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Home My WebLink About1104 SANDI LN - Building Permits PROJECT ADDRESS: 1104 5ANDI LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 065333 4: OWNER'S NAME: DUFF, DAVID i / ADDRESS: DUFF, LISA PERMIT NO: B 065333 PLAN CHECK NO: 04914-93 L GOVT: N SUPP : N 1104 SANDI LN a, COSTA MESA,CA 92626 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ADD AflCNIEN EREG.NO.: JOB DESCRIPTION : EXPAND EXISTING BEDROOM INTO ATTIC SQFT: 98 ADDRESS: UNIT: CLAIM VALUE: 6, 000 , 00 CALL—VALUE; 7, 252 , 00 GROUP OCC : R-3 /• • PERMITTEE: BEACH CITIES REMODELING ( 714 ) 722-1791 ADDRESS: 1101 SANDI LN COMMENTS: EXPAND 2ND FL BEDROOM INTO 98SF EXISTING ATTIC C.M. CA 92627 #################************#####*#*############******#####eTa***##########*#aE# LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under pro2 urs o pier 9(commencing with Section Z ONING R E UIREMENTS 70001 of Division 3 of the Business and Professions Code.and my licensy full,e a I. SETB QA C K S CITY LW.: 078596 STATE LIC.:580586 ' ss:/ Dale.. //� (93 Signature:_ -/ ' ' MAIN BUILDING ACCESSORY BUILDING WORKERS•C PENSAT ON DECLARATION: Ihereby affirm .I l have a terrific a of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT : FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV: PARCEL: 42204203 ZNE: PDR— REF NO: ❑ Certified copy d hereby furnished. D Certified copy is filed with the city Building Division. PLANNING NOTES> INTERIOR-'RENOVATION, CONVERT ATTIC TO BEDROOM EXPANSION > nn . Date: Applicant: *###**#***#*#***** ****'********************************************* ********* EXEMPTertify 1ha FROM e ORKERS'COoPE f the DECLARATION: ECtAwhichA IIONis Oermiliis section all be emplloedi�pep sane in any one mhead edso es�o)or become D E V E L O .P M E N.-T S E R V I C E $ R E Q U I R E M E N,j,T S subject to me Woucers'Compe sation Laws of California. �r ZONING APPROVED B Y : - 4:1-. DATE: V2-( W (Cl 3 Date:�d--/ ,3 signature: �-/� N TICE: r atter maki g this declaration,you shout..co e sub(' I to th• orkers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. _ i C � �� 9I / (, CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: . S—c1.4r DATE: `1 ( (4 ( -1_l which this permit is issued(Section 3O97.Civ.Cr. ***************.****aj..)(.***.**.. .}{/.*#.*.*.****#****#**#******#*#*************.*} tit=******.)E. LENDER: ************************ ****************************************************** ADDRESS: LEGALIZATION :14 F E E SUMMARY STRUCTURAL SEGMENT: Y 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 99 , 00 7 x' 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 SMIP/NON RR ES • 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 64 . 35 t any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE %cif I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILD INC—D 1V -> PERMIT ISSUE PLAN—CHECK TOTAL PAID 1 DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS——--> 99 , 73 0 , 00 64 . 35 164 , 08 164 , 08 . 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 TOTAL S--> COLLECTED : 164 . 08 OVER/SHORT: . 00 lor the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING /PIAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 99 , 00 , 73 ,'i- 64 . 35 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon and who contractsfor such projects with a contractor(s)license pursuant to theContractors'State License Law).l am aware ,*.****,*.*,#*,#*#***##******#*#*#*#*******#*+t#****************##****#****#**#***#*** that proof of their Worker's Compensation insurance should be provided to me. n ❑ am exempt under section: B.a P.C. I N D I V I D U A L F E E B R E A K D O W N c for this reason• r'r TYPE QTY DESCRIPTIO N UNIT COST - `TOTAL COST Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 98 DWE—TYPE V—WOOD FRAME —GOOD 74 , 00 �An 7, 252.00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit tot construction or modification from the Air Duality Management District.Residential construction applications are exempt from '7 these provisions '4 ,.../ Date. Applicant: I hereby certify that I have read this application and state that the abov/ forma, s correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby. 'sr �• .sentatives of this city to enter upon the above-mentioned property for inspelion purposes. Date `Q3 Signature: 01 00152323-00152325 TOT 164.03 DATE: 12/15/93 TIME: 15:S? Driver's License or Social Security ___ 164646 White-Building:Green-Code Enforcement:Canary-Applicant:Pink-Revenue;Goldenrod-Assessor —_` r POOL & SPA CONSTRUCTION AND PLANNING APPROVALS Permit#' • Date Inspector APPROVALS Permit Date Inspector 1:Temporary Electrical Service 4r-Pole '- - 52. Pool & Equipment Location a 2. Soil Pipe-Undrgrnd. • - 53. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrnd. - 54. Forms 4. Electrical Conduit-Undrgrnd, I 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. , i 60. Backwash Lines, P-Trap, O Undrgrnd. • .r 10. Structural Floor Systerd ` / - 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 T 22. Ducts, Ventilating 71. Product Piping ❑Gas ❑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 /..41,c7cj &cs4-- 76. Dry Standpipe 28. Lathing& Siding at-4- 77. FIXED SYSTEM FINAL 29. Insulation /9A -'/ 78. FIRE PREY. FINAL 30. Drywall Nailing /27-1/q. ,w HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing -_---- 39. Water Service-Final • 40. Gas Service-Final 41. Solar Domestic-Final t 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING e_?.RC( 6�[f� Sk.O"4G- ,4 -/- _ / - ��. . ./i 48- FINAL PLANNING G(y� !�� 1�` 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date i I --------------- __ _ _ _. _ _ _ . -..__ -_ .. _ spaces__ _ _. _ lines . _ all - ,- - rat, _ Applicant to fill in all except those within heavy border and sign appropriate decla ons. R IT �.r i TRACT NO. LOT'NO.' UNIT NO. i I 1 ! i r '' • •CITY OF COSTA MESA CONSTRUCTION PERMIT '' L �� li I _ • i 2090 '2/10/87 ' be Q0 TL Project Address (v �C� /, / A 1 �' (�' ,A' _ • TYPE OF CONSTRUCTION �❑ NEW LJ ADD H ALTERATIONerREPAIR. ' - ' Applicant's Mailing Address �� , _ y� ! ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p,#_- _ i_ - Zone_ ' Owner's Name ' ',Aro/2nm P/ ' Phony!}, DESCRIPTION OF WORK/USE OF BLDG. . - .. _ _ . . _ . _ , .4..._ _- Address - _0--*t.72 /! 1 • + ' S Main Building: . • Accessory Building:; ' E Z , Arch/Eng.• - ' License No. TYPE OF PERMIT ❑ GRADING; LI FOUNDATION ❑ STRUCTURAL T Front , I I O ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B ' f • N Address I ' per- /y/�J� A Rear I I C ioim-r b Phone (IJg1(l0J Cl❑ OTHER _ _ _ _ _ Contractor.'s Name - - - C Right - - .f 'f , N ' srPROJECT DESCRIPTION' Q. FT. ' - OCCUPANCY • Addresslmailing) '`�tJ^!$-hr"- • -• CONSTRUCTION TYPE - ,VALUATION$ , S Left I + R + City License Na OR DECLARATION* ZONE 1 IGRADI NG CU.YDS. ACRES - Ping. Ref.# Perking.Req./Piovided I • E I LICENSED CONTRACTOR DECLARATION• ' _ ^ : Q 1 hereby elf irm�thaLl am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes:, -' M with section 7000) of Division 3 of the Business and Professions Code, and RECEIVEDC�O �urs� T my license its in ful f• - and effect. //h//r-O/J ! • 1 „ v j FEB 6 Ja S. ra License CIA .I. is='nse •o. a'/'V-T / I • _ - O Date `iW Signature iS��2 .' 41 _ , . ' PLUMBING FEES _ , l' I WORKERS' COMPENSATION DECLARATION s ,Bar Sink • r Showers Y - •ELECTRICAL: ! ' FEES ' I hereby affirm that I have a certificate of consent to self-insure or a certificate 1 1 - _ I i %C of Workers. Compensation insurance, or a certified copy thereof (Section . 