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HomeMy WebLinkAbout1711 SAMAR DR - Building Permits CITY OF COSTA MESA O pMFy BUILDING DIVISION Fµ yl %pg 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • wrowv.ci.costa-mesa.ca.us 4, ! FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: BX09-00091 PERMIT TYPE B_MISC STATUS: ISSUED APN: 13927306 DATE ISSUED: 05/06/2009 Zoning: R1, ISSUED BY: RMD JOB ADDRESS: 1711 SAMAR DR CM Suite/Unit: Vicinity: HOUSE Primary Occ: Const Type :?? SQ. FT: 0 Valuation: $16,000.00 SCOPE OF WORK: FOUNDATION REPAIR TO EXISTING 1-STORY SFD. OWNER: YOUNG, NANCY D Address:: 1711 SAMAR DR Unit City/State: COSTA MESA, CA Zip Code: 92626-3629 Phone: 714-432-9856 APPLICANT: OLSEN, KYLE Address: 11017 ARROW TE Unit: City/State: RANCHO CUCAMONGA, CA Zip Code: 91730 Phone: 909-816-4038 CONTRACTOR: EAGLELIFT INC License No. 778157 Address: 11017 ARROW ROUTE Unit: City/State: RANCHO CUCAMONGA, CA Zip Code: 91730 Phone 909-980-6222 Cell: ARCHITECT: License No. Phone ENGINEER: HAYMAN RESIDENTIAL ENGINEERING SERVICES License No. 34229 Phone 605-381.2254 FEE SUMMARY Building Plan Check: $172.41 Building Permit: $265.25 Electrical Permit: $0.00 SMIP Residential $1.60 SMIP Commercial $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $440.26 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No.92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. coot r, INSPECTION TYPE ' DATE IN1111AL$ CODE i INSPECTION TYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval ��)���/�(//[/,�� ^ 'A�.` 203 Final Sign222 Final Site V y L ` 204 Final Demolition 250 Final BuildinglOaupancy �l WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivers license. ❑Yes ❑ No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers'compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feel in depth into which a number are: person is required to descend,will be made in connection with work authorized (Carrier: G-'7"''/C -51/4-fes r,., sc by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This seam need not be mnpetetl✓me petm#svalued ar one hundred(o9ars(SttlO)or less.) 2 Aril Sec.341,Title 8,California Administrative Code). Policy Number: Lu- e 3o - 3/- ❑ As owner-builder, I will not employ anyone to do work which would O I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicants Signature Date the Labor Code,I shall forthwith comply with these provisions. 5/`V 2.cocr Division of Industrial Safety Permit Number: Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the Califomia Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No Lic.# - 77 es/S 7 Class ,4 £6/ t02/sl/2 (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by �z q each business which at any one time has on hand a quantity of acutely Contractors Signature Date hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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 Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors informatnion n be furnishedothe California Government Code requires b i dithnt thee requested License es Law osr 9 Code)(commencing with Sectionhis 0)of Division 3 of the information on applications for non-residential building permits). Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If yes the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by Califomia License Law does not apply to an owner of properly who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If. however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penally of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I. as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sgnalur Legal Owner(s) Date signature Date / _G �r ,s-1/4/726.? 3057-4613/07) And/or Authonzed Applicant '- Date 7 CITY OF COSTA MESA 4 BUILDING DIVISION F ' ,i DEVELOPMENT SERVICES DEPARTMENTwressar PE IT NUMBER i111 'PERMIT • BO6-00234 41tb*Pcntargo.4* (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.Bl7LDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1711 SAMAR DR Status: ISSUED Suite: Applied: 02/13/2006 Vicinity: ROOF Issued: 02/13/2006 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: 13927306 Zoning: R1 Applicant: GILLIS, JOSEPH Address: 1809 N ORANGETHORPE PK Phone: 714-773-1820 ISSUED BY: ANAHEIM,CA Zip: 92801 Owner: YOUNG, NANCY D Address 1711 SAMAR DR Phone: COSTA MESA,CA Zip: 92626-3629 Contractor: HOYT ROOFS Address: 1809 N ORANGETHORPE PK Phone: 714-773-1820 ANAHEIM,CA Zip: 92801 License: 606111 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF.INSTALL 1 LAYER OF 30#FELT,40 YEAR COMPOSITION SHINGLES AND REPAIR/REPLACE SHEETING AS NEEDED.26 SQUARES INCLUDES ATTACHED GARAGE. