the burden of proving that he or she
did nol build or improve for purpose of sale.). -� �
❑ I, as owner of the property, am�E%CLUSIVELY CONTRACTING WITH
UCENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Pm(essbns Code: The cont2ctors License Law dces not apply to an ovmer of
property vfio builtls or improves thereon, antl who contracts for such project with
a contractor(s) license pursuant to the Contractors Ucense Lav.s.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
]OS]-46(3101�
Owner ID verifietl by tlriv. .,;ense. ❑ Yes ❑ No
Driver's License No. Expires:
Venficalion.of Ovmership 6y (rype of tlocument, i.e. - property tax bill or deed):
. �
�DIVISION OF INDUSTRIAL SAFEN PERMIT CER7IFICATION:
❑ I hereby certify Ihat no eacavation fine (5) w more feet in depth into v.hich a
person is required to tlescend. vnll be made in connection with wnrk aulhorized
by Ihis permit, and that no builtlinq structure, scaHdding, falsework, a tlemolition
or dismantling ihereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp
2, Art 2, Sec. 341, Tlle B, Califomia Atlministrative Cotle).
❑ As owner-builder, I will not employ anyone to tlo work which vroultl
require a permit (rom Ihe Division of Indus�rial Safery, as noted above, unless
such person has a permit to do such work from Ihe division.
ApplicanYs Signawre Date
Division of IntlusMal Sa(ety Permit Number. _
HAZARDOUS MATERIALS AND EMISSIONS CER7IFICATION:
1. Will the applicant or present or tuNre building occupanf neetl to file and
certify a Business Plan for emergency response to release or threatened
release of a hazartlous material? ❑ Yes ❑ No
(Section 25505 of the Cali(ornia Health and Satety Code requires, with some
exceptions, that a Business Plan be filed vnth the Costa Mesa Fire
Department by every business which has at any one time during a reportetl
year a quantity of hazardous materials equal to or greater Ihan a weight of
500 pounds, or a volume of 55 gallons, or 200 cu6ic feet of compressed gas
at stantlard temperature antl pressure).
2. Does or will Ihe applican� or present or fuNre building occupant need to file
a registration fortn for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of Ihe California Health and Safety Code, with some
exceptions, requires registration with Ne Costa Mesa Fire Departmenl by
each business which at any one time has on hand a quantiry of acutely
hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet o( compressetl gas at standard
IemperaWre and pressure).
3. Does or vnll the applicant or present or fuNre building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 0! Ihe California Health and Safery Code provides Ihat the
Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Departmenl.
4. If an RMPP is presently required, has Section 25534 of the California
Health and Safety Code been fully complietl with? ❑ Yes ❑ No
5. Does or will Ihe applicant or present or fuWre building occupant require for
the work which is the subject of this application a permit for such conSWction
or motlifcation from the South Coasi Air Quality Management District or from
any other air polWtion wntrol district or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Code requires that Ihe requestetl
information be fumished on applications for non-residential building pertnits).
6. Will any part of Ihe facility to be conslructed under this permi� be within
1000 feet lrom the outer boundanes of a school? ❑ Yes ❑ No
(If'yes", the (acility must meet the requirement of Sections 25534 and 42303
of the Califomia Health and Safety Code).
7. If a pertnit from the SouM Coast Air Quality Management District or other
air pollWion control disMct or agency is required for the work which is the
subject of this application, have all of the tlisclosures prescribed by California
Health and Safery Code Section 42303 been made? ❑ Yes ❑ No
8. (If'yes", attach certifcate of compliance from the appropriate air pollution
control oKcer). �
CERTIFICATE OF COMPLIANCE: I certify thzl under penalty of perjury Ihe
informacion giden above is correct I agree to comply with all state lav+s antl
city ordinances reqartling Hazardous Matenals and Emissions.
SlgnaWre Oale
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty o( perjury that I have read this application and state that
the information given is correcL I agree to comply vnth all state laws and city
ordinances relatinq to building construction, antl authorize representatives o!
the City of Costa Mesa to enter upon the above-descnbed property tor
inspecfion purposes. I agree not to occupy or allow occupancy of any builtling
authorized by this permil until final inspection.
aW re ol Legal pwneqs) Date
�' 1 1 -i� ^_�
�Im^y ��
N
'rescriptive CertiS"icate o1'
tea•identia7 Akerations
ecl Nan r 2
�� /�/l4 %
�eneral lnim�ma[imi
{ite Address:7O/3 _ 2 2 e�
ce: Residential
Building Type � Single Family �Multi Fainily
Conditioned Floo� Area (CPA)',
%niorcemenl Agencp:
Circle the Froni Orientation
Yrojeci Type: ❑ Alteratio�
CF-IR-ALT
� (Pe �l ot'S)
ne � I q uT Stories
Dflte:
E, S, W, or degrees
] Envelope O Fenestration �Roof ❑
7 Duci keolacemem ❑ Water Heater
NOTE: T/iisJbrnr i.e �im In be used /nr Newlp Constructed!lui[dings m'Additions
�nsulntion Vtduex Fnr Opnquc Snr(nces (fm� Furring use 1he Mlass anc! Furring Sn�ips Consn�uc�imi mble beloH�)
Assembl)' Alteration
❑ Opening of framed ca��t�' fllone- Alierations ihni invoh�e die opening oJ(hc finrned cavi�� ofn wol1, ceiling, a.Poor mus� insmll (he
mmidamrr mininttnn insuln�ion nn(ue per _¢I SO,fm� ihe altered assemG�p. Fill in Columns A-C and enter mandatorp insulo(ion value in Colunov H
❑ Replacemen[ of entire assemblp-Reylucemeni ofon emire wa/1, ceiling, or fioor ossembl�� reguires (he ins�allation ofComponent _
PGCI(OPB- L 1RSUIpIIOH YqI'G2S Ui TLlGIP 151-C. Fill in Columns A- J. .
�a ue SuCf�ece DBtai15 Por the turred purtioned of Mass N'alls see
q B C D G
Assembly Name
or Tvoe �
Noie For fwred
Framing
Material
and Size�
U-
�urring Strips Construction Table below.