3800, LabE } �1•/ Backflow Preventer' i Service Sink Automatic Washer .Transformer 0 15-50 KW 1 Policy Noi�°(�9cat�'x'7 Company '�,^ Backflow lrrianon i ,_ 0 50+KW . _Certified g 's •I ': 'Sewer Cap -'' ConstructiomPole Sub." , CCee d copy is hereby furnished• . • DlCerpfl-- cp s filed with the city B+ + pP%lap�t p- ./ . Bathtubs I - ' _ 'Sewer Connection Cooking:Unit , - •' Meter ❑up tO 100 amps //TIO d Applicant ON /vim ' • I EXEMPTION FROM WORKERS'COMPENSATION DECLARATION • Clarifiers Solar Collectors. '1 - Dishwasher, - - ,Meter'Dover 100 amps' ' • (This section need not be completed if the permit is for one hundred ($100) or _ _ - _ - - 1 - ' , less). . 1 i I I Dishwasher - I '� �. Solar Piping: _ , . ' Dryers ❑Gas. ❑Electric: ; , i 'Sub Panel' - I certify that in they per mance ofahe work for which this permit is issued, I 4 • • shall not employ any person In any manner so as to become subject to the Drinking Fountains. ' a 'Solar Tank ( • - Fan T� I Workers' Compensation Laws of California. -, I Mot. DO-1.HP 01'/x-8, .^ I Date ' Signature ' ' Floor Drains" • Swimming Pool w/Spa F.A.U1 - NOTICE>If,.a Eter Makin tthis declaration,- - _ _ _ .-+ _ Inc.Solar 09-15 HP 016_15+ g you should become subject to the - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks ' Urinal ! Fixtures Microwave I ' • comply With such ,provisions or this permit shall be deemed revoked. - - 1 . I CONSTRUCTION LENDING'AGENCY i - - I ' herebyaffirmGas Service . Outlets • Water Closet Device Boxes Pole Light that there is a construction lending agency for the 97- Cimzn ce g I of the work for which this permit is issued (Section' 3097.,Civ. C.) Interce tors I Water Heater i Lender's Name; '°' P Outlets Range • Lender's Address ! ---L.- - - - --If' ' ' -- ,-- Kitchen Sink - -. 'Water Service - -t -- - - Switcher ' 's gn - -' ' -'- - - OWNER BUILDER DECLARATION - I ' I hereby affirm that;I am exempt from the Contractor's License'Law for the Lavatories Auto-Wash ' Garbe a Disposal I ! I ' g p Standing Sections following reason (Section 7031.5 Business and Professional Code: Any'city or - i e county which requires a permit to construct,alter,'improve,demolish or repair P-Trap ' 'Laundry Trays Generator DO-51KW 05-15 KW I any structure, prior to its cesalso requires the applicant for such permit , I Trash Compactor , i 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 I t + • Division'3' of the-Business and-Professions-code) or-that he/she is exempt-- • �- - ' ' -' - 7031.rom and the basis for the alleged perm exemption. Any violation of Section I , 17031.5 by any applicant for a permit subjects thej applicant to a civil ' - ; ' • Li I,,y;pf not more than five hundred dollars($500). I I .- ' , i • ,- I' , i co as'oioner of o-th foperk, or myi employees with wages as their sole Reinspection Fee ! Ej $15 Issue Fee $ � compensation, will do.the work, and the structure is not intended or offered - ' Reinspection Fee .) !$15, Issue Fee - , $ 3 _ for sale (Seodoes n 044, Business and Professional Code: The Contractor's • I • MECHANICAL FEES ' - I thereon, and 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 thatisuch improvements are not intended or offered for Boiler ■ - - I sale. If, the ownerr,.the building or improvement is sold within one year of com- V ! Iype _ - Zoning Approved By - ' Date prove , the will have the burden of proving he/she did no[build or im- Duct-Under Ground Building Approved By - Dat- ' rove for the purpose of sale). ' I LIil, as owner of the property, am exclusively contracting with licensed-con- Duct-Structural • IcanopyRefrigeration _ Application Issued By �I[`v I/ Date fir `1 tractors tOactor uctIthe project (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 as aa• : • . , ''SUMMARY,OF FEES . 4 - . builds or improves thereon,'and who contracts for such projects'with'a con- 11 . - , • tractor(s) license pursuant to the Contractor's License Law), I am aware that. Exhaust System'El Multiple,0_ BUILDING PERMIT ' $ JSMIP . - $ - ' t proof of their Worker's Compensation insurance shoultl:be provided.to me: - . - PLAN.CHECK + $ PERMIT - D am exempt under Section' • B.&P.C.for this reason Fire I/FactnBlt. ICRO# ' D PLUMBING "$ � i - 1 : P Lj r ISSUANCE ' $ Date. • ' 'Owner _ . ' - -I _ - ENERGY P.C. $ ' f _ N. PLAN CHECK 25% $ : _ - • ,I hereby certify that I have read this application city tate that the'above ■0-100,000 0100,000. : ,GRADING $ • • information is correct., agree to comply with all city and county ordinances - - . ELECTRICAL - - $ +:and!state laws relating-to building constructs above- hereby authorize repre- - - - MICROFILM $ .sentatives of this city to 'enter pon .the above-mentioned property for '. • - , PLAN CHECK 50%,t$ - - ' 'inspection pu •ses. • lam/ f • ' MECHANICAL . $ TOTAL FEE $ • 5' 'Signature /� : ! PLAN CHECK 25% $ -• I , CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor • CONSTRUCTION AND PLANNING POOL&SPA . Date - Inspector • P ` Date Inspector APPROVALS Permit lb - APPROVALS Permit# 1. Temporary Electrical Service or Pole ' , • 52. Pool & Equipment Location j , u.) 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms C: " 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding -" - 5. Steel-Reinforcement 56. Rough Plumbing'& Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-G,UNITE , ,• 7. Footings - 58. Electrical Conduit-Undrgrnd; • '7 • 8. Foundation - 59. Gas_Pipe, 0 Undrgrnd.,Testi - 9. Water Pipe-Undrgrnd. - - - ' -60. Backwash Lines, P-Trap, 0 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 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 Oita !..go 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 - - - • I NO; - Date 1 PROJECTW 'S NAME: 1104 SANDI LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 05636E OWNER'S NAME: BRONNICHE, ROGER A • ADDfless: BRONNICHE WANDA C PERMIT NO: P 056366 PLAN CHECK NO: N GOVT: N SUPP : N 1104 SANDI LN COSTA MESA,CA 92627 CONSTRUCTION TYPE; V—N PERMIT TYPE; PLU PURPOSE: OTH ARCH/ENGINEER: 548-2560 REG.NO.: ADDRESS: UNIT: JOB DESCRIPTION ; CHANGE OUT WATER HEATER • SQ FT: PERMITTEE: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / I ADDRESS: EARLS PLUMBING ( 714 )772 3470 1533 W, LINCOLN COMMENTS; MAIL IN PERMIT IAN puErM CA 928�S x*******4************x*#*#***********Y**** ##x*********** F+e****# ***.x********* LICENSED CONTflACT RDC RAT10N: hereby affirm that I am licensed antler provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS I7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. CITY LIC.:00Sg3R STATE LIC.:211657 CLASS: 1 SETBACKS Date: 3' U -9Signature:—Pi2-0 i< PI) MAIN BUILDING -- ACCESSORY bUZLDING • WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN POLICY NO.: UCA—i 1686 EXP.DATE: 03/01 /92 CDMPANY: UNICARE PARKING REQ; PROV: PARCEL; 42204203 ZNE: REF NO; ❑ Certified copy is hereby furnished. Q Certified copy is filed with the city Building Division. PLANNING NOTES> Date: cl0 4a- Applicant: tawed #######*#*#*#*%xN1F if 3F iE#**if#%*eE ii3f#?F*)E###%*ir*if iF 1E 1E;74YIEM%###1f iiiE#>:3(#3i 3(-iF#3F#3r####E_iF#•#3:%* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT S E R V II C E S h REQUIREMENTS 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 subiect to the Workers'Compensation Laws of California, ZONING APPROVED BY .'T 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. k CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for 2 APPLICATION ISSUED BY• Wine GQ��a, _ DATE which this permit is issued)Section 3097.Clv.CI. **********##*********)E '•' • xR x '" r . .. .