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HomeMy WebLinkAbout2222 SAYBROOK LN - Building Permits 4(w'' CITY OF COSTA MESA F w �'� BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT PERMIT NUMBER B99-00016 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2222 SAYBROOK LN Status: ISSUED Suite: Applied: 01/04/1999 Vicinity: 2222 SAYBROOK LN. Issued: 01/05/1999 Parcel Nunmber: 41901342 Zoning: Applicant: PEARSON, VESS Address: 4872 CANDLEBERRY AV Phone: 714-761-8173 SEAL BEACH,CA Zip: 90740 Owner GARDEN PARK VILLAGE Address HOMEOWNERS'ASSN P 0 BOX Phone: %HOME FEDERAL S&L ASSN - Zip: 92112 " Contractor G M ROOFING . Address: P.O. BOX 3908, Phone: 714-761-8173 SEAL BEACH,CA • Zip: 90740 License: 472566 Arch : - • Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT • INSTALL 25-YR LAMINATED COMP SHINGLES 0/EXIST LAYER(SINGLE)3-TAB COMP ROOF.ROOF CERT ATTACHED TO PERMIT. GARDEN PARK VILLAGE HOA. ROOF COVERING 2222 SAYBROOK LN.(POOLHOUSE)._ - FEE SUMMARY Plan Check: $0.00 Calc Valuation: $1,500.00 Permit: $48.50 Claim Valuation: $1,500.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other $0.00 Inspection: $0.00 Total: $49.00 • 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 NOTES: 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 WORKERS'COMPENSATION DECLARATION: 7 _ I hereby affirm under penalty of perjury one of the following declarations: ❑ 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 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 permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number. (This section need not be completed if the permit is valued at one hundred dollars($100)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 Calif mia,and gree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provi io s. c Applicant Signature: Date: 1 - C^c l WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisi s of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.s 'VA ' / Class# Contractor's Signature: V A.. _ n Date: 1-C - C C CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). 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 end 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 Law(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 en 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.). ❑ 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.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 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: ❑ 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 B,Califomla Administrative Code). O 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 end 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? 0 Yes 0 No (Section 25533 of the Califomia 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 Califomla Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of en 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? ❑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 appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes ❑No (Section 65850.2 of the Califomia Government Code requires that the requested information be fumished on applications for non-residential building permits). 6 Will 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 es ❑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. Si ture Of Legal Owner(s) Date And/Or Authorized Applicant Date CODEL INSPECTION TYPF DAM II{DLAIS COOEI INSEECTIONTYPE DATE UIIl➢ALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final �,/ // 208 Final Plumbing -j'r'/ 200 Final Re-Roof q -/ 210 Final Electrical 201 Final Block/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 2446-46 CITY OF COSTA MESA ,4y- -•, BUILDING DIVISION F:4" ' DEVELOPMENT SERVICES DEPARTMENT 44":**xerceri el PERMIT PE ITN MBER E98-01011 • (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2222 SAYBROOK LN Status: ISSUED Suite No Applied: 09/23/1998 Vicinity: Issued: 09/23/1998 Parcel Nunmber: 41901342 Applicant: ALLEN THRAILKILL Address: Phone: Zip: - Owner: GARDEN PARK VILLAGE Address ,HOMEOWNERS'ASSN' - ' ' ' • A'. P,O BOX V - Phone: - 2 %HOME FEDERAL S'84 L ASSN Zip: 92112 Contractor: SUNDOWN LIGHTING INCORPOR Address: ' ' 00012 MAUCHLY Phoney714 582-6255 - � IRVINE CA _ ; ,Zip`, 92718 - ,\ - . '•License: 479677 . • SCOPE OF PERMIT ,STATE HEALTH AND SAFETY CODE SECTION 116049.1, PUBLIC POOL GFCI INSPECTION. - • c. r FEE SUMMARY Quantity - Quantity ' - ISSUE FEE $22.00 - .; -,'''? , -.- Ternp-Dist System'/Lighting,• $0.00 0 ` , Temp service test $0.00 - _ - - •--Busway/100 ft ' - $0.00 0 - Res.a/c package $0.00 - - Standing Section $0.00 0' i New Res(1-2 units), $0.00 0 Misc Electrical Equipment $0.00 0/ New Res(3+units) ' $0.00 0 Transformers,up,to 1 kva/kw $0.00 0' , Pool/Spa $0.00 0 - up to.10 kva/kw Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 ±'-0 ,i Recept Outlets .' :• $1.00 1 up to 100 kva/kw $0.00-': '0 - 1 " Switches '- ., $0.00 0over 100 kva/kw $0.00 , 0 Non Res Appl $0.00 0 • -' • Low Voltage Equipment $0.00 0 , Res Appl $0.00 0 _ ' Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00' 0 ' .'' Misc. Conduit - - --$0.00 , 0 .: ' Service to 1000a , $0.00 0 , Misc.Conductor _ $0.00 0 Service over 1000a ' $0.00 ' 0 ' Circus(gen or ride) ' $0.00` 0 - Motors to 1hp - $0.00- 0 ' ' Circus"(mech ride or lights) $0:00 ' 0 / - Motors to 10hp . - $0.00 '. 