� F G H - � , .I. . �,]
Values From JA4 Table '
Framed Continuous JA4 Pro�
JA47able Caviry ]nsulation Assembty AssE
Numbers R-value� R-Value' Cell Valueb� U-ff
Insula��on R-value, see Pnge JA4-3 mid 6g�mtion
use thc Moss and
Fu ring Cwrstruclim� lable 6elmr.
l. Fw' Tng/!D indicaie the ideu�i�ca�im� name dra� mntches !he building p(ans.
2. /ndicate the Assenabin Name m- ,rype: Roo(/Ceiling, Wa!!s, Flaors, Slabs, Crawl Space, Doors and e�c...Indica�e the Frame rype and Size' Fm�
N'oad, Me1a1, Meial Bi�ildinga, Nlass, en�er 3x4, 2x6, or eic... see JA4 for o�herpossi6le f-ame rype assemb/ies.
3. Ex�er rl�e diiclmess fa' muss in inches or Syacino 6enveen fi'mning members emer; ]G "or 24 "OC; or O�her for al( oiher assem6l�� descripiiwi
such a.r Concrete Sandw�ch Panel, Spandre! Pane7, Logs, Sn'aH� Bale Pane! and etc.... -
4. Based mi Ihe CGnm�e Zone; enler !he Slandard U facmr fi�om Table 151-B, C w� D jor each d�erenl assembl�� Name or' ry�pe.
S. Enter tlie Table number fhal closel�� resemGles J�e proposed osa�embli�.
G. Ln�er Ihe R-value Ihn� is Leing ins�alled in the wa11 cm�ih� or beiween the f'nmirig, od�erlvise, enier "D ".
Z L• nter �he Cnntiiruous Lrszrlation R-i�alue jor �he proposed ae�sem61 p; othe�wise, e�xer "0 ".
d'. Lnler tlie rnw mid column o(the U factor vahie bosed av Column FTuble Number ond enler !he Aasem6l�� U-facmr in Column J
I. The Proposed Ren'enrLlr U-jnc+or, Colzunn J, nnisi be equal to or less than the S1a�idrsrA U-jactor in Co�unm E ln con>p1 p.
FmTing Strips Construction Table fm� Mass Walls Onh�
A ll C ll � F G N I J K L M
Propused Yroper[ies of Masonry and Concrete Added lnterior or Exterim' ]nsulntiun
Walls Trom Reference in Furring Space irum Referencc
Joinl A i endix'Iable 4.3.5. 4.3.G. 4.3.7 Joinl A endia 7'ablo. 43.13
u V u � p� � 4.G �: U
hszcmbly �- j � c° �- t� c a,'.v A `.., Fltlal
Mass Numc or .1A4 Tablc a= � I v � F a o �t 10 L_ °� Assembly
Thickness� "f� e' Number' ���` g = w' � LL u` 3 � r �� u�i r U-faCtol�'� Commenl
I
��
I I
Regi.tTrutinn Nunvlier: Registruunn Uare/Trmc: HEIfS' I'rnvider:
GOOd' Residentiul Cnnvplicu�ce Form.t �lugu.s/ 200y
�
e CertiScate of
A[lerations
IProject Namc:
.�
Residential
Climate
CF-1 R-ALT
(Pa�e 3 of 5)
k of Stories � �
ROOrINC PRODUCTS (COOL ROOFS) §757(p�2
When !he nrC�� oJer(erior moJsurjacc !n bc replaced exceeds inore than 50% oj[he rXisting roajoren, or �nore lhan 1,000 jf, rvhichever is
less, !hc nern roofing aren iiins� niee/ tlm roofng prodnc/ "CoolRoaj" requireu�ents oJ§I52(bJIHi, l52(b)IHri, or752(bJlHiii.
Check applicable a(temrstive a� cccep�fai GelaH� if �he raoJaLera�ion is ezemp( fi�om !he roofing producl "Cool Roof". requirementa�. Note: IJan��
one oJlhe afiernoiives or escep�ion be(ow is checked, �he AgedSo/ar ReJlec�once and Thermal Emii�ance requirements jor roofing produc�s in
§/ 18(iJ a�e nol app(icable. Do no{fill mble beloH�.
Cool Roofs Noe Required iii Climate Zones 1-12, 14, and 16 with a Low Sloped. Lets or 2:12 pitch.
�Cool Roof5 Not Required in Climate Zones ] through 9 and 16 wi[h a Steep-Sloped Roofs (pitch greater than 2:12) and product unit weight less
than 516/ft'.
Alternatives to §152(b)IHi and §152(b)Hii, Steep-slope roof (pitch > 2:72)
❑ Insulation with a lhermal resisiance of at least 0.85 hrft ��F/Bm or ai least a 3/4 inch airvspace is added ro the roof deck
over an attic; or
❑ Existin6 ducts in the attic are insulated and sealed accordingto §151(�10; or _
❑ In climale zones 10, 72 and.l3, wi�li 1_ ft''.of free ventilation area of attic ventila[ion for every l50 ft oFariic floor erea, and
wheTe at least 30 peccent of the free ventilation area is within 2 Ceet veRieal distance of Ihe roof cidge; or �
❑ BuildinE has at least R30 ceiling insulation; or � .
❑ Buildin� has radiant bartier in the attic meeting the requiremenu of §151(�2; or
❑ Building has no ducts in the attic; or
❑ In climate zones ] 0, 1 l, 13 and 14, R-3 or greater roof deck insulation above vented attic.
Exceptfon to §152(b)1Hiii, Low-slope roof (pitcL <2:12J
❑ Building has no ducu in the attic.
Other Exceptions
❑ RooSng area covered by bullding integrated; photovoltaic panels and solar4hermal panels are exempt from the below Cool Roof criteria.
, O RooT constructions that have thermal mass over the roof inembrane with at least 25 Ib/ft is exempt from the below Cool Roof criteria.