- . .#**# **# *#%#*#***#i.** LENDER: ******%*****.-*****#*********#*****#****# '********�F#?c***#*##le*#*********fflf#***If ADDRESS: • LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT: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 iffy I T 2 . 0 0 r- .. 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 o1 the Business 2SMIP/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 live hundred dollars($500). ISSUE FEE 300 •,, I. • as owner of the property or my employees with wages as their sole compensation, wfe do the work, and the BUILDING—D.IV—> PERMIT ISSUE MAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTAL S----> 2 . 00 3, 00 '• 0 . 00 5 , 00 5 , 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--> COIECTED• 5 .00 OVER/SHORT' 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC M CHANIC FIRE SMTP/TOT GRADING PLAN—CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 5. 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon i. and who contracts for such projects with acon0actor(s)license pursuant to the Contractors'State License Law). l am aware #**#********x,##********#,**lF.x.*****?F-p,**,**,)Ea4*t6%iEtti,*****%3!,#**IF***.ifa(..1F#***,%**.*.x.#*#.y. that proof of their Worker's Compensation insurance should be provided to me. **# o I am exempt under Section: R.8.P.C. I N D I V I D U A t F E E BREAKDOWN for this reason: TYPE QTY DESCRIPTION UNIT COST TOTAL COST Date: Owner: , I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and PLU 1 WATER HEATER AND/O VENT 2 . 00 2,00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a ND OF FEES permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: c= I hereby certify that I have read this application and stale that the above information is correct.I agree to comply with all city and county i 01 0011'x`•30—C0111JJ7 '—Iii r a ordinances and state laws relating to building construction and here authorize representatives of this city m enter upon the above-mentioned DATE: 03/27/92 ?7(!C; ) 7'(i1 property forfoorinspectionsppurposes. (/�y� // / /J//x�' I ��°( Date: ,g 0�^+� Signature: t ./[11,2 LLl[.C(.f-1L9924) -1 Driver's License or Social Security 4: .), . • 'a 164646 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-Undrgrndr. • 55. Electrical Bonding 5. Steel Reinforcement • 56. Rough Plumbing & Pressure Test 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. APPROVALTO DECK - 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final - ' 12. Sewer Cap - . t 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 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:.?/q& No o/Yg#somC-L,g crGa.zo- L6o 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test • 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing Q 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. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 1104 SANDI LN UNIT. CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 065334 OWNER'S NAME: DUFF, DAVID ADDRESS: DUFF, LISA PERMIT NO: E 065334 PLAN CHECK NO: N GOVT: N SUPP: N 1104 SANDI LN COSTA MESA, CA 92626 CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: ADD ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: : SQ JOB DESCRIPTION EXPAND EXISTING BEDROOM INTO ATTIC FT: PERMITTEE: CLAIM VALUE: CALC—VALUE: GROUP OCC : R-3 / ADDRESS: BEACH CITIES REMODELING ( 714 ) 722-1791 1101 SANDI LN COMMENTS: EXPAND 2ND FL BEDROOM INTO 98SF EXISTING ATTIC, RE : #B65333 C .MCA 92627 ********iE**+E#4t-4rar*****4t*a6***iE*�E**aE46a6yr*a6�E*******aF>Ey6+�a6*iF86�E4E*TF*fE*iP*a6****+6*aF****y6*** LICENSED CONTRACTOR DECLARATION:. I hereby affirm that I am licensed und•r provision hooter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my Ii so is ull force flet). S E T B A C K S CITYLIC.: 0. 8596 STATE LIC.: 580586 G 5: F Dale:.L-Z—)/'(J Signature:_, : : MAIN BUILDING ACCESSORY BUILDING WORKERS'C PENSATI DECLARATION: I hereby. that I have ace icale of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof ection 3800.Lab.C). LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN POLICY NO.: EXP. DATE: COMPANY: PARKING REQ: PROV: PARCEL : 42204203 ZNE: REF NO: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NUTES> > Date: Applicant: ******************************************************************************* • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section •d not b..pleted cr.'.ermit is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS 1 cedify that in the performance of the work for which this permit is i ,I shaa%ore .;Pperson in any manner so as to become subject lP the Workers'Co ensation Laws of California. / ZONING APPROVED BY 1 Date /.'//Le 9 Signature: DATE: OTICE'If.after m mg this declaration.you shoo ..O .s - to the Workers'Compensation provisions otithe Labor BUILDING APPROVED BY DATE: Code, a must forthwith comply with such provi ion or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: ` V' DATE: 12..I t y I q.3 which this Permit is issued(Section 3097.Civ.C). *************************. ** **************, _** ************************gam.****** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 703t.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or P ERM I T 3 . 75 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 50% 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 15 , 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIC PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 3 , 75 15 , 00 0 . 00 18 . 7 5 18 . 75 . 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 : 18 . 75 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 7044.Business 18 . 75 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such protects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *. ,,.x.********,**,****************************************************************** that proof of their Worker's Compensation insurance should be provided to me. o am exempt under Section: B. &P.C. I N D I V I D U A L F E E B R E A K D O W N for reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date- Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ELE 1 FIXTURES LIGHTING 1 S T 2 0 EA. , 7 5 75 25534 and that Ior any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a . ELE 3 REC EP T/OUTLET 1 ST 20 EA, . 75 2. 25 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from EL E 1 REC E P T/SWITCH 1 ST 20 EA, . 75 , 75 these provisions. END OF FEES Date: Applicant: I hereby certify that I have read this application and state that the above i math/'correct.I agree to comply with all city and county ordinances and slate laws relating to building construction and hereby au rte rrr nlatives of this city to enter upon the above-mentioned property for inspection purposes. iDate: !a///.'(14L7 Signature: ( 01 00152326-00152326 TGT 13.75 Driver's License or Social Security p.: 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, Undrgrnd.,Test 9. Water Rpe-Undrgrnd. , K/• r t' 60. Backwash Lines, P-Trap, 0 Undrgrnd. - 10. Structural Floor System i • f -` r 61, APPROVAL TO DECK .. • ~• 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ' 12. Sewer Cap I • 63. Heater & Vent-Final , 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 9 66. Solar System-Final 16. Rough Electric Wiring /-y-y./ Few 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 ❑'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 1 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 ,://44,/, 4 Notes: 34. Final Heating& Air Conditioning' 35. Final Gas Pipe-Test 36. Hood or Canopy , 37. Final Factory Fireplace • 38. Final Plumbing ' 39. Water Service-Final 40, Gas Service-Final . 