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $8,000.00 Permit: $153.25 Claim Valuation: $8,000.00 SMIP Res: $0.80 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $154.05 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No. 92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced 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 required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446+6(6/00) WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the �n-6-.sc work for Which this permit is issued. f y yy. l�lave and will maintain workers'compensation insurance,as required by section 3700 of the Labog Code,for the performance of the work for which this permit is Issued. Iii-`' y workers'compensation Insurance carrier and policy number are: Came'r: % en- )11/O - - /7x5/7' .,f RPohdyaNumber �seeflon need not be completed i/the permit is valued at one hundred dollars(5100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomi. . ./gree at If` outdbe me subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisio f1 .,amp L; Signature �/ i;'_, ` co- QanWL re. • UR- •SE:"zr O' COMPENSA ON COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMIN. PENAL S AND CIVIL FINES UP TO ONE HUNDRED 4 USAND COLARE�4L',, C• if),IN ADDITION TO THE ST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE i BOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED ONTRACTORS/ DECLARATION: .erebyuudge at Ya1mt, .ed under.rovi ions of Chapter 9(commencing with Section 7000)of Division 3• he Uiress and Professions Code,and my license is in full 117.93:1010CaS '..i,7'7.7-"-z-...1.e,.- / .'�� Qom© PP_ o sQ�inature d � ���� r-Cala _ ?�_iv- CONSTRUCTIO .J •'INC AGENCY: ❑ I hereby! rm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Cale). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: • I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city Or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior 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 the Contractors License Lew(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I.as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' O I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: O I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8.California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that 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 Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? II yes I�No (Section 65850.2 of the Califomia Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 WIII any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If'yes".the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer).- CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. '...fdtTIlrtuni, �':_• s) / D /} �®��- g00�A,ip/sPECT10N TYPF QAC 1NTIiIAL$--r BODE! Final Mechanical �1CATP'-' INRML$ (/' 6 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final / -� t 208 Final Plumbing 200 Final Re-Roof I/ 210 Final Electrical 201 Final Brock/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site • 204 Final Demolition 250 Final Building/Occupancy PROJECT ADDRESS: UNIT: OWNER'S NAME: 1711 SAMAR DR J,6.&—. CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 069050 ADDRESS: DONKIN FORREST W TR 1711 SAMAR DR PERMIT NO: P 069050 PLAN CHECK NO; N GOVT; N SUPP : N COSTA MESA,CA 92626 CONSTRUCTION TYPE; PERMIT TYPE: PLU PURPOSE: OTH ARCH/ENGINEER: 545-0873 REG.NO.: ADDRESS: UNIT: JOB DESCRIPTION ; C/O WATER HEATER SQ FT: CLAIM VALUE: CALC—VALUE; GROUP OCC; R-3 / PERMITTEE: AMES, A PLUMBING, HEAT, A ( 14 ) 530-2440 ADDRESS: 9911 LARSON AV B COMMENTS: WATER HEATER C/O GARDEN GROVE CA ' 2644 ***-trx*dr*ar#*dL*"r*->EaE*tr**prsE****x********rt*x**"P***sr******N-dr*+t**5r*+r*d!