Note: If no C�C-I label is available, this compliance method cannot be used, use the Performance Approach to sho�a compliance, otherwise,
box below if Exem t from the Roofm Products "Cool Roof'
RoofSlape ProductWeight
Numher� < 2:12 >2:12 < Slb/ft� > 516/ft�
Aged Solar I Thermal
.efleciance1'° Emittance
OQ
�Q
❑Q
OQ
❑Q
SRIS
TLe C2RC ProducllD NinnLer can Ge obminedfi�om /he Caol RoofRaling Council's Raled Producl Direclay at w�v�r caobnoh ore/nroduus/se rcl�
/ndimre !hc lype ofprndud is bemg used jor lLe raof lop. i.e. single Vf�� roof, atpha6 roof, me�al roof, elc.
1(Ihe Aged Hejletioncr ia no� ovailoble in.lhe Coof Roo(Raling Cmnsil's Raied Produci DireGop� ihett uxe 1he Inilia! Refieclonce vaive j�wn Ure same
direcmr�� ond use tlie egua�iorr (02+0.7(p�������i— 0.1) �o ob�ain n calcu/aied aged vaL�e Where p ii ihe Ini�ia( Solor ReJlec�ance.
Check Go.�' if ���c Aged ltelleclm�ce is n calndmed nalue using Ihe equaliwi above.
Calcidoie /hc SfU volue Lr using Ihe S/U- k'a�k.rheei oUuqr.//w�vm.enertm.ca.env//i//e24/a�d eme�' Ihe msu6ing vofuc in dre SR/ Cohnnn obo�e and arruch occ
rHe SR/- Workshee! m rhe CF-llt.
o apply Liyuid Pield Applied Cuatings, lhe coating must be applied across the eutire ruof surface and meet the dry mii [hickness or coverage
commendeJ by the coatings manufacturer and meet minimum performanee requirements listed in §118(i)4. Select the applicable coating:
Alumimm�-P��Smented Asphait Roof Coating `0 Cement-Based Roof Coating �fl Olher
Regis7rulton Nurnber: Regislrolion Da�e/I'ime:
2008 2esiddnliu! Compfiunce Fornts
FIEILS Providere
Augus�2009
I'rescriptive Certiflcate ot CumpSi.�. .:�. Jtesidenti�l Cr-1R-ALT
Residentirr/Alterations • (�'a,qr � of i)
Yrujecl IVnme: I Clima[eZunc3! �$ofSluries
HL',I:S VI;F�IFI CATJ ON SUMAIAP Y The enlorcemeN ngener xhmdd pnp syec�a! aneniion m 7he HERS' A4eas�u�e.� specijied m this
chechfist bclo�r Fi cau�p(e�eci m�d sioned CF-4R Form,fnr n!l lAe mensw�e.; s7�eci)ied sh�Jl Le suLu>iued �n �i��a building in��pecior Lelore fuvnl
UllCt Senline ci: TrStille HL/iS i�erificniion is requirc[i_Jor lhia munszn�e. �
❑ 1'�S ❑ NO 1'CS�. ln Climate Zones 9 and J-I G, if mort tha�i 401inear feet of new or replucement Aucin zire insialled in uncondnioned
spaCe, the ducls are to be sealed per jU52(b)IDii and tlm newiy installed ducis are w be insul.ued pei §]51(f110.
❑�XC�PTIOI�': Lxistin� duct sYslems th�i ere extended; wliicl� sve cuustructed, insulate[I ur sculed �vith ci5hestus.
❑]'�S ❑ NO YES: ]n Climate `Lones 2 and u-16, if the existinE space-conditioning system (HVAC equipmeni and ductingi is replaced, the
� ducts are to 6c sealed per (152(b)1Di. .
❑ �'ES ❑ NO Y�S: ]n Climate Zones ° and 9-16, if [he existing HVAC equipmem is repluced (including th� replacemem o1 the air handler;
ouidoor condensing onii of a splii system: cooling or heating coil, or the furnece lieai exehanger) the ducts are to 6e
sealed per §152(b)]E. �
❑ EXCCPT]On: Duct systems tLni are documented W liave been previuusl�• se�led confirmed tLruu�L HERS
� verifice[iou in uccordance with prucedures in the Reference Residenfml Apyendia� RA3.
- ❑ iXC�PTJO�: Uuc[ syslems with less than 4U Iineer ieet in unconditioned spnce.
❑ P.XCRPTin�� Existin� duct svstems cons[ructed. inxulated nr r,ealed with as6esms.
�.2ei'rigerant Charge - Split System HERS verifica�ion is required forlhis meo.nrre.
p Y�S ❑ NO YLS: ln Climate Zones 2 and F-I5, when the existimo H V AC equipment is replaced (including the replacemem of the air
handler, outdoor condensing unii of a split system A/C or lieat pump, coolmg or heating coil; or the tumace heat
exclianeeri a refrieecant clisree measuremem shall be veri5ed ner F 152(b)1F.
Central Fan Integrated (CFI) Ventilation S,ystem and Fan V�'att Dra��
Tlie ventilation renuirements of F150fo) do not anplv tn existine residential homes.
llucted Split 5.1'stems - Aic' Conditioners and Heat Pumps: Airfloh� HERS verificaiiai is required.Jor rhis measurc.
p Y�S ❑ N01'E5: ln Climate Zones 10 through 15, wlien the existiug space-conditioning system (HVAC equipment and ductinej is
reolaced. ths airfloH• and ian watt draw shall be verified ner § 1;2(bl l Ci to meet the renuiremencs of & I� I(f17B.
tion Author's
that this Certi
i
—25— �C�
L71
�,�,}�� � SZs� � i ��� ��z�ozz S
Responsible Buildine Designer's Ueclaratiur Statement -
� 1 um eligible: under Division � ol thc Californiu Business und ih�ofessions Code to accepi respunsibility la� tlie buildiug design iden[iGed Un
this CertiLcate of Compliance.
• 1 cerllfy thai thc energ�- fevmies ancl performancc speci5cations for the buildinE desi�n identified ai thls CertiLcute of Com��llance conform
to the rcquiicinents ol'TiOc 29,1'�n��s 1 aind G of� the Caliibrnia Cndr of Regulatiais.
• Thc buildinp design ieature;, IdentiG�d on thi;�� Ceniiic�tc o1�Compliunce nrc cunsisieni wi�h thc inlormation pruvided tn ducwneni thi�.
buildin� desitin on th� other applicable cumpliunec lonns: woii:sheeis, calculations, plan:, and speciGca�iom: wbiniucd w the eniorecnreN
u�enev for apprnval with this buil�in� permii appliculion.