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow 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 I A . RUBY L. RODIa1QUEZ CIVIL ENGINEER JOB NOgllz CE 28, aio PAGE.!.OF. 1 . . 6./AA P-13 ST2[JOT UR-ASI, GALGULATI 0?LIS Foe QskpFESS/oNoil D �� .RDDR/ FZ owkiCa. : /n2 62O J JI [-NE ti� Q, P ro ADD�E55 11 04 SAN DI LANE c GST'' m COSTA /A I.:-.3 " XI s CE23 ' f�LD4 PEPr VES/AT : P2ovi pc UI LLt AT10N TO - CIVIL 4 ,:; ZCPA12 1 1EL0 CONDITION AT SIGYLI(�HT �9j� • Ck0,1110 - a 4 FTE>? �P Z •L = 15 sI t l = (I I f l 6) I. 33 t--: 3 G I��T 11111111111111111181111111 PI = (II -Fit) r.33 (5.511 = 19�'ti PZ = (1I f 16) 1.33 (11.15) r- / 5 3 'b 2, • eZ DL. C.L IL H vcc U2 s AT 'X = _ . - N / v = 2-, ( -71) - m( .,.)_7- = a 142 FT-14 Z sr` _ N 1 z_ I 4, t Iti3 G Z H SG) /5. I7_ 140(i.zs) - El,.t" 3 = 1 1 3 4- rr-Ib • tr../ - Sa c = 7.51 IH 7,SZ • Mme= 1� = = IOBo pito 2A-r—rE¢s AT SIcIL-14HT • F.-APPROVED , 4-16ei FACE HAIL AI ENDS ADD 1- 27- D,F•�� z To REST F FULL SPAN City�gf Costa Mea Buildin epi. w/; 1/"I e 14)10,c, F4c5- NAIL ELSENNE'• RAFTS SEE I�ELOw VIL a !c 8r 2'x 4 O EACH SIDE aF BY wA, 1<..----{{----y .19-..- 5 k-Y L 14 H'r S K--%1 LI CI HT. 'Tv-CA L Z P Ee THESES �IL,ST BE ON JOB AT A IM $icy 1.../414-1-, NOTE; IJIoT MAKE NO CHANGES WITHOUT PRIOR APPROV 4 122-00P A-f Rape,,-- Ly LI . $ C11H OF DEPT. EX I ST Lt l7L` Q-A FTEIL THE ISSUANCE OR GRANTING OF A PERMIT DR APPROVAL - I '-I' OF PLAYS AND SPECIFICATION SHALL NOT BE CONSTRUED TO BE A PERMIT FOR, OR AN /PPROVAL OF, ANY VIOLATION I 9 u` / OF ANY OF THE PROVISIONS OF IRIS CODE. NO PERMIT PRE- S± 4 I - wA u SO PSaOET SUMING TO GIVE AUTHORITY I VIOIATE OR CANCEL TH PROVISIONS OF THIS CODE SHI .. 14_? 'A LID, EXCRILI1R.60 1716 ADDED-ON Zb'I FAR AS THE WORK OR USE W- r u• IS LAWFUL. MAX //' THE ISSUANCE OF A PERMIT BASED UPON PLANS AND SPECIFICATIONS SHALL NOT PREVENT THE BUILDING OFFICIAL FROM THEREAFTER REQUIRING THE CORRECTION OF ERRORS IN SAID PLANS AND SPECIFICATIONS OR FROM PREVENTING i BUILDING OPERATIONS BEING CARRIED ON THEREUNDER WHEN IN VIOLATION OF THIS CODE OR OF ANY OTHER ORDINANCE OF THE CITY. I OWNER PROPERTIES WEST, INC. DATE 10-14-76 JOB ADDRESS 1104; 1106 Sandi Lane BUILDING PERMIT NO. 40618 GENERAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK Du AP w/ 3 Gars AP No. 115-031-17 LOT TRACT FIRE ZONE VALUE a 51 OOO.00 d\INSPECTIONS Signature Date TYPE V GROUP I & J ZONE PDR-MD \smL Z /2•2ni. SUBCONTRACTOR - PERMITS ISSUED 3 GAS �' 7.T•77 Date I Number I Signature WATER (4 fn. t ,t n1 'S Plumbing • ROUGH PLUMBING ♦ 4 LD•// as}r O / /Z 3-X 7071Q i PROP. SWR. LINE Q HOUSE CON. f6 7 25777^�� 11�. .-0w , a'+ 17}ST R/f ' SPRINKLING SYSTEM ""6_` Y'� "[/Y tsM ISCELLANEOUS a�++ OUGH HEATING AND AIR CONDITIONING b5 3.26 .7-/ TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER ❑ ROUGH WIRING l 4//J Neating'pnd Vent. . • TRENCHES El FORMS fl STEEL REINF. ImK v'/.• + ?6 �'i)2jt) lne44wee'est -2,1-77 /361R- FLOOR SYSTEM -f 755, I i L. 7? Gt4.c•r![SL t � rt 33-Zy 77 t-870C--- BOND BEAM n STEEL REINFORCE n SHEATHING fr. 7 -=p • 77 FRAME AND FLASHING�-yQ L 49. 7+1 LATHING -- IN I1OUT n t.77 PLASTER. BROWN COAT e` c �!j� .rr�e ��'��' �J HEATING.STRUCTURAL.VENT IN REFRIG. AND A.C., FINAL 4• • ri,J,/1le(f AL C�7////�A/l27e",3-X-77 .31/'�Jr PLUMBING, FINAL AND GAS TEST [Lr ` T. i v'�'Oy I / I • ELECTRIC, FINAL j,/AjQ� YO wI 1 I __ BUILDING, FINAL /I/�CH -244 /" R. IN • PAID 406.tt SEP 3O-75c7001363u *t*r99.07 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 I NP I C ION FOR STRUCTURAL PERMIT For Applicant to Fill in Om r letel — se Ink Onl _ REC ri i r fa&Y T,E�FECEIVED DATE ISSUED BUADILDING DRESS r---•• - ...� �� 75 (a '/T�f�M1JI 7 ( r PEF419SO1R� OWNER �// �7 A.P. NO.t' p'13� f MAIL rJ�f a� i1fA / . BUILDING . • AV�o- _ .Vei= ' ADDRESS, /p!8' Jr/7 % Il�l_f/J( • ��jy ADDRE'- �- s _ CITY A ', NOTELi�r 7'7�a TR ACT�SS LO'9Q BLOCK' CONSTRUCTION/ N, EW ADD ALTER REPAIR MOVING DFMOLJSH LENDER BRANCHr")Q OWNER 1"0V . _ t& Y-V C- rt LiLC_ ADDRESS _ ` LTA" y�� • ' VALUE fn. /��i./�, p� _IL�R3 • ARCHITECT aft/ AC�� _SE i L $V/°"ve/. OR ENGINEER Q•ti NO. FIRE I ADDRESS p '-//i-a_ / I rr ZONE 1 PE GROUP I/� CONTRACTOR - �i,j APPROVED ,u,� DATE (0• Ia:1K ADDRESS O. I TEL. ZONE NO.OF," USE OF NEW CITY NO. 'PD'R—MD PLANS Z BUILDING/A-TC• GA, F STATE CITY YARDS APPROVED YARDS APPROVED gLIC. NO. - LIC.NO. MAIN BUILDING ACCESSORY BUILDING • W SIZE / rNO.OF BLDGS. (FROM C/L STREET) a OF LOT 72 o00 NOW ON LOT Q FRONT Ie FT. FT. a USE OF ! / /� /J ► EXISTING BLDG. ALL..........-; R,_SIDE / FT. FT. col lgEtc) 1 J ,{/ 1 FSeparate permits are required for L.sFTI i �q, • G electric,plumbing and heating work. REAIlif FT.Oe.l FT. W USE OF BUILDING AND WORK TO BE PERFORMED F DISTANCE BET. BET.MAIN& Q t MAIN BLDGS. ACCESS.BLDGS. a coG�O/yY! A �/ VAR.43 DATE ^y�-' Q �Gtf/�'�. - C.U.P.'Xc-G 7/l.J'+7�{N�APPROVED/0��7/, } APPROVED / /• 101 SATE ir /✓ -12-7h w MOLD FOR SPECIAL REQUIREAAFWTS 0 I hereby acknowledge that I have read this application and state t` n (Y., that the above information is correct and agree to comply with a all laws regulating building construction, and I shall not employ m Z any person in violation of the workman's compensation laws of e the State of California. //J ./T-_ {/J�) {�(r_ /y /y'� `� / % °1 f SQ. FT. V & ✓ ,&E'zs w I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ro Chapter 9, and that such licenses ere in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from a provisions of the State of California Business y and Professions C vision 3,Chapte VALUATION PERMIT FEE $ N t PLAN CHECK $ 5, co �/� Cq m Signature of /$r_}- Yea / .— / 0 Permittee /��+ $ L (/(,p TAX $ LL 3 : s7 2 U Authorized Agent TOTAL PAID $ ,C> 6 OWNER ROGER BRCNNLCHE DATE 1/22/81 JOB ADDRESS 1.104 Sandi Lane BUILDING PERMIT NO. 51287 GENERAL CONTRACTOR Fortier Construction DESCRIPTION of WORK Arched Opening, 4 skylights AP No. 422-042-03 LOT 22 TRACT 9381 FIRE ZONE VALUES 2,000.00 INSPECTIONS Signature Date TYPE V GROUP R-3 ZONE PDR—MD SOIL PESMITS ISSUED GAS SUBCONTRACTOR Number f Date Signature WATER Plumn^g �r,t£� W ROUGH PLUMBING \ 4(5T i-J1)'� /i 'y./nti PROP. SWR. LINE n HOUSE CON. ❑ ' X r I '-��jj'' SPRINKLING SYSTEM IPtV peCtjpRS eCifilMISCELLANEOUS I" P Cance —;rU/ B.'qL ROUGH HEATING AND AIR CONDITIONING _g � Q TEMPORARY SERVICE OR POLE 03t0t0 li.�A]¢%�,' }�}y1� � UNDERGROUND 0 POWER 0 ROUGH WIRING ?kV- tlA r / HeatingadVennt. {!TRENCHES 0 FORMS 0 STEEL REINF. n L�ee/fL ( IJAH /-09.9-9/ / 0,5g ___ ,-1 FLOOR SYSTEM rd BOND BEAM n STEEL REINFORCE n SHEATHING !(J�� q 4fFRAME AND FLASHING /�j(� 5/0/ W LATHING — IN n OUT n PLASTER. BROWN COAT STRUCTURAL. FINAL fide Oa HEATING, VENT., REFRIG. AND A.C., FINAL Mnje,e.-- OAST f--c22- ) ‘714<7..9 PLUMBING, FINAL AND GAS TEST n rat 33041 ELECTRIC. FINAL �R1t BUILDING. FINAL it..rx we't' :.t • r 4 COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATIOl3 OR_i5TRUTEURaLPERMIT30.50 TV . P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 •- -•• - ' REC V PERMIT For Applicant to Fill in Completely — Use Ink Only T N° 12 8 7 BUILDING I i I^ µ s `lI L��r� A.P. N0.4-ZL.--�� ADDRESSBUILDING 1 `1 ! --ii�� .L •n , 1 OWNER OR:Y� (�') 1l QOON I(tj G ADDRESS , O� , ��j.V I Lu�J TENANT K L�•)L., 1 `l: ITG UNIT OR ADDRESS I I ®/� ,'("N�p, SPACE NO. TEL. T NO.Q M3et `� LOT�J BLK. CITY NO. \ NEW ADD ALTER (REPAIR MOVING DEMOLISH CONSTRUCTION C 11 LENDER _!