**+t**x-sr-srTeae**+e*atxe LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under pit ' Ions. hap commen ing with Section Z O N I N G R E U I R E M E N T S 7000)or Division 3 of the Business and Professions Code.and my license is . • an. et $ E T B QA C K $ CIT LI 6664 STATE LIC.: 250307 " 3- 1 . /95 it_' ' —2,Q —?CI Signature: y ./� : MAIN BUILDING ACCESSORY BUILDING KERS' MPENSATION DECLARATION: I hereby affirm that I have.7•'d.'• • .r e sell- suraorr a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN mpensation Insurance.or a certified copy thereof(Section 3800.Lid. / LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN POLICY ND.: 3903261 EXP.OAT' $ /Q1 /95 ' COMPANY: REPUBL IC PARKING REQ• PROV: PARCEL; 13927306 INE: REF NO: Cenilied copy is hereby furnished. 4t Certified copy is file. .ith . city/uil'ng Di ion. PLANNING NOTES> 4 — , 7- VL, Applicant: _I/ V, * ***************************************************************************** MWOgwr XEMPTION FROM WORKERS'COMPENSA4ION DECLARATION: (T' t be completed it the permit is for one hundred(3100)or less). DEVEL OP M EN T SERVICES R EQU IR EMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY , DATE; Date: Signature: NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY ; . .. DATE: Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby atlirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY; which this permit is issued(Section 3097.Civ.C). DATE: * * *************************************** * t********************** x *;.LC LENDER: **************************************************************************** ** ADDRESS: LEGALIZATION; N F E E SUMMARY STRUCTURAL S GMENT;N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 7 , 00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 20 , 00 I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'Slate License Law TOTALS----> 7 . 00 20 , 00 — 0 , 00 27 , 00 27 , 00 , 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If.however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 27 . 00 OVER/SHORT ; 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 1044.Business 27 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contractslor such projects with acontractor(s)license pursuant to the Contractors'Slate License Law).l am aware *,****,*****,********************************************************************* that proof of their Worker's Compensation insurance should be provided to me. ❑ lam exempt under Section: B.8 P.C. INDIVIDUAL F E E BREAKDOWN • for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: PLU 1 WATER HEATER AND/OR VENT I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and 7 , 00 7 • 0 0 25534 and that I or any suture building occupant will/will not(circle one)need to comply with said slate codes and the requirements for a END .OF FEES permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: -- I hereby certify that I have read this application and state that arrest. :gree to comply with all city and county ordinances and state laws relating to building construction..•. • • e r,es'natives of s city to enter upon the above-mentioned u�AP�ny for inspection purposes. DATE:01 00168643-0016E643 TOT / a p G► 09/29/94 TIME: 13:47 27.00 r D e: ! -2 I - /tf Signature: Driver's License or Social Security r: 1641.46 White—Building,Green—Code Enforcement:Canary—Applicant;Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service.or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53, Steel Reinforcement , 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation • 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe•Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 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. 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 APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. 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 D_ trej 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. 8ackf low Preventer 43. 9ackflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations • 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date t Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ' CITY'OF COSTA MESA CONSTRUCTION PERMIT TRACT NO, LOT NO. UNIT NO. • Project Address 1711 Samar Dr. dv 7r��' 5085 10/ 14/86 5.00 TL Appl'icant's Mailing Address 10422 X Trask Ave. G.G, 92642 TYPE OF CONSTRUCTION LI NEW ❑ ADD Li ALTERATION ❑ REPAIR - Owner's Name Donkin • Phone 545-087$ ElCONVERSION IIIDEMOLISH ❑ OTHER A.P.# Zone DESCRIPTION OF WORK/USE OF BLDG. Address 1711 Samar Dr. - S Main Building: Accessory Building: Arch/Eng. _ License No. TYPE OF PERMIT LJ GRADING IE FOUNDATION T FE Zront • D Address _ _ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear N Contractor's Name A-ames Plumbing—Heatinghone 530-2440 ❑ 'OTHER • C Right N Address(mailing) 10422 Trask Ave_ a a 92642 PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G CONSTRUCTION TYPE VALUATION$ S Left City License No. 2S85012 6664 ZONE GRADING CU.YDS. ACRESE LICENSED CONTRACTOR DECLARATION Ping. Ref.4 Parking Req./Provided � I hereby affirm that I am licensed - D • '-•s of Charter 9 (commencing Remarks: Planning Notes: RECEIVED OCT 1 1988 M with section 7000) of Divislo• of the Business nd P ssi• s ode, and RPP)AfP Water HPAf RI my license is in full force and •ffect. -- T /\ 'Da9-License Class — • J Licens- rr 41 7 Date 9-24-86ra Signaw �� . ..r2r - PLUMBING FEES WORKERS'COMPENSATION D •LAR• - 0 ' Bar Sink Showers "'000 I hereby affirm that I have a certificate of o •nt to self-insure or a certificate ELECTRICAL FEES 1 of Workers' Compensation Insurance, of . certified copy thereof (Section Backflow Preventer - Service Sink 3800, Lab.C.) Automatic Washer Transformer ❑ 15.50 KW PolicyNo. 978832 Company Republic Tndemity Backflow Irrigation Sewer Cap0 50+KW 9 Construction Pole Sub. / )1ik Certified copy is hereby furnished. :9 Certified copy is filed with the city Building Di P1t,. Bathtubs Sewer Connection Cooking Unit Meter Dub to 100 amps 00 Date 9-29-86 Applicant A- P. P111fiCionLAR EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps s). Dishwasher eclion need not be completed if the permit is for one hundred ($100) or less). Solar Piping Dryers (]Gas•DElectric Sub Panel I certify that in the performance of the work for which this permit is Issued, 1 shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan ..' Motors❑0-1 HP 011/48 Workers' Compensation Laws of California. ` ..Date Signature - Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09.15 HP 016-15+ NOTICE: If,after making this declaration,you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures - - ' comply with such provisions or this permit shall be deemed- revoked. Microwave • CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet - Device Boxes 1 hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors1 Water Heater 2 OC Outlets Lender's Name , Range • . Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the Lavatories • Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal !Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap LaundryTrays any structure, prior to its Issuance, also requires the applicant for such permit Generator 00-5 KW❑5-15 KW Trash Compactor to file,a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains the Contractor's License Law (Chapter 9 (commencing with Section 7000) of • Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil malty of not more than five hundred dollars($500). i, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered • - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's ' MECHANICAL I FEES - License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: • employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or Improvement Is sold within one year of com- Canopy Type I I 0 Zoning Approved By Date prove , the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date • ���� prove for the purpose of sale). ` 0 I, as owner of the project exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By `' kl) Datal� tractors to construct the protect (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). 