N;nne-. Signaturc:
hddress:
Gry;5mtd7.ip-.
Late:
License:
J�nr u.v.ri.rmnec nr gucstinn:: r•eg«rrling the Energr S'ttoidtn�d.r, coniuc� tlic L'nero,i� Ho[line ut: I-klll1-;72-.i3llll.
Ife�eslrmion h4unber l(eg�airnna� Laie/Timc.-
ZObf; 1(c;itiervicd Comp(iunoc Fnrvns
I-/ERS J rnwner:
/ugua�l ?p0%
OF BUILaNG:�
ADDIIE55:
AYPL. M�I11NG RODHE55:
K��BAY�GARDEItS�S .- `-- - • _-_.-..-__uNr:- y ,—
RIVIERA DR #B
TA MESA,CA 92627 _ ... ,
AfICHRECT OH �qNEEA: 11C. NO.:
ANCX.OP EIIG.'S ADOXE55: UNT:
ROSS 6 HARROWS INC. (714)557-7440
coxm�crarsru�: z60 E, ALTON AV
CONiNRCT0A5MYl1NG SANTA ANA .. CA 327802
ADDRE55: (3 Z% O% IIC. ND.:
uxr:
LICENSEO CONfN�CTOflS DECLARATION: I hereby efl'vm uMx penelly d pe�jury ihel I am licensed under proviaiona d Chepter 9
(commenunp wil oiDivieion 3 d�ha 8 ne Pmieaeiom C nx�sin erM
/c�iT7Y no.: b�`�°i°� uc. cuss: �-°3�i uc. No.: ��/�/i°��Ci� ��CP :°i°'i / 9 6
I Date: V � Conlredor. � 2f'� /�C.//i�i-LLrt.!
N BUILUEH DECLARATION: I hereby elfi�m unJer Po�eMY d perjury Ihm I em uemq fmm ihe Conlrepon Licenae lew lor tM
I011owinB reeeo� (�w� ��� �5 Bueneaa enE Prde»iona Coda: Any cily a caunry whiM requiiea e pertnn �o mnairvct, ellx, impraro,
demolsh, a repei any atructuro, p'v to aa uweMe, e6a reQuirm Iha eppli�eni Iw euch pemiA lo file e ep�wE sletemenl the� M ar ehe
is IicenaeC punuenl lo Ihe provieions d Ihe Conlreclors Licenee Lew �Chepm 8(comme�rp wilh Sed'on ]OW) at Ovuian 3 d the
Busimsa eM Ptdeasions Gode� a Ihel he or ehe ia uemq tlixehan vM IM batis in Ne elbpeE s�emqion. My vioW un of $eqion
]03t.5 by eny epplirent Iw a parmn eubjecb Ihe epplicenl lo e cnl penelry oi nrn more then 1'va hundrad dollen �E500�).
❑ I.mownarMthepropanyarmyempbyeesMilhwegeaesihe'xedecampeneatbn,willEOlMvroM,eMihaewctunuiwtinlaMed
w oflerad br aeb (�� ]�. Buvmm eM Prdeaaiona Code: TM Conlrmare Lioenae lewdoea mtepplyto en ownerd propeM
wlw W Ms w vnprovee thereon, eM who doea auch wo�ic MmeeH «hereeH w ihrough hb a her own empbyaea, praided �ha� euch
improvemenls are rol inieMed a oHered lar cele. X, howerer, �he WiNi�p a vnprtwemaM is edd wilhin aie yeer d mmpb�ion, tlw
owerer-0uiNx will heve iM burden d provinp he or ehe CiC nM Wild a imprave lor tM Wm�e d eale).
❑ I, as owwr d Ihe propeM. � aRduvivety contreniq wnh licenead cmirecton b aonsVud Ihe 0�1� (�� ��. �eiiwea eM
Prdassiom Code: TM Comrepon License lew doec m� appy to en ox+wr W propeny wiw WiMa n impwn theieon eM who
mnvecla !or wN prol�a wilh e canVeUoqe) IcenaeC punuent to iha Conveaore Licenee law).
� I em uamq under Section�. B. 8 P.C., br ihia reeaon:
Daie: Owner.
I Eo Mreby cMify Nel I em ewere d enE uMembM Ihe reQuiremenb M CelAomu HaaM1h arM Sdery Code Sediwu 25505, 2553], eM
25531, end ihet I or eny Mun Wildiip omipem will / wiA nm (arck wro) metl to wmply wih eeid mms oodn eM iM repuinmanie M
e pe,mG IammVudion a moEifimlbnhomihe Re�yl�erepemsm Disirid. Reaidenliel mnat�W ion eppYcelionsere uemp Imm �heee
prwisiom.
De�e: ApplceM:
W ONKEN'S CONPENSITION DECLAHATION: I hereW elfi�m unEer penelly W pe�jury a�e M ihe lollowi�q dadvetuna:
� I hew enE wil meinlein e cenJcele d mnaeM �o eell-inaure br wsken' canpenetlion, ea povided la by Sedion 3)dO W iM Lebar
coae. �« ine rortortneM. a Na won� �a w1Ycm m� ro�il ia os�ee.
��, � I hava arM vril meinlen xwknn' mmperoelion inwrarKe, m rpulred by Seqbn 3]00 d ihe lebm CaEe, br �M perlormence d ihe
j .� i�.,mm� �ma p,�a �a ��.�a. n+y wa�� gC9CTtl49A'4a'1°QYPfi°, °"a wikv ��mw, a.: E X P I R ES
c°'"" �9���2���� 07/O1/96
Pdiry Number: - -
(Thia seaion r�eeE rro� 6e comde�ed d tM pemirt is br one hundrod dWlan j41001 w bae./
❑ I cen/y thet in Ihe parlormenca W the woA br whkh Ihie permn ia iuued, I ehdl nd empby eny penon in any menner ao ea to
oma suEl� to �M workaa' canpametion lewa d Celilanie, eM eprea thet il I shauW becoma euEprJ to iM Mwken'
mpenaeiion pwieione M Satlion 3]00 W Ihe lebor Coda, 1 ehell lorlhwilh oompN'�� �� C�Weiona.
od,: �. '�?r� —%G aoa�,�. '�[d'/�.l�l.nr�...i
�mlrp: Fillun ro �xun wodxY rompwuatlon coverp� h undwNl, �ntl iHll �ub/�cf �n xlp/oYx ro ctlMrwl PM/��� �nL
c/vll n�w up ro on� hundM rMuurM tlo/Nr� (Sf00,000), In xMltlon ro M� cwr ol rompxuetbn, d+�npu u prvHtlM ror In
SNtlM 3NM o/ N/ LIDOfCod, InfMlf, ans IffOmsyl /Ml.