°V"l V t"T BRANCH OWNER '` N ADDRESS ALOE s� ARCHITECT • TEL. USE* s " � $ 2Ow OR ENGINEER NO { \[� 1a �� ADDRESS ZONES R''K^ TYPE l GROUP 2.3 LesA APPROVED DATE I/ZZf� I CONTRACTOR V c, (LC I C VL 'rr ` i 1'S II ADDRESS 4I L� C E. (IICIVT J&4 '' D 1"+ CITY �-k I CIL. NO. .I I ii* 1 Fi—I STATE f"� �i`v CITY APPROVE SETS 6 LIC. NO. ` t_�d rJ LIC. NO. VLE$r a. SIZENO.OF BLDGS. /// (FROM WI_STREET) Own OF LOT S.--. X ,S I NOW ON LOT / FRONT FT. Q • USE OF CA / .—. EXISTING BLDG. _R,SIDE FT. co HSeparate permits are Iequired for L.SIDE FT. G electric,plumbing and heating work: REAR FT. C. USE OF :JrrIN `•ND W2 RI{. 8PERFORMED PLANNING ACTION CI /^ f DATE :-1 Cr) U '�/�✓ Rp APPROVED //q� ' \ \ rte. _ay RC1-JK'. _DATE ` 19...^YVI w � . ., C�ww.er _. 0 I hereby acknowledge that I have read this application and state U]l(tA fir. 1. 0 p( that the above information is correct and agree to comply with — ""`�� "•^�•8. .. 0. all laws regulating building construction, and I shall not employ Q� 1 ne.C.. i Z any person in violation'of the workman's compensation laws of 1 - c e—>rw�.r . a l+•1 the State of California. 1l I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR CO Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: n am exempt from the provisions of the State of California Business I /7 VALUATION PERM\T FEE % LQ �� a and Professions Co e,-Division 3, hapter 9. n Signature of ,qI/AI 1 r� PLAN CHECK $ to, et p Permittee rib e $ •2030; TAX $ Q` So LL �r� F Authorized Agent Date /' 1 _J ' TOTAL PAID s 30 4% U PALL ./. �D(o 11.1" 11-76r. r.CUi P73 <-j�^�•** 191.00 COSTA MESA BUILDING-SAFETY DEPARTMENT • P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 A'PL CA ' ON FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only RE•ir gi DATE RECEIVED O•TE ISSUED BUILDING ' , 6.11-7.6 ADDRESS I •I _ ► PERMIT NO. OWNER i s{p 71a�r MST 10 e, A.P. NO. _ MAI L ISSUED •ESS l 044 l(7‘ s �0t 13 ADDRESS I TEL. CITY NO. TRACT LOT BLOCK CONSTRUCTION NEW I ADD]ALTER I REPAIR IMOVINC: DEMOLISH LENDER ✓\R/\ BRANCH OWNER 1."P2g* 'CIe$ id air 'Vel ADDRESS "7D QLE2 (A V ORC NITETECT • NEL. USE ,X)•/1 OR ENGINEER NO. - FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR BY DATE ADDRESS ZONE INO.OF USE OF NEW TEL. CITY NO. PLANS BUILDING STATE CITY YARDS APPROVED YARDS APPROVED gLIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLOCS. (FROM CAL STREET) L OF LOT I NOW ON LOT FRONT FT. FT. a USE OF EXISTING BLDG. R SIDF FT. FT. rn F Separate permits are required for L.SIDE FT. FT. C electric,plumbing and heating work. REAR FT. FT. WUSE OF BUILDING AND WORK TO BE PERFORMED F DISTANCE BET. BET.MAIN AMAIN BLDGS. ACCESS. BLOC'S. VAR.# DATEJ QC.U.P.# APPROVED APPROVED >. —B-Y —DATE g W SaMBIMieniL 0 I hereby acknowledge that I have read this application and state n IX that the above Information is correct and agree to comply with L all laws regulating building construction, end I shall not employ m Z any person in violation of the workman's compensation laws of o W the State of California. m , SQ. FT. 3 I hereby certify that I am properly licensed as a contractor underN the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE 0 Y: em exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ and Professions Code, Division 3,Chapter 9. m PLAN CHECK $ Signature of o IL Permittee $ TAX $ 1 �+��2 �7, i \ Authorized Agent TOTAL PAID $ 7 s7/ . Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. / 24. CITY OF COSTA MESA ONSTR U TION PERMIT . PER NO. TRACT, NO. LOT NO. UNIT NO. , , //�'I`'- N �iN �a68/, Soul 2i:ioie6 5aob -IL - Project Address A• {J e • 1 _ , A TYPE OF CONSTRUCTION _ U NEW'❑ ADD ❑-ALTERATION LJ REPAIR f s Applicant's Mailing�i dress •..-- _ e, . - �yar y'' I 'C,i _ • Owner's Name Q g� • O/t//V�' Q- PhonB..�^D�AaK� III CONVERSION DEMOLISH El OTHER A.P.# _ - ! I Zone_ • 7m DESCRIPTION-OF WORK/USE OF.BLDG. - _ c (1 Address a�q f'� _ - _ . _ = " S Main Building: Accessory Building: ' %J Arch/Eng. - - ' License No. TYPE OF PERMIT ❑ GRADING ❑ OUNDATION ❑ STRUCTURAL T Front I - - • O • �S - • - ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL . B • - . N j\_IjV^I Address Q�f1 Rear Contractor's Nam. £ / II - one//R��O ❑ 'OTHER - C .Right N PROJECT DESCRIPTION SQ. FT. OCCUPANCY _ Address(mailing) IVEO�i✓ .��A-469-hem, �dt5/O� 'K ' - �/ CONSTRUCTION TYPE - VALUATION$ S ,Left ,1 ' City License No. U ZONE GRADING CU.YDS. ACRES ` E \ . LICENSED CONTRACTOR DECLARATION . • _ Ping. Ref.# Parking Req./Provided ' I hereby affirm that I am licensed':under provisions of Charter-9 (commencing Remarks: • Planning Notes: - - • 'M • ' with section 7000) of Division 3 of the Business and Professions Code, and RECEIVED JAN 2 J '^36 - , S • my license is in full forr an. -ff-ct. 105" c.I Licens IIa v . • ice se N.. - • O Date on Signature W� ' ^ -A. -• . PLUMBING FEES ' WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES • I hereby affirm that I have a certificate of consent to self-insure or a certificate I _ of Workers' Compensation Insurance, or a' certified copy thereof (Section Backflow Preventer , Service Sink.'. - - - 3600, Lab. C.) p - ''j' — Automatic Washer - Transformer' D 15-50 KW '- ' ' ' " Policy No. ,O 'i# Company 7309� f/Vl5 l - Backflow Irrigation Sewer Cep' , ❑ 50 i- KW rtified copy is hereby furnished. ' . p i Construction Pole Sub. • • � -1 CerrLa led co y `£IIed with the city�}a�iilldisng�J Ision. yygg I Bathtubs Sewer Connection Cooking Unit „� Meter ❑up to 100 amps Date/-n'" - Applicant�'/Ovaf(/T� •L 4d44•. - . EXEMPTION FROM WORKERS'COMPENSATION DECLARATION ' Clarifiers I • Solar Collectors ' Dishwasher• •f' Meter Dover 100 amps - (This section need not be completed if the permit is-f or one hundred ($100) or - - , less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel I I certify that in the performance of the•work for which this Dishwasher is Issued, I - • shall not•employ any person in any manner so as to-become subject to the • Drinking Fountains Solar Tank • - Fan ry' Motors❑0-1 HP ❑1%-B Workers' Compensation Laws of California. , . ; - . Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc Solar ❑9-15 HP ❑16-15+ • ' '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 I _ . Fixtures - • Microwave - - - comply with such provisions or this permit shall be deemed revoked. - - CONSTRUCTION LENDING AGENCY • ' Gas Service - Outlets ' Water'Closet I - ," Device Boxes Pole Light I ' I hereby affirm that there is a construction lending agency for the performance 9 • I of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater, 4 rd Outlets Range Lender's Name. - Lender's Address ' . Kitchen Sihk Water Service ; - Switches Sign • OWNER-BUILDER DECLARATION- - - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash A Garbage Disposal l Standing Sections ' following reason (Section 7031.5 Business and Professional Code: Any city or . ' county which requires a permit to construct,alter,improve,demolish or repair P-Trap ' Laundry Trays - Generator KW❑5-15 KW Trash Compactor ' any structure, prior to its issuance, also requires the applicant-for such permit - - 4 to file a signed statement that he/she is licensed pursuant to the provisions of ROOF brains 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 permitsubjects the applicant to a civil - • ' - ' ' - eenalty of not more than five'h untlretl dollars($500). $ 3 ' LJ I,as'owner ofl the property or my employees with wages as their sole ;Reinspection Fee I $15 Issue Fee compensation, will do the work, and.the structure is not intended or offered - ' Reinspection Fee I $15 Issue Fee , i '$ 3' ' 1 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 _ . _ I thereon, and who does,such work himself/herself or through'his or her own - - DEVELOPMENT SERVICES REQUIREMENTS: I • ' employees, provided that such'improvements are not intended or offered for . Boiler Hood or ' Type I ❑ sale. If, however, the building or improvement is sold within one year of com- • Canopy , Type II '0 ,. Zoning Approved By - i Date_ , ' Dletion, 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). , • � I •` O I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System ., , .Application Issued By ' ' W.' ' Dat: � X7/.7,_ • tractors to construct the project (Section 7044,Business and Professions Code: I•. I1\ The Contractor's License Law does not apply to an owner of property who Duct-Ventilating DO-100,000 BTU ❑100,000 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with acon • - tractor(s) license pursuant to Ino Contractor's License Law). 