0 • - ,Christmas Tree Stand $0.00'" - 0 Motors to 50hp - $0.00 0 Fireworks Stand $0.00 ,0 Motors to 100hp $0.00 , 0 Other Electrical Fee ' $0.00 - Motors over 100hp $0.00 0 Communication drops $0.00 0 ' Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee .$0.00 • Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $23.00 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS • EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned fora 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 FIETrza WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 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 work for which this permit is issued. ❑ I have and will maintain worke s'compensation insurance,as required by section 3700pf the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation I rance carrier and policy number are: [// t// Carrier: ,A/9 Policy Number:O�FJ fifr //aki 6 21 (This section neednot be completed if the permit is valued at one hundred dollars($100)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 California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these yyy[[[ows onJ� Applicant Signature. 1p �-. Date: 3 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION ERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with S(coon 7000)of Division 3 of the Business and Professions Code,and my license Is In full force and effect.Lic.# ' • Class# r f O Contractor's Signature: c = .._e. �fl /`ti. / Date: (:?•--z 3 CONSTRUCTION LENDING AGENCY: c/ ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). 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 Law(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.). ❑ 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 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: ❑ 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? 0 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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will 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 e (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. natereget Owner s) //+ � L t 2 Date -1' An Or Authorize ASO ant Date ram t DISPFf 0NTYPE DATE MEALS LOOS! INSPRITION TYPE DATE ICALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final _ 208 Final Plumbing t _7 it 200 Final Re-Roof 210 Final Electrical —tO -4q bj'��bJ". 201 Final Block/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 2446-46 (CATION FOR A BUILDING PERM' L BUILDING PERMIT NO. PermitElectr'cal m � Tract j 05. w (P Biock Lot No. , L Building � ^ U 1,, Plumbing 6 Address 22:2-2- Sr1' 1 6✓'Ob F— ,3 / DD Permit No. in Cross F zv ions-.� £ �j o 7 Mechanical 0. a AreaLoh�Street Permit No. �bs'�P Cc's> c'�\e s A co" Owner e0-b tr2 _ a .S Type of Project: 0 New 0 Alter ❑ Addition Andress 22t �', 1 7C/•s��LLna+ .\ /� C ❑ Repair 0 Convert ❑Demo ❑ Occupancy Pmt. • City �C$Te-6-Ip-/a• jA e3a Zip Phoneto'5 3(( A.P. up.Dist./ S _ InSp.Area Architect/ Designer y1yt/ ".4.,lsense No. S i S� Zone SDI.Pmt.No. Andress .. Setbacks P/L Front C/L St. Street Width (..AS- /=I �- wtiv o R'c,,......( • Yards Left Right Rear City V S-t-irnZIO80Phone j33$lo22Z / �s,� }"�(� (.CD��ct�Q,S et/ Ease Prol. Lett / Right s P. Engineer ��7/��P,.(-S (I "'�'./"' lGo.�s�s1'ail C1rT� i _ -C Parking Spaces Teguired Provide Covered 8 Address / '7_�C+ bet e tt.SS 4t / ry (( I Struct r No.o/ No.of m Cit yA�µ1 / • ZIP9d(L3 f Phone gii t 88 Height Stories Family U LICENSED CONTRACTOR'S DECLARATION f Park Fees In�I Yes Fee N Required U No C.T. Receipt m I hereby affirm that I am licensed under provisions of Chapter 9 L (commencing with Section 7000 of Division 3 of the Business and Zoning Approved By; Date Professions Code,end my license is in full force and effect) C 7k License Clan. <- rS 3 License'Number ifG' 0 v-0 Jr. Date 1'5--6-A I Contractor C#'.P-S C e4cr a c Misc. E Address I"3,[< -�Dal [JaS s I - - L..