LONSTNUCl10N LENDIN6 I10ENC1': I hereby elfirm �Mer pereM1y o/ perp�ry Ihe� �Iwn u e mns�wabn bMi�p eperwy lor IM
�IBI�Of111011M O� Ih0 N'Of�I �W M�1lf�l �hB VeT1119 99UBf� ($Bdq1130'�i. riN. (�i�.
LENDEH'S N1ME:
LENUEN'S ADDRES3:
II cenily Ihet I heva reed Ihis epplcelion eiM etele Ihel ihe ebove inlormetion ia corted. I eprea to mmply wnh ell ary uM coumy ordinentta
eiM ateie lexs relmnp lo buikvq conarucun end Mreby eNhorrzs roproeenteiivea W thie cny to enier upan the ebova�men�oneE pmpeM
'°��^°o°°0ona°��°°°. NANCEE KILHOURNE
Deie:_G /.1��
�5151dB.WP) Whne-Build'up 8 Selety; Oraeo-Fle; Canery-AppFcenl: Pink-Revenua; DOIEenmd-Neneor
��____ � C.ITY_OF COSTA_MESA,__,HU.ILDING,__PERMIT__.
PERMIT NO: B 078252 ,PLAN CHECK NO:. N . ,
CONSTRUCTION TYPE: V-N . ___ PERMIT TYPE: STR .___ _,_�. PURPOSE: OTH
JOB DESCRIPTION._: T/OFF 6 RE-ROOF W/2 PLY 6 GRAVEL , SQ FT: 1,700
CLAIM VALUE: 1,700.00 CALC-VALUE: 1,700.00 GROUP OCC: R-1 /
COMMENTS:.iX
1E IE 1F iE iE if 1E if 1f'lE iE if 1E if fE if if if 1E 1F ik iE iE if iE if iE 1E 1E 1E if 1E 1E 1f iE if if iE 1E if 1E 1f 1f� ik iE iE 1f 1h IE 1E iE iE iE 1E 1f 1FiP 1E 1F ik 1E 1F if 1E IE aE fE iE iE iE iE iE 3E iE 1E l4 iE 1E 1E
__ __ Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN.BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: . FT IN AEAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN.RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ� PROV: PARCEL: 43914329 ZNE: REF NO:
PLANNING_N6'PES> �
7 I
fE 1F 1E 1F 1f 1E iE 1E 1E iF 1E 1FlE i81E ik 1E iE 1F iF fF iE fE 1E 1f 1E 1f it f! iE iF 1E 1E iE 1E 1E 1E 1F iE 1E 1E 1E IklF 1E iE 1E 1F if 1E 1f iE iE 1k 1E iE if k ik iF 1E 1! if 1E i!'lE ik 1k iE��iE iF iE 1E 1E 141k iE 1E 1E
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: `'�a
HUILDING APPROVED BY : DATE: /�
APPLICATION I�SSUED HY: DATE: �
�r*�tx�t*�t�t�t�t�t�t*�tx�t**x��+t* x�x�x�t*x�**+t+t x�
LEGALIZATIONeN F E E S U M M A R Y STRUCTUAAL�SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 54.00 .50
SMIP/NON-RES
PLAN
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 54.50 0,00 0.00 54.50 54.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 54.50 OVER/SHORT: ,00
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
54.00 .50
iE iF ik iF 1E'lE iE if 1E If if i8 iE 1E if iE iE 1E iE iE 1f ik iE 1f 1F iF if if iE 1E fE 1E 1E 1E 1f iE iE 1E 1f' iF 1E if iE if 1i 1E 7f IE 1(' Mlf i(�1E 1E fE iF iE i� if if IE jE if 1f II� iE 141E Ik ih if iE 1E iE 1f 1E 1E IE 1E
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY, D E S C R I P T I O N UNIT COST TOTAL COST
SFA 1700 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 1,700.00
, END OF FEES
LL
77 ^`12"v9L:.-�'�i�_99�°; T�+r'r , -
C6TC• C��/;q'q5 •I;:"; , .Q '-
�CONSTRUCTION AND PLANNING / P�DOL & SPA •
�"'APPROVALS Permit# Date Inspector qppROVALS Permit�h--
i. Temporary Electrical Service or Pole � � � 52. Pool & Eqoipment Location �
-,
2. Soil Pipe-Undrgrnd. `� _ 53. Steei Reinforcement '
� �3�,�lectricaf Conduit �tlity-Undrgrnd. - : � 54. Forms � . . �
�� .c
' ' F4Electrical Condui"�rigndrgrnd. _ 55. Electrical �Bonding,
-�<�5.;Steel Reinforcement; 56. ftough Plumbing & Pressure Test
�..'S?�Electrical UFE�3 S�imd. � 57. APPROVAL TO COVER�GUNITE
� 7t-Footings �-. �. . 58. Electrical Conc}vit�Undrgrnd.
C ��
?'8. Foundatio� ��� � � 59. Gas Pipe, O l,{gifrgrnd., Test
- t��J Water Pi e�Uni#� d'p '
p g5� 60. Backwash Linac��Trap, O Undrgrnd.