1 am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP S. proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT 0 I am exempt under Section B. &P.C.for this reason Firepl/Fact.Bit. ICBG 4 Fire DampersPLUMBING $ vC OO ISSUANCE $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby c- y that I have ead this app�li,}/at'•n and state that the above 00-100,000 BTU 0100,000 BT - ELECTRICAL $ GRADING $ informati• is correct. I agree o com• 1,• .11 city and county ordinances and stat: .ws relating to b a ding and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ _. sentativ- •f enter u•• abo e- entioned property for inspectio• •urpo / 9-29-86 MECHANICAL $ TOTAL FEE $ 5.00 Signature �i ` / Da - Drivers' ruse or SS# ` / - ' - Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev.10/84 ite - Building: Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING - PO, &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole ' 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrbd, 54. Forms 4. Electrical Conduit;Uridryrnd. 55. Electrical Bonding 5. Steel Reinforcemeni 56. Rough Plumbing & Pressure Test 6.:Electrical UF ER Grrid.' 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation , 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd' , 60. Backwash Lines, P-Trap, 0 Undrgrnd. I� 10. Structural Floor System • 61. APPROVAL TO DECK 11. Property Sewer Line'& House Co^nection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof,Drains ,64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final -J 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 APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. 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 LEO 39. Water Service-Final 40. Gas Service-Final ^' 171 41. Solar Domestic-Final r+e 42. Backflow Preventer, - t'y II 43. Backflow Irrigation 44. Landscape Irrigation System . 45. Sound Attenuation 46. Handicap Regulations • •, 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date - _- P'•-Applicant to ill in all spaces except those within heavy border lines and sign all appropriate declarations. 'CITY Of COSTA MESA CONSTRUCTIONCn ` ' PERMIT PERMIT NO. rt. T-R/AC NO.al i LOT NO. UNIT NO. 8220 2/26/05 13.75 IL Project Address /71/ n e2 (m/ait) /y,,s �1 ••r r �O Applicant's Mailing Address 0,7890 't4 2Yla_4 hg L i90,J TYPE OF CONSTRUCTION H NEW ® ADD U ALTERATION U REPAIR l� ❑ CONVERSION El DEMOLISH ID OTHER q P•# Zone (��1( Owner's Name - . .O h � f�� C] ri Kui Phone -Sti -f"127,3 DESCRIPTION OF WORK/USE OF BLDG. W Address /71/ . {� - S Main Building: Accessory Building: Arch/Eng. '- License No. TYPE OF PERMIT CI GRADING ❑4FOUNDATION O STRUCTURAL E Front 0 Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING 161 MECHANICAL A Rear - N �' Contractor's Name S- f 4 .4 n9Cl/ Phone ��_ /?7O . ❑ 'OTHER - + - PROJECT DESCRIPTION SQ. FT. i foo OCCUPANCY K Right G Address(mailing) .2840 110-- Orn" Q-hef�-L.-LYK-, 9 CONSTRUCTION TYPE a /1 ���7 VALUATION$ $ Left • City.License No. /0a9GYp ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION . , Ping. Ref. # Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Q Remarks: Planning Notes: • - M with section 7000) of Division 3.of the Business and Professions Code, and my license is in full forf}e and effect. U39-'�i T: , License Class t% - o a License No. Y 7 to • - 'late r'2 - (an Signature re-1/1 o1A ) Ci7(<avt • PLUMBING FEES • : • AORKERS'COMPENSATION DECLARATION - - Bar Sink • Showers i hereby affirm that I have a certificate of consent to self-insure or a certificate ' ELECTRICAL FEES -of Workers' Compensation Insurance, or. a certified copy thereof (Section ._ Backflow Preventer Service Sink - - . - 3800, Lab. C.) / !r - Automatic Washer Transformer ❑-15-50 KW - Policy No. C 4 A Company Backflow Irrigation - 0 50+ KW . �, � Sewer Cap Construction Pole Sub. LiCertified copy is hereby furnished. M — Certified copy is filed with the city Buf�in9 D�iv�is�iop �� �1 Bathtubs Sewer Connection - Cooking Unit Meter Dup to 100amps Date a -,.