1 am aware that Exhaust'System ❑ Multiple 0 • • System Repair/Alteration • BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. , ^ _ _ PLAN CHECK $ -at PERMIT I: I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers ISSUANCE $ " PLUMBING ' $ Date ' - Owner - , Heating System& Ducting Registers • . ' PLAN CHECK 25% •$ • • ENERGY P.C. '$ I hereby'certify that I have read this application and state that the above ❑0-100,000 ETU ❑100,000BTL • - - - GRADING $ information is,correct. I agree to comply with all city and county ordinances ELECTRICAL $ ' ' I .and state laws relating to building construction, and hereby authorize repro- PLAN CHECK 50% $ MICROFILM $ • sentatives of t is city to enter upon the above-mentioned property for • ' inspection p es- yA ,y o ' MECHANICAL $ TOTAL FEE !$ r-5 a Signature � Reinspection Fee $15 i Issue Fee - $ 3 PLAN CHECK 25% ,$ CMF 0865-46,rev. 10/84- White- Building; 'Canary -Applicant; Pink -Accounting; Goldenrod -Assessor - - ._ - - - - . ' CONSTRUCTION AND PLANNING - t POOL& SPA - - - - _ APPROVALS Permit - Date. Inspector APPROVALS -Permit# Date Inspector 4. 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. a - - 55. Electrical Bonding • 5: Steel Reinforcement .. 56. Rough Plumbing & Pressure Test .,.,,K - 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 r 61. APPROVAL TO DECK - ` 11. Property Sewer Line & House Connection - 62..Backwash & Receptor-Final .• -12. Sewer Cap - '-i , 63. Heater 8-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 _ 201 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 c 30. Drywall NailingHEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat -79. FINAL INSPECTION , 32. Electrical Power Meter-Final •80. 'FOOD CERTIFICATE ISSUED 33.,Final Electric - Notes: 6-SSC. L r-c.ae4. 4..e.0. ifit. 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test - - - 36. Hood or Canopy - - • 37. Final Factory Fireplace - 'r 38. Final Plumbing . 6-4 4a L.-an 39. Water Service-Final. t-• • 40. Gas Service-Final 41. Solar Domestic-Final - , - • - - 42. Backflow Preventer _ . . . _ . 43. Backflow Irrigation • ,.r - t 44. ,Landscape Irrigation System' , r . 45. Sound Attenuation - - - 46. Handicap Regulations ' - - • 47. FINAL STRUCTURE & BU:ILLDING, • , . . 48. Special Requirements Completed - ' 49. Electric Release.to Edison ' . - • - - 'ii 50. Gas Release to Southern California Gas Co r -1' - 51. CERTIFICATE OF OCCUPANCY , No. - Date ... ! .._-..'... ' - . -- . - - _ - . • 'Pc- C.4„3,.. •" •� • - - --- Applicant to fill in all spaces except-those within heavy border lines and sign all appropriate declarations. - "- CITY OF COSTA MESA CONSTRUCTION PERMIT _ PER N - TRACT NO. LOT NO. - UNIT NG. ' - ' f 1405 12/11 /57 L 5000 TL i/�U .LiU) i L n v q I /S3(o Project Address ,',I' Cq- '- r' I /, IVdO -'ATYPE OF CONSTRUCTION L I NEW LJ ADD 'LJ ALTERATION, U REPAIR • - Applicant's MailingJgddrec55 y� �t ❑ CONVERSION ❑ DEMOLISH ❑ OTHER • ' /\ g �N IC-h`, ! S, - - - A.P.#. I - - Zone Owner's Name Phone .DESCRIPTION OF WORK/USE OF BLDG, AddresL. s - - - ' - ' - I S Main' Building:' , - - Accessory'Buildi ng:' , Arch/Eng, • - - . - License No,'_, 1 TYPE OF PERMIT ❑ GRADING 4 ❑ FOUNDATION ❑ STRUCTURAL T Front : z , , - , - O Address ' ' - _ • ryry1 ' ' -❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL t B Rear N Contractor's Name - • i. ,L. O.' Pone 98 4.7V, ' ;❑ OTHER, - C -Right ' ' - - G / h PROJECT DESCRIPTION, SQ. FT. ' OCCUPANCY, .53511 Address(mailing) IA! -��x�LA7 , A7af \�)� K _ - .2,Ob CONSTRUCTION TYPE • I '• VALUATION$ s Left City License No. • - ZONE •- GRADING CU.YDS. ACRES •- Piny. Ref.# Parking•Req./Provitled - E LICENSED CONTRACTOR DECLARATION - -L, I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: - , - ( Planning Notes: ` I,L, .1 1 , •O/ M , ' with section 7000) of Division 3 of the Business and Professions Code, and I ' - - _ ,r,�qQ�— my license is in full f rce3�njq effect. s //�� //-- _/7 • I , I\/Cfl 11 I,OI License as '_S('a • - Licegs NoS�I S / , ' . - i REL-E V f�I J IJ S Date `7 'O " /J/Y�CL' nt.G' • , ,' , 1 • PLUMBING - I FEES I I ' a WORKERS'COMPENSATION DECLARATION - Bar Sink ' Sh'owels ,-ELECTRICAL + FEES I hereby affirm that have a certificate of consent to self-insure or a certificate I , of Workers' Compensation-Insurance, or,.acertified'copy-thereo!(Section I -' ' Backflow Preventer Service Sink 3800, Lab. C.) (� �/ 'am/.51` - : , Automatic Washer I 1 - ,Transformer ❑ 15"50 KW ' ' co Policy No, o'I '~D' Company- 600C ie ' / S Backflow Irrigation Cap ° - , ❑ 50+KW �y� a Certified copy is hereby furnished. 9 Sewer Construction Pole Sub. , �l1 1 `. , �l1 Certif e• copy i 9-d with the city BuiWInpfOiy+�sign. /,/ �r ��A Bathtubs Sewer Connection Cooking Unit , ,Meier ❑. to 100 amps I • uisr4. . Applicant • / ./r Of„/LL .�_(.1-- ee , , p p , .� EXEMPTIO ' ROM WORKERS'COMPENSATION DECLARATION - - - Clarifiers- - -- 4,-. i -- - Solar- Collectors - •i J - Dishwasher --- - -- - Meter ❑over 100 amps-� -• '• • - •- need not be completed if the permit is for one hundred ($100) or • r - less). I Dishwasher Solar Piping • Dryers ❑Gas ❑Electric i :Sub Panel-- I I certi ' • •• ork for•which this permit is issued,I '- s not employ any pets in any manor �� subject to te i Drinking Fountains • Solar Tank •• I Fant '/ l ' •rkers' .m._.sa q� of California i/alt// Motors ❑0-1 HP ❑1%-8 I . Da • �•:vacu� ,•.. - ��Qi�.�, � Floor Drains) ' SwimmingPool w/Spa, 1 I ' 'NOTICE: If,after making this •eco .. .• __" _ F.AiU. ,Ina Solar ❑9-15 HP ❑16-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks r Urinal - e • comply with such provisions or this' permit shall be deemed revoked: - - . . �J Fi Xtures" Microwave CONSTRUCTION,LENDING' AGENCY . - I - ' Gas Service Outlets Water Closet ' } I hereby affirm that there is a construction lending agency for the performance • - - '; Device'Boxes Pple Light v of the work for which this permit is issued (Section 3097 Civ. C.) I •• �1 - -- ' Interceptors; ,/ Wates Heater, n_ , r-((1� ,� ' Outlets•4, Range Lender's Name - - - - - - - •- , • Lender's Address ' ' Kitchen Sink ._ r •' - Water.Service ' P = Switches' Sign OWNER BUILDER DECLARATION -^ - I - - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories. .f - - Auto-Wash - I ' t• . Garbage,Disposal !Standing Sections following reason (Section.7031.5 Business and Professional Code: Any city or _ , 1 _ county which requires a permit to construct,alter,improve,demolish or.repair P-Trap r „LaundryTrays' - - r ' any structure, prior to its issuance, also requires the applicant for such permit - V I ,1' Generator ❑0-5 KW❑5-15 KW Trash Compactor 'to file a signed statement that he/she is licensed pursuant to the provisions of , ROOF Drains , i ". l - • '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 - _ ; - - 3 - j{ s . — 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 i — I , e . - •. "r' ' penalty of not more than five hundred dollars-($500). 