70. Structural FlootSvstem ��$ 67. APPROVAL'�DECK '
t t; �Property 5eWer Line & HouS�e Connection . 62. Backwash & Recepior-Fina� �
72:_Sewer Cap o � 63. Heater & Vent-Final
13. Roof Drai�s _ 64: Plumbing System � Final ,
74. Rough Plumbing r; . 65. Electrical�Final
15. Rough Electri�ai-Cp'nduit ? . � 66. Soiar System-�»�I
16. Rough ElectriEWir�jg 67. Fencing & Ac&� s Approval �
17. Rough Wiring Gign �, � 68. APPROVED �CSR PLASTERING
18. Rough Electriayl-T Bar Ceiling 69. POOIlSPA SY$SEMS FINAL
79. Rouyh Heating & Air Conditioni� � EIpF� Pi� REQUI,REMEn�T
r�.+ � 1� t c�' _ TT :! riJ ru K ] Cf' � F.TL'� , r-r (ti
[- . , . � 'r , _. . .n �� ,. � -, rJ x '�r r•
2o�o�n �ctoiv �.e's�iace , sr, �c r s �., Q,� � qvR,fto�A}.��. �rmit #t �a��x;
21.-Du� s, irT•5tr`aau`re� i ,.. .. ...,c �;., � p tix ,7 ^ ,-•-.,- .... �K
.-. � � -'� r. � r. ::# r-� 77HUnder'�c�¢r ,�nd:�iYdro t.
- �:
22..-0uots, V�ntUatirig� j ; C � �i p,� � 77. Prodasat,Pi inJ
,� p g L-aGas zOOii
23. �Gas-Pipe-fioagh &�est T= > tT' t" � O� r 72, Under�rQ�nd C9;�'tst�' � �"' c
r c-. � > , .. _ t ';. f_j C R �' � n ' . "
24:`Roof Frarning � ' - .,. �� , r - �� Undergrnd.Stacr3gpTarik OGas �Oii
25. Roof StrE73thing � �y � `� �%" � �y ��aOverhead HyQ�� �
L
26�T-�ar Ceifin {$t�u ural) &�',trt'en`acoat '� � C' M'' - "` � �.•
� 9 �i? x n � _.�e �D�y Ch�micalF. �- * t�i
27.;Frame ar+d F+ashing. x ++ T >� '-� " 76. Dry St cfpipe"'z �5 y O
�"' r. r.� -,. is c�. a: " �u i
• � 28. Lachin � Si9in �` �' -�� " '` � . ..'� ,'���y" S -
c 9,. 9:e. Gxt- C # � ;� �� EIXEy �STE1'r� FINALti i,
.. v .� . .�: � . .
29. Insulation �' * � " � � . FIREPREV.F,�`iv�AL �' ` ��
�
30. Drywall�Alai Yng � ti � i F-� � ! � S i�EALF}i DE�7.'RE~QU�iEMENT
� 31. Plaster BrowPoCoatx S �?'` r � i i* tT' 79. fINAL'6r7SPEC�'JON `� ��?
32�Iectrica�3�Po,wer M�i�r-tinal� ��'� � � �', r" 8D. FOOD CERTf�.�,�qTE�S�UF� �
,�- _ �. � . , � � .e� •, i . _ .
_ 33.firipi ElectriF 'K [T7 i C �k � � Notes: "� -:at *^_ U yc
�.
34� Fina�l HeaTin & Ai�rn A�itio'rnn ;� * � b' �,� " � �"�" * S O.,
u, 8' M � r > � .4 �. f+ � * C
W
35.--Final G�P�pe-Testt �;s •• x r, � � �o ��i-� 'k F+cc�
- T .r(l Y I':� ti
- 36. `Hood or`CanoPY `=` .-Y-' n :k C� f ' i{x � nc x c,m
- s c :% !i S,r, u R � 't %:•7 X r! -LTi
� �r
37 �:Einal Pactory Fireplacex i=N y F �� I � '" ��
M
' 38. Findi PIuF�bin9 �r �.. �J j .✓ .k I � � �-+ � �� � �l
� Q
39. Wet1� SeFvic�-Finalf � � � .t, r_! � � .. a"' s _
t-.- :i
40. Gas Service�Fnal �� �'s �:^�' � .k �* ' , � ��. n,sv *.
r. nrr r•; : I � [- � c� t�:.
-' 41. Solar pome�cFin�i ir .. q `' t � � � ^Jo .-,,� « x "
c
42.yBackflow Preventer:'' r� * ^ i ' '� x p" . �` -r' '�
�(L' r. = k H K C'i ;*i � 1'.: h' F
- 43. Backflow Irr,�ationk y"-' j x x cv � � x ,'i •
- � w z n
c�44. Landscape I�aigatioK Syste ��Y ,� y*, `'� � `7 `=�' ' � � �=� � `" '
� •:. �Q # = � N ,., R F S �
`45. $ound {iitertuatiori =; .. .. ' '� j i,; � js E, c� r ¢. f=.p x
C46 �Handicap�Regulati6ns - O x ~ � � �*, � � �:� '�.^ ..�.� i
_47.`FI(�YALS7RCJCTU,�E&BUILDING k J ��-�''
7 z3.-26 �c�� � � � F•
-�
48._FIPfALPLANNINO E-'`' r:�ty ' .� ..}�-�' "• a. * ` -'
�: . � + x�� n n� s x w
y: �
=49.�Iectric.HeleSseto��dison � � � �"� 1j:.n � .- ;�; ' c
�
-50._GasReleasemSouther�CalifdrNiaGasCv ' � "s- `i � • c'�` * -r' •
� � � a: � w. ; � o �� y. a: o
-61. CEFSIFICATE OF'OCCUPANCY '� - -'-' - "
No Date
Date I Inspector I
i
�
Applieant to fill in all spaces except those within heavy bortler Iines ana sign all approoriata Oeclarations.
GTYbFCOSTA ES O S7RUCTIONPF�iMI� .. Tw�������n �iranr.Ttin Tn T��.��T.�T
Project Address � ��
Applicant's Mailing Address �
� ,ry�
Owner's Name Phone���
Address
Arch/Eng. License No.
Address � {�y7����� /'�
ConVactor'sNam � PhoneL3.a2T_v
Address (mailing) �`S3� �
Ciry License No.