-20 Applicant r/ / -1 �1-/%LOA-al/fl-1.4d- - _ EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors '- Dishwasher Meter Dover 100 amps; (This section need not be completed if the permit is for one hundred ($100) or • • - - 'less): Dishwasher Solar Piping Dryers OGas ❑Electric , Sub Panel I certify that in the performance of the work for which this permit isissued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank ',r FanMotors❑0-1 HP ❑1%-8 • Workers' Compensation Laws of California. Date Signature \_Floor Drains Swimming Pool w/Spa F.A.U. NOTICE:If,after making this declaration, you should become subject to the Inc.Solar ❑9-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks ' Urinal' - Fixtures comply .with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service . Outlets Water Closet - Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance - 9 of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water HeaterOutlets Lender's Name - • Range Lender's Address ' Kitchen Sink Water Service Switches OWNER BUILDER DECLARATION . - . Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories- following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal 'Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap any structure, prior to its issuance, also requires the applicant for such permit - _ Generator 00-5 KW 05-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains - ' the Contractor's License Law(Chapter 9(commencing with Section 7000) of - Division 3 of the Business and Professions Code) or that he/she is exempt ' therefrom and the basis for the alleged exemption. Any violation of Section _ • 7031.5 by any applicant for a permit subjects the applicant to a civil - enalty of not more than five hundred dollars($500). LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 - - • compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue'Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's • MECHANICAL FEES - License Law does not apply to an owner of a property who builds or improves • thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 • sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 _ Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground ,Building Approved By Date rove for the purpose of sale). U I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System • . Application Issued By Date tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating X 0-100,000 BTU 0100,000 BTU 9SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. ,_ PLANLCHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# PLUMBING $ ISSUANCE $ Date Owner Heating System & Ducting PLAN CHECK 25% $ ENERGY.P.C. $ f hereby certify that I have read this application and state that the above , AO.100,000 BTU ❑100,000BTLy_ - ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances and state laws relating.to building construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ � sentatives of this city to enter upon the above-mentioned property for inspection purpos ;.e nn!-e�✓ u) 1 L Dae rat ,9C7 • MECHANICAL r O �/- TOTAL OFEE $ Signature 55 L GCS Reinspection Fee $15. Issue Fee $ 3 PLAN CHECK Ver CMF 0865-46,rev.4/84 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod -Assessor 4,0-431--"Cr- 1 3 .75- -c CONSTRUCTION AND PLANNING POuL&SPA APPROVALS 'Permit# Date Inspector APPROVALS Permit - �1 Date Inspector .1. Temporary Electrical Service or Pole' 52. Pool & Equipment Location 'i 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement l '- 3. Electrical Conduit Utility-Undrgrnd. 54. Forms , 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test i! • • •6. Electrical UFER Grnd. • 57. APPROVAL TO COVER-GUNITE ) 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation , 59. Gas Pipe, 0 Undrgrnd., Test ,' . .9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System - 61. APPROVAL TO DECK • li, 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final {I - 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 APPROVALS Permit# • ' 21. Ducts, in Structure 70. Underground Hydro , 22. Ducts, Ventilating 71. Product Piping 0 Gas 0Oil 23. Gas Pipe-Rough &Test • 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing _ - 74. Overhead Hydro ' 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing - 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL . 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION • • 32. Electrical Power Meter:Final I ' 80. FOOD CERTIFICATE ISSUED ' 33. Final Electric Notes: 1.124(6' Nor Asesm:,e+EQ yer tetra 34. Final Heating& Air Conditioning .inter 6169 3/nils- ten" caeo. c 6,0 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 Domestic-Final ' 42. Backflow Preventer 43. Backflow Irrigation . . - . ' 44. ,Landscape Irrigation System • 45. Sound Attenuation 46. Handicap Regulations . .' 47. FINAL STRUCTURE & BUILDING _ 48. Special Requirements Completed . •' 49. Electric Release'to Edison _ . 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - ' No. 'Date " . 1 11_2931: 12 6=EE RECEIVE..- . COSTA MESA BUILDING-SAFETY DEPARTMENT JAN 211960 u P.O.BOX 317 COSTA MESA.CALIFORNIA - FINANCE DEPT. FOR APPLICANT TO FILL IN COMPLETELY APPISHATRAM6SFPA WIARM IT TYPE OR PRINT BUILDING BUILDING 1711 Samar Drive ADDRESS rA COSTA MESA, CALIFORNIA FOR OFFICEUSE ONLY OWNER Kenkol Development Co., Inc I RECEIPT NO. I 1Pefe79 1. MAIL 1555 Placentia RECEIVED BY I DATE RECEIVER (DAT.SSUED ADDRESS / -,?/+y DtMPAA_ 4 I ISPIJ CITY Newport Beach TNo. -3227 BBDDRESS O ARCHITECT LI . OR TICTER C. COSTA MESA. CALIFORNIA FIRE oQ ADDRESS - c ZONE TYPE GROUP (�I' V,ny CONTRACTOR K.W. Koll STALIC.CTO. 61195 APPROVED 1555 Yiacentia• BV DATE ADDRESS Newport Beach California ^ ZONING LEGAL I LOT6 I I3529 ZONE f ` 1 I NO.OF USE OF NEW /L L_c, .4-- DESCRIPTION � DESCRIPTION NO. BLOCK TRACT ! 111 (PLANS/ �T/ BUILDING�f..LL,�/I) /i i A.P.NO. BVPROV ED(L/ y/L//)Z DATE / 'O/ i-1//L'�•60 SIZE 75 .5 'x100' I NO.OF BLOGSO YARDS 1 [L�aEV S, OF LOT NOW ON LOT REQUIRED ALLOWED USE OF none (CENTER LINE ST.) /�-. EXISTING BLDG. FRONT :J Lb FT. IN. SETBACK LINE FROM 50 ' 28' G CENTER OF STREET REAR YARRD R.SIDE /n FT. IN. SIDE YARD ILEFT 7 .51 I RIGHT 81 - L.SIDE (0 FT. IN. DESCRIPTION OF WORK .? (/ REAR n FT IN. NEW I XII ALTERATION I II ADDITION I REPAIR I II MOVING I II DEMOLISH I • SIZE BUILDING 1800 $ .f NO'OF ROOMS 6 STORIES 1 I�, wood snaices EXTERIOR WALDtUCCO I&Tit INC COVERING 4. USE OF BUILDING AND WORKBE PERFOj2 ED Single-Family Residence and Attached Garage I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE T T THE ABOVE IS CORRECT AND AGREE TO COM• THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PLY WITH •TY ORDIN NCES AND ST E -EGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING • ST-UCTION.. I SIGNATU-$O' VALUATION I �/ PERMIT FEE $ 3 a —' PERM ITTE• / •, .FF- F ' rry $ /V 736J9-_ 7 PLAN CHECK 5 f AUTHORIZED AGENT TOTAL FEE S J s7-- 130 ;EE RECEi1'�D COSTA MESA BUILDING-SAFETY DEPARTMENT JAN 211960 u P.O.BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. I CITY OF COSTA MESA fOR APPLICANT T0_1/LL ./N COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING AD BUDREILDINGSS 1708 Samar Drive COSTA MESA. CALIFORNIA fOR OFFICE USE ONLY OWNER Kenkol Development Co. RECEIPT NO. id IPE�NIr,NO. , Inc.nc. li 0) JGMII MAIL 1555 Placentia RECEIVED BY DATE RECEIVER DATE ISSUED ADDRESS' 555 1 l� - • �- / '.�-�-V JAN 2 1 7560 CITY Newport Beach TNO.6-3227 ABUILDING DDRESS ARCHITECT LIC. COSTA MESA. CALIFORNIA OR ENGINEER NO. FIRE (� A (� ADDRESS ZONE TYPE P GROUP tJ-� /T� CONTRACTOR K.W. K011 STAE LIC.NO.T61195 APPROVED DATE fJ 15S5 Placentia ADDRESS Newport Beach ZONING LEGAL LOT 352 ZONE ^� ' NO.OF USE OF NEW/2 On, `— DESCRIPTION I NO. 16 I BLOCK I THACT /'K !PLANS ,7/_ I BUILDING `�l�]//` - A A.P.NO. o B PROV(ii . C Fi ` DATE L/A-�-F 1/�R`�/O SIZE OF LOT 80x95.56 I nia OF NOW ON LOTS 0 YARDS CM EVES REQUIRED ALLOWED USE OF none (CENTER LINE ST.) �--• EXISTING BLDG. FRONT �-J O FT. IN. SETBACK LINE PROM . 50YARD 24•56 CENTER OF STREET REAR . R.SIDE / 00 FF. IN. SIDE YARD I LEFT 5 t I RIGHT 10' L.SIDE 1.-C--FT. IN. DESCRIPTION OF WORK XII •"A/•�FT. IN. NEW I XII ALTERATION I II ADDITION I REPAIR I II MOVING I II DEMOLISH I SIZIEDING 1800 Sf ROOMS6 STORIES 1 EXTERIOR WALL,-. ROOF Wood COVERING LOtUCCO I COVERING Sh1npl e USE OF BUILDING AND WORK TO BE PERFORMEIO Single-Family Residence and Attached Garage • I HEREBY ACKNO• -.GE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE T THE ABOVE CORRECT AND AGREE TO COM• PLY WITH A CITY O'DINAN A. LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING C•NSTRU ON. ..A11.10 VALUATION SIGNATURE OF PERMIT FEE $ 3 7e PERMITTEE Lttie _ _ VV /j7/3,5%— PLAN CHECK $ I — AUTHORIZED AGENT -- TOTAL FEE $