1 , - ,- I , D 1; as owner of the property or my employee's with wages as their sole ' Reinspection fee l $15 Issue Fee $ 3 73 • + • compensation, will do the work, and the structure is not intended or offered ' ' Reinspection Fee ; $15 Issue Feel $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's , - , - ,MECHANICAL - FEES -'A - - -. _ - - - 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 - - • I I - I _ DEVELOPMENT SERVICES REQUIREMENTS;, , employees, provided that such--improvements are not intended or offered for , Boiler ' Hood or, Type I ❑ t , , • - I I sale. If, however, the building or improvement is soldwithin one year of com- • - Canopy Type II El 4, Zoning • ' , Approved By _ trate_ pletion, the owner will have the burden of proving he/she did not build or'im- Duct-Under Ground I - • ` prove for the purpose of sale). - , I C Building Approved By • Date ❑ I,'as'owner of the property,am exclusively contracting with licensed con- Duct"Structural Refrigeration System - L. Application Issued By ' _V- Date /0 7 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' ❑O-100,000 BTU 0100,000 BTU - C•, ! SUMMARY' OF FEES , builds or improves thereon,and who contracts for such projects with aeon- • I tractor(s) license pursuant to the Contractor's License Law). I am aware that . Exhaust System ❑ Multiple 0, System Repair/Alteration - BUILDING PERMIT • $ ' SMIP $ i proof off their Worker's Compensation insurance should be provided to me.' • - f PLAN CHECK $ - PERMIT I I am exempt under Section B.& P.C.for this reason Fire I/Fact.Bit, ICBG# Fire Dampers ^ (�Q 'ISSUANCE $ 1 ' p ' I PLUMBING ' $ 5 Date Owners - Heating System&Ducting • Registers PLAN'CHECK 125% $ ' 1 ENERGY P.C. $ , I hereby certify that I have read this application and state that the above 00-100000 BTU 0100,000 BT GRADING $ information is correct, I agree to comply with all city and county ordinances , I' I , t ELECTRICAL $ - 1 and state laws relating'to building construction, and hereby authorize repre- I - I PLAN CHECK 50°,61 $ MICROFILM I $ • 1 ; I sentatives of,this city to en\ r' upon the above-mentioned I roper[ .for , , ' inspection put s s / MECHANICAL I I $ TOTAL FEE I $ 5�O . Signature /. •- / CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor ' CONSTRUCTION AND PLANNING - - POOL &SPA '- Date Inspector - Date Inspector APPROVALS Permit# - -APPROVALS,. Permit# ,t,. 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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings . - . 58. Electrical Conduit-Undrgrnd. : • • 8. Foundatioh • - 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. , 60. Backwash Lines, P-Trap, 0 Undrgrnd. _ . 10. Structural Floor System61. APPROVAL-TO DECK , . 11. Property Sewer Line & House Connection 12. Sewer Cap 62.- Backwash & Receptor-Final _ g 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 - - - . - 1 16. Rough Electric Wiring _ - 67. Fencing & Access Approval . ' d7: Rough Wiring Sign • • , 68. APPROVED FOR PLASTERING . 1R..-Rough Electrical-T Bar Ceiling . .,69. POOL/SPA SYSTEMS FINAL - • 19.,,Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT • "" - , 205.Rough Factory Fireplace , - APPROVALS Permit# • 21. Ducts, in Structure 70. Underground Hydro . ' 22. Ducts, Ventilating . 71. Product Piping ❑Gas LI Oil, i , 23. Gas Pipe-Rough &Test 72. Underground.Flush - 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil • 25. Roof Sheathing 74. Overhead Hydro. - , '26. T-Bar Ceiling (Structural) &Monocoat - , 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe J • - 28. Lathing & Siding - 77. FIXED SYSTEM FINAL 1 29. Insulation ' 1 ' • 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:j42#eg ter• Otea. 4L0 34. Final Heating & Air Conditioning 3/ 7/88 Zei ro4, Lego 35. Final Gas Pipe-Test , /a)/i _77/ iJ24:rce-e - 36. Hood or Canopy iiJJy/v/wY E omeg ._ as PEZ&3 UPC.. LCD- ~ 37. Final Factory Fireplace - _ /1 _ 38. Final Plumbing - f ' . - ;I 39. Water Service-Final 40. Gas Service-Final , • 41. Solar Domestic-Final CC • - _ - . . , - 42. Backflow Preventer ' r) w - I 43. Backflow Irrigation r-t-=t - - "�: 44. Landscape Irrigation System;; 7 - . 45. Sound Attenuation r 0 - _ - 46. Handicap-Regulations ::i _ � - 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed. - 49. Electric Release to Edison -'cm - - - - _ cr - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY _ -. No. Date . - - ADDRESS OF BUILDING: 1104 SANDI LN UMT' CITY OF COSTA MESA — BUILDING PERMIT GWNErrsNALtEIFrm: PERKMAN MANAGEMENT PERM NO: B 085005 ADOREss: 800 S BROOKHURST #2A r ANAHEIM,CA 92804 PERMIT NO: B 085005 PLAN CHECK NO: N GOVT: N SUPP: N 956-2012 APDL.MOUND ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH ARCHITECT OR EMBER: OF NO.: JOB DESCRIPTION : T/OFF & REROOF W/COMP SHINGLES SQ FT: 3, 400 ARCS OR END'S ADDRESS: CNN: CLAIM VALUE: 3, 400 . 00 CALC—VALUE: 3, 400, 00 GROUP OCC: R-3 / caanACTOWSNALt J D JONES ROOF CRAFTER ( 714 ) 826-4827 CONTRACTORS WANG 6011 SAN YSIDRO COMMENTS: REROOF 2300SF DUPLEX W/COMP, ADDRESS INCLUDES 1106 SANDI LN ADDREss: BUENA PARK CA mm, 435996 +t;r*****aEaE3EaE;tst;tfi�E�,esEjt*�t�E********impl*�taE�E�EiE*;e*;t*alt*stat;t**st*ie*iE*****alt; ****;t**;r;tat;r*;tx*;t3t* 90620 utc: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby Wim under penalty of perjury that I am licensed under provisions of Chapter e SE TB ACK S (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect. cm(LIC.NO.:029223 LIC.CLASS: c 39 LIC.NO.: 435996 P: 09/ 7 MAIN BUILDING ACCESSORY BUILDING Date /O—2— 99'7cantraaarTnTtlneB � E FRNT: FT IN REAR: FT IN FART: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I em exempt from the Contractors License Law for the following reason(Section 7031.5 Business end Professions Code:Any icily or county which requires a permit to construct,alter,improve, P RO V: PARCEL : 42204203 Z NE: REF NO: 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 PARKING REQ: is licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commenting with Section 7000)of Division S of the PLANNING NOTES>' Business end Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section >^" 7031.5 by any applicant fore permit subjects the applicant to a civil penalty of not more than five hundred dollars MOOS. ***************** ************************************************************* 0 or�e"edd i«sae((Secctionn or Busies and Prof"fess�utw:sTThe Cone tractors L Lion.will do awe n'not a the pplyyt��Ownerofprewe�ty D E V E" L OPMENT SERVICES REQUIREMENTS who buids or improves thereon,and who does such work Nmself or herself or through he or her own employees,provided that such owners-buiMderwit havave the bueuriden or proving he or or shehdid oft thebuilding fpr«rihe p�apossedofMwaee).COO y�a completion.� ZONING APPROVED BY DATE: • ❑ and Prawn owner Code:TheMContraans LcenseeLLatw°dom not with sicensed appy le contractors owner of Property Moconstruct buildsi�a(Section r'llseerateme')�nd who BUILDING APPROVED BY : DATE: contracts for such projects with a centrada(e)licensed pursuant to the Cantraecs License Law). �` � ❑ lamexempt under Section: El.SP.C..for thisreason: APPLICATION ISSUED BY: <`-� DATE: , (C)(2-( 1 Date: Owner: ***********1(;iE**********************3E.