IICENSED CONTRACTOR OECLARATION
I hereby atfirm tnat I am licensetl untler provisions of Charter 9(commencing
with zection ]000) of Division 3 0( tne Business antl ProfeSsions Cotle, antl
my license is in full ( e eftect. /e(
Oaten� flas��-- � �� �'icf�s�o.� Vv �
� c'onaf ,��/
� WORKERS'COMPENSATION,�ECLARATION
' hereby affi�m that 1 hav¢ a certi(itate of con5ent lo self-insu�e o� a certiflCat¢
'Norkers' Comoensation Insurance, or a certifi tl wpy Ihereof (Sectlon
J, Lab. CJ /'�,/y///
iicy No. (/�/�/ `/� COmpany �
�% ertifietl wpy is hereby �urnisheA. �
lG Ce���e /c�y�letl w�inth the city �iytlj�ng Dj�iSjon�����
Oate pplicant /� K ( � (
EXEMPTION FROM WORKERS' COMPENSATION �ECLARATION
(TM1is section neetl not be completeG it tne permit is for one huntlr¢tl ($100) or
less).
1 certify that in the pe�fotmance Of the work for whith thi5 pe�m�t is issuetl, I
shall not employ any parson in any mdnn¢� 50 as to beComC Subject to the
Workers' ComOensation Laws ot Calitornia.
Date Signa[ure
NOTICE: If, after makin9 [his tleclaration, you shoultl become subject to the
Workers' Compensation provisions of the Labor Cotle, you must tortnwith
comply with such p�ovisions or thi5 permit shall be tleemetl revoketl.
CONSTRUCTION�LENDING AGENCV
I hereby affirm that there is a construction lentling agency for the performance
� of the work tor whiGh [hi5 permit i5 issu¢tl (Section.309] Civ. C.)
I�enEer's Name
Lentler's Atltlress
OWNER BUILDER DECLARATION
1 hereby affi�m lhat I am exempt from the Cont�acto�'S License Law tor tne
following reason (Section 7031.5 Business antl Professional Cotle: Any city or
county whiCh requires a Oe�mit to ConStruct, alte�, imOrove, tlemolisn o� repair
any slructure, prlor to Its issuance; also requires the applicant for such permit
to file a siqnetl statement tha[ he/sM1e is licensetl pursuant to the provisions of
��the ConVactor's License Law (Chaoter 9(mmmencing wiM Section 7000) o�
f��vision 3 of the Business antl Professions Cotle) or that he/she is exempt
'efrom and the basi5 !or tbe allegetl exemptlon. Any violation of Section
1'.5 by any applicant fo� a permit 5ubject5 the applicant to a civil �
.alty of not more Ihan five huntlretl tlollars ($500). .
�U I, as owner of thE pro0erty ot my employees with wage5 as their sole
compensation, will tlo the work, antl the struc[ure is not �ntentletl or.offeretl
for sale (Section 7044, Business antl Professional Cotle: The Contractor's
License Law tloes not apply to an owner ot a property wno builtls or improves
thereon, antl� who tloes sucn work himselt/herself o� through hi5 or h¢r own
employees, providetl that such imorovements are not intentletl or otferetl tor
sale. If, however, the builtling or improvement Is soltl within one year ot com-
pletion, the owner will have the burtlen ot provin9 he/she tlitl not builtl or Im-.
prov¢ fo� the purpose of sale).
❑ I,-as owner ot tne property, am exclusively contracUng with Ilcensetl con-
iractorsto construct the project (Se<tlon 7044, Business antl Professions COGe:
The ConVactor's License Law tloes not apply to an owner ot property who
� Cuiltls or imDeoves thereon. antl who contract5 ior suCh o�oiect5 wlth a�on-
tractor(51 I�cense pursuan[ to ine Conhactor•s Licenze Law). I am aware tbat
proot o1 their Worker's Compensation insu�ance shoultl be provitletl to me.
❑ 1 am'exemp[ untler Section B. & P. C. tor this reason
Daie Owner
I hereby certify ehat I have reaa tnis application antl state thac the above
information is mrrect. I agree to comply with all city antl county ortllnances
antl State laws �elating,to buil�ing con5t�uction, antl he�eby autho�ize r¢pre-
Sentatives of this city to ente up n thE above-mentionetl propetty _for
Inspection purpos . � / / /�_
Siqnature Date
Drivars'�License or SS � _ ,
TVPE OF CONSTRUCTION LI NEW LJ ADD LI ALTERATION LI REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BIDG.
TYPE OF PERMIT LJ GRADING �LyJ FOUNDATION LJ STRUCTURAL
❑ TENANT ❑ ELECTRICAL L7 PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION 54.FT. OCCUPANGY
CONSTRUCTION TVPE VALUATION $
ZONE GRADINGCU.VDS. ACRES
Remarks: �NST
Bar Sink
Backflow Preventer
Backflow Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Ki[chen Sink
lavatories
P—Trap
Roof Drains
Reinspection Fee � $15
DuM - Under Ground
Duct � Structural
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Blt. iCBO #
Heating System & Ducting
❑0-100,000 BTU 0700,000
Reinspec[ion Fee I $15
0865-46, rev. 5/88 White - Builtling; Canary - qpppcant; Pink - Accountlng; Goltlenrotl - Assessor
PLUMBING �
Sf10W2f5
Service Sink
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash - �
Issue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0-100,OOOBTU ❑100,OOOBTU
System Repair/Alteration
Fire Dampers
fiegisters
Issue Fee
FEES
$ 3
$ 3
X.Y. 9F
5 Main Buildi
E
T Front
6 Rear
A
C Right
g . Left
Ping. Ref. #
Planning Notes:
Bu
Parking Feq./Provided
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW
Construction Pole Su6. ❑ 50 + KW
CoOking Unit
Dishwasher .:
Dryers ❑Gas ❑Electric
Fan , '
F'A.U.
Fixtures 1�
Device Boxes ' '
Outlets
SwiLcheS
Garba9e Disposal
Generator �0.5 KW �5-15 KW
zona
FEES
Meter LJup to 700 amps
Meter ❑over100amps
Sub Panel
Motors �ai HP Oi %- 8
Inc.Solar �9-15 HP �76-75+
Microwave
Pole Light
Range
Si9n
Standing Sections
Trash Compactor �
Fee �$75 � � Issue Fea
DEVELOPMENT SERVICES REQUIREMENTS:
Zonin9 APProved BY .
Building Approved By
SUMMARV OF FEES
BUILDING PERMIT $ SMIP
PLAN CHECK $ �,,�, PERMIT
PLUMBING $ _ .7 (/(/ ISSUANCE
PLAN CHECK 25% $ ENERGY P.C.
ELECTRICAL $ GRADING
PLANCHECK 50% $ MICROFILM
MECHANICAL $ TOTALFEE
PLAN CHECK 25% $
$ 3
$
N
I.
N
G
H
E
Q
M
T
S.
01 OUOS1S85-0005I585 TO'1"
DA7E� 011i1/90 TI17E:_inea+.
♦ N-. . .�w.... �,,
_ _ ,. � .. .�\. \� U\ , _.. . . ,. _ .. .. ,.. ...,
, .
';�'CONSTRUCTION AND PLANNING .
'� APPROVALS Permit#
l-
� t. Temporary Electrical Service or Pole
2. Soil Pipe-Undrgrnd. , -
� 3:1Electrical Conduit Utility-Undrgrrid. •
� �:. Eleetrical Conduit-Undrgrnd. .
�.5..Steel-Reinforcement �,) �
, -� n
G;, �6:� Electrical UFER Grncl. .
..,
�, 7,�Footings ' -
9. Water Pipe-Undrgrncl. "
Y10. Structural Flooi�System - .
� ,..
�11 �Property Sewer Line & House Connection
i.
. � 12.; Sewer Cap .
` ' . ..
� 13. Roof Dreins
74. Rough Plumbing
15. Rough Electrical-Conduit
16. Rough Electric Wiring
i7�7 Rough Wiring Sign
18< Rough Electrical-T Bar Ceiling
19. Rough Heating & Air Conditioning
20- Rough Factory Fireplace
21. Ducts, in Structure
22. Ducts, Ventilating •
23. Gas Pipe-Rough & Test -�
," 24. Roof Freming ' `
�'�
25. Roof Sheathing ' �� -
- 26. T-Bar Ceiling (Structural) &'Monocoat
27. Frame and Flashing � �
28. lathing & Siding v'��
:�
29. Insulation �
30. Drywall Nailing ,' j
31. P�aster Brown Coat r
'Y
32. Electrical Power Meter-Final
- 33. Final Electric
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 pomestic-Final' �:
•-.,
42. Backflow Preventer ,-� �
43. Backflow Irrigation .,
44. Landscape IrrigatiomSystem
45. Sound Attenuation � �
.._
� 46. Handicap Regulations�_ �
47. FINALSTRUCTUREi&BUILDING
48. Special Requirements Completed
49. Electric,Re�easeto Edison �
50. Gas Release to Southern California Gas Q
51. CERTIFICATE OF OCCUPANCY
No. Date
Daie
� I
POOI 'PA �
Inspector qppROVALS Permit# Date
52. Pool & Equipment Location
53. Steel Reinforcement
54. Farms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVEfi-GUNITE
� 58. Electrical Conduit-Undrgmd.
59. Gas Pipe, � Undrgrnd., Test
60. Backwash Lines, P-Trap, O Undrgrnd.
61. APPROVAL TO DECK
62. Backwash & Receptor-Final
63. Heater & Vent-Final
64. Plumbing System - Final
65. Electrical-Final
66. Solar System-Final
• 67.'Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit#
70. Underground Hydro
71. Product Piping O Gas ❑ Oil
72. Underground Flush .
73. Undergrnd. Storage Tank O Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
' 79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes:
!
/'r'
�
�
�
Inspector
�
�
OWNER DOYLE & Shie" Develo�ent Co.,IriC. DATE 6-3-6� .
JOB ADDRESS 329 Rivie��a Dr. BUILUING PERMIT NO. 1�� _
GENLRAL CON1'RACTOR DOy12 & Shields D2v.00. �II1C. _ VALUE $]�( �5l�0•90
AP Nn i.nT l QS TRAC'�' �liZ� F7RP '/.(li1*F. DESCRIPTION OF WORK ue�.,.,/a++. e�
INSPECTIONS
SUBCONTRAL'TOR
'LONE
� 19?I9
COSTA MESA BUIIDING-SAFETY DEPARTMENT
P.O. BO%9f� C08TA MHBA. CALIFORNIA
For Applfcanf fo Fill In Completely
� TYPE OR PRINT
ILDINO �
JRESS ��.�
COSTq MESA, CALIFORNIA
Anaheim
R Hai C. Tan
l0 9TATE
LlOAL
FEE,�ECEIVED
JUP! 3 1`';�i3
FINANCrEn DEPT.
APPO�iTI�� `F�Ri'PERNfIY�
BUILDING
For Office Use Only
116CEIrT NO. P��
�,
Y OATH R6CCIVlD OATE I
ZONING
NO.O� I U8E
rLANB lUll
Lot 135. 7
EAVE
vrw� i nowonwr �� YARDSAPPROVED
USE OF MAIN BUILDING
E%157tNG BLDG.
(FROM C/L 6TREET)
6ET9ACK LINE FFOM � " O .R�
cenT[rs oF ciaEEf 26 � REAR YARD FROf�1T
SID6YAR�I �� '� . . R1�3HT — R.61Ofi 0 FT.
DESCRIPTION OF WORK L. SIDH Fr.
Bi EXTERIOR
uSE OF 9u1Lo1nG AND
Model 42G
TO
�
�
�1 HEREBY ACKNOWLGOOH TXAT 1^AVH RBAD TX18 /�PPL�CAT�ON
ANO 9TATE THAT THk ABOV[ IB CORRECT /1NO AORE6 i0 COM�
PLY WITH ALL CITT bNDINANCEY AND /TAT[ LAWB P[GULATING
BUILDINO CON6TRUGTION..
� AUTHOHIZ6DA6ENi �t
VAR. iC
TXE AMOUNT 6H9
PURP098 OI� 8�1
VAWATION
$19,��y
SHALL BE LESS THAN
/U.B.C.REQUIREMENT.
YARD9APpROVED
ACCESSORV BUILDING
DATE
T
S<�f0 � ,
0
UNDER VALWTION IB FOq THE F
18HIN0 A PERMIT FB6 ONLY. Q
`� � N
PERMITFEE $ '� v �
PLANCHECK $ �� � £
�',�L 5� '�`