*************' E ********************* * I do hereby ceniy that 1 am aware of and understand the requirements of Catania Health end Safety Cade Sections 25505,25533,and LEGA(IZATION;1J F E E SUMMARY STRUCTURAL SEGMENT:Y 25534,and that I or any future buikming occupant will/will not(circle one)need to comply with said date codes end the requirements for e permit for construction or modification from the Airy aagement District Residentil construction applications are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES' GRADING provisions. PERMIT 87. 25 . 50 Date: Applicant: SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following detlwtons: PLAN C1 ❑ I have and will meiman a certificate of consent to self-insure for waken'compensation,as provided for by Section 3700 of the Labor ISSUE FEE Cede.fortheperformanceoftheworkforwhichthispermiisissued. BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE PIhave and witmaintain waken'compensation insurance.as required bySection 3TWathe Labor Code.for the pedamanceofthe TOTALS----> 87. 75 0 . 00 0. 00 87. 75 • 87 . 75 . 00 work for which this permit a issued.My workers'compensation insurance carrier and policy number are: Canter: STATP FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 87. 75 OVER/SHORT: :00 Policy Number: 2RS—TmITT000741 01 /01 /98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This section need not completed mpleted f the permit is for one hundred dews 151001 or less) 87. 25 ' I' . 50 o I certify that in the performance of the work for whish this permit is treated,I stall not employ' any person n any manceso as to bcm ... ohwok'cmatolswdCmonare . Ieaaohwrks **********************************f,*************************** **************** compensation 3700athe : . wan comp* those ys Date: DZ � INDIVZDUALj FEEBR EAKDOWN Warning: up to secure workers'tonpwwdon coon- o,and Isubject comenation, a damages penalties and TYPE QTY DESCRIPTIO N .UNIT COST TOTAL COST civil fines up to one hundred thousand dollars 0100,.m m. addition to the cwt of compensation,damaps as provided for In section 3703 or the Labor coda,lnranaL and s .. SFR 3400 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 3, 40 0 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the . iEND OF FEES - performance of the work for which the permit is issued(Section 3097,Civ.C). I LENDER'S NAME: LENDER'S ADDRESS: Of) I certify that I have read this application and stale that the above information is correct.I agree to comply with W thy and county ordinances and stale laws relating to building construction and hereby authorize representatives of the city to enter upon the ahem-mentioned properly { for inspection purposes. .S.° i� JENNIFER HAUSER , 18-82-1997/12:18 PVsg7.75 Pdnt : : sr )". RCDT8:8188131% rl AIM Dae: /O-2- 9-7 % PERMITa138$085 / 'gnat .of Owner/AgenttAppicant/Contreda r/'r 15151-46.WP) Whim-BuiMive&Safely:Green-Fie:Canary-Appicanl:Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING " POOL & SPA . Date Inspector ' Date Inspector' APPROVALS Permit #- . 'APPROVALS Permit# . , • r ' 1,'Temporary Electrical Service or Pojei 52. Pool & Equipment Location -/ • •2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement •'�,,.- 1s . .3. Electrical Conduit Utility:Undrgrnd.. • 54. Forms - ,i Ste, 4. Electrical Conduit-Undrgrnd. _ - 55. Electrical Bonding - • t .- 5..Steel Reinforcement , 56; Rough Plumbing & Pressure Test -•j�-- :, .6. Electrical UFER Grn8. - 57. APPROVAL TO COVER-GUNITE "' is 7;Footings - . - 58. Electrical Conduit-Undrgrnd. 8:' Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. • ., ' 60. Backwash Lines, P.Trap, u Undrgrnd. • 10. Structural Floor System 61. APPROVAL TO DECK '-f{ 11. Property Sewer Line & House Cotinection '62. Backwash &.Receptor-Final - 12, Sewer Cap - 63. Heater & Vent-Final ' '• 13. Roof Drains • -- - - .$4. Plumbing System - Final �1 - 14, Rough Plumbing - •65. -Electrical-Final ;� - .' . . 15. Rough Electrical Conduit- . 66.-Solar System-Final - % - - - • , 16. Rough Electric V'iri ig • • • "`67 ' Fencing & Access Approval `�`, 17. Rough Wiring Sign - '68.t .APPROVED:FOR-PLASTERING - i ._ 18. Rough Electrical-T Bar Ceiling ' 69.- POOL/SPA SYSTEMS FINAL • ' • 19. Rough-Heating &Air Conditioning ' :-- - FIRE"DEPT"_REQUIREMENT - - - `- 20. Rough Factor, Fireplace .. , _ ` . APPROVA'LS';:' Permit # ` 21. Ducts: in'Structure' •• •• I ' " ? 70 1Undergrourid Hydro r i. 22. Ducts', Ventilating.. • e- c ••i ,• : 71. Produe;tkaping'�l=Gas O Oil • 23. Gas Pipe-Rough & Test - . 72. Underground .Flush - 24. Root Framing" - ' . , i i _ . 73. Undergrnd.StorageTank.0Gas 0 Oil 25. Roof>Sheathing j • / (,1: 74: Overhead Hydro.:_ ' 26. T-Bar•Ceiling (Structural) & Monocoat 'L -: • ' ' 75. Dry Chemical - i 27. Frame and Flashing , - . .. 76. Ory Standpipe • ^ 28. Lathing &Siding - I, _ , . 77. FIXED S.YSTE'irFINAL _ 29, Insulation =•-r. .4 78; FIRE PREY. FINAL ` • ' - ' 30. Drywall Nailing '? l - ' ,HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - i i 79. FINAL INSPECTtON 32. Electrical Power tvletgrFinal ' ' 80: FOOD CERTIFICATE ISUED - 33. Fin#Electric ' I t. r• Notes/0 -•3 4.7. �O 0 _•4:10-7-6-771_/ ,C) /��//J-1 34. Final.HBating& Ai?Conditioning . . -' P ,. . - , ,.. y • -. 35. ,Final Gas.PipeTest• : - .. . . _ _ - s . , • 36. Hood or canopy ." '- r •'-' l -,•? • ,t 37. Final:Factory Fireplace I •- - ' 38. Final Plumbing I • ° - " -- 39. WaterSer'vice-Final' r - =' r 40. Gas Service-Final - 'r. 1_ ' - 41. Solar Domestic-Fin"al - - I .. 42. Backflow Preventer - _ + 43. Backflow Irrigation t r - 1 - ' - 44. Landscape Irrigation System _ _. :. - ' ' -' ' - •� 45. Sound Attenuation: - r _ ;T 46. Handicap Regulations - - - - - 477. FINAL STRUCTURE & BUILDING /m/1/®r /• b- : - �='-_ -~ V 48. FINAL PLANNINGr - " 49. Electric Release to Edison • • ' 7-d CO .. .. .. > I �w iU 50. Gas Release to Southern California-Gas Co 4 w 2la 51. CERTIFICATE OF OCCUPANCY - - ', C. . iU No. Date Li city or c,APPROVED &"x 1. .s.,-/c-‘t-,s �l �-v.� .�C T Costa Mesa � f.a.-{-;.a-mac vC �' �� Fl fTJ - v O L' BY eu"Iding peer �_. N�TCHANSE GES NJ i;1 (.i2E V. DATE ` NI TIl1 tl THE I '.'J'✓'i TINEC MAK PLANS ISSUANCE OR GH:,::-2:,:: Cr �'�ROV,y� �F DEPT.E ` /� 7 PERMIT Fpq OEgCIAICA710(1;;.::.1,:11_ :.�: E..>,!IgA�_3 a ✓� I/e�- D✓- y wet. AUTHORITY PROVISIONS OF THIS C��,, � ` „,�V!C:iNSlP,Ufp APPROVAL OF co / • CODE SHALL RE VIOLATE CP ,�'�`'C.::�a,_F LA7!ON OP ANY 6�A ,a WHICH ITAUTDE VALIJ EkC;C:'; ;1..:, !_rr,„ ,`,��V,�h11NG r0 GIVE HO'T! • 'S OF it11S T THE FIE WORK Oq USE —1"' (ti S V 1c-i-'79 /1, ISSUANCE F ��, tufa , / FROMTHEREAFTER THAI!. F.'1 f' _[3A �— t3 ✓l./ it SAIDDINGANSE I`AND 8:I L Irsa Ti Il COG,�cr ��n�l C'.'iaGr)FFI AND _.1 i IN GF , - 2 -.3a �: (IIN-ss 1 IOC VIOLATION A:IONS U1.IN 1 E" '`• " CORS 1 _ I/t� t D �r`'}— I ( fi lE C17Y. 01' II IIS COPE O.. 1iF[I ^Ct` rV=Yc'NYING .eq S ""r+ar .7 < .y`;7 Hi.?(i!`I;^`q WHEN T I r,.+NCE OF M . . X 1.5 T 1 N f 4 wI ► , 00w �� QE � � o� IV� II✓ WfI� � 3 -Ifl"� � -� / 13� t#I II wig G� rV V � Str� E.? - a-s &'-6-'l �', { Fit ,,/, 5 4-e pa)vw n I� S : I . i APPROVED t= ,k \ $TTJc . �V VJ _ ATI OP COSTA MESA W I to 1D a W II I N 'ADW PLANNING DEPT. ---•:---1-L-Ii S- !o"� -c� /i �m,i^na�r ro tea. DVT. IEO. 3 -c / - t� � r DATE_• - •• m of PIA*" _. .._ • SCALE: 1/// C // APPROVED BY: DRAWN BY DATE: I�1 / /�Z REVISED � ID �; l g_+ 'JDb �'. L .� I � C ( ,_ / DRAW ING NUMBER 11 II 17 MINTED ON NO.100011 CIEARPRINT•