- Proposed Use ii 1 City and Zip r",` ("M CA Phone 9—/R1 �7' P1 (C'•O 8 of Structure - Va CONSTRUCTION LENDING AGENCY r i hereby affirm that there is a construction lending agency for the Performance of the work for which this permit is issued (Sec. 3097, Oct. ype ea 0. r • Civ. C.). ease Const. I ear C Lender's Name USE/OCCUPANCY SIZE SO.FT. Lender's Address ': OWNER-BUILDER DECLARATION-le I herebyaffirm that I am exempt from the Contractor'st' License Law OfI'n'�r the following reason: D I, as owner of the property, or my employees with wages as their 2. sole compensation, will do the work. and the structure is not Z intended or offered for sale. 3. I. as owner of the property, am exclusively contracting with licensed contractors to construct the project 2 (] 1 am exempt under Sec. B& -,PC for this reason ' G Date Owner. Total Valuation EO WORKERS'COMPENSATION DECLARATION Il--ll 3 I hereby affirm that I have a certificate of consent to self-insure, nrr acn.nent Permit Required l..' Yes ❑� No Eor a certificate of Workers' Compensation Insurance, or a certified E - - Ecopy thereof, `` Grading Pmt. Grading y Policy No 2' G-ILMDY' rriPany Reo..ver `r el RSL-4.r Required ❑Yes 0 No Pmt.No. � a Lrertifieri copy is hereby furnished. Rough Grading a c Certified/copy is filed with Ora re Cq`nty, EM• Approved by: Dale n Q Date 5-�- br Applic nt - -a...v� 3 CERTIFIs-TE EXEMPTION FROM WORKERS' •t•iP:NSATION INSUR ' E 2 (This section need not be completed if permit is for $100 or less). C I certify that in the performance o1 the work for which this permit is 3 issued, I shall not employ any person in any manner so as to become cc rbbject to the Workers'Compensation Laws of California. \PERMIT FEES Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Structural 3 Plan Check S Exemption, you should become subject to the Workers'Compensation Special Provisions of the Labor Code, you must forthwith comply with such Electrical f S Provisions Or this permit shall be deemed revoked. Invest. I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO Plumbing S COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ` RELATING TO BUILDING CONSTRUCTION,AND HEREBY AUTH. Mechanical $ \ ORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE MENTIONED PROPERTY FOR INSPECTION PUR. Pre-Grade POSES. Inspection s Pre-Grade /Permit Signature of Applicent or Agent Date Rec.No. 6 Issue 6 • Print Applicant's/Agent's Name I Plan Issuance ` All spaces within this box must be completed to processCheck BY: Approved: J\ CMF 0335-46(BU-2B) rev. 6/80 ...a Applicant to fill in all spaces within heavy border lines andsign all appropriate declarations. \ CITY OF'COSTA-MESA' PERMIT NO. -TRACT'NO. LOT NO.- BLDG.NO. '- - - I-669 7/28/8.1. .. . 13176 TL ' CONSTRUCTION PERMIT C,---4-�2...G".,'' Project Address.22„2-2--2„;L2-- �Ay L 42, :44„/ TYPE OF CONSTRUCTION • . _ . , • - ' - ` J Owner W1 -—e N&)c Ai Phone 0 NEW 0 ADD 0 ALTERATION - I - t .. "i ! Address - - - - -- - - - - .- b REPAIR 0 CONVERSION ❑DEMOLISH .. ` • Arch/Eng: - - . . - - -- License No. - . ❑OTHER. ZONING REGULATIONS • ''Address' .ln - DESCRIPTION OF WORK A.P. ' ��q,� p.y��� ! 1 v. J, _ ZONE PLNG.REF.�! Contract& Y-7II--0401/44 R-!oteyt--h�one6./z-3`vi.TYPE OF PERMIT - -- - - BUILDING -- " - Tp BRI DING ^ Address'i3 'f-ya��-ry •_`-( ❑GRADING" '❑ FOUNDATION -D STRUCTURAL SETBACK YARD/LST. PROP TV LINE LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL DPLUMBING DMECHANICAL L DE YARD ' ,l hereby affirm that I am licensed under provisions or Charter 9 (corn- - RIGHT " mencing with section 7000) of Division 3 of the Business 'and 0 OTHER- - - Professions Code antl y license is In full force nd eff t. • , REAR YARD(TO P/L) �1 7 1�j -• PROJECT DESCRIPTION License Class cen No, - PKG.SPACE REQ. PROVIDED • Date - Siqhat urSO. FT: • WORKERS'COMPENSATION DECLARATION - OCCUPANCY=CONSTRUCTION TYPE STREET WIDTH PARK FEE$ I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION - ZONE ZONING APPROVED BY , DATE cpr Ificate of Workers' Compensation Insurance, or a certified.copy - - - - - -- - , +} ;.f(�,,ctioq 3800,I,ab. / GRADING CU. YDS. - ACRES ,SPECIAL CONDITIONS: aNialirSf Cly"'/'2��((JCompany/ LL yh lli�Nn ✓� _ . • :riffled copy is hereby fu1-nished. _ - / REMARKS: 1- _ . . _ El-Certified copy Is filed with the city Building Division. - - --- 1 ' • EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - • - ' • - (This section need not be completed if the permit Is for one hundretl •` ($100) 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 PLUMBING PLAN CHECK .- - - ELECTRICAL - - - PLAN CHECK - subject to the Workers'Compensation Laws of California. - - - ami LLLING - -.. UARAGE • Date Signature BATHTUBS SHOWERS SO FT SO FT - NOTICE: If after making this declaration, you should become subject TOILETS - .- URINALS GENERATOR" 0-1 KW_"1-10 KW • to the Workers' Compensation provisions of the Labor Code,you must 'TRANSFORMER • forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE L.AVS - • APPLIANCE 10-50 KW_50+KW ' - revoked, .. - ._ _ CONSTRUCTION LENDING AGENCY L • KIT.SINKS - DISHWASHERS ' - - MOTORS' 0-1 HP 1-10 HP ' I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS , SUMPS - - - .(INC.SOLAR) 10-50'HP 50+ HP - - • formance of the work for which this permit is issued (Section 3097 ' Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS ' ' SWITCHES 1, .�• ;/S Lender's Name Lender's Address DRINKING FOUNTAINS - GAS TUBE SIGNS _... 4.0-0 OWNER BUILDER DECLARATION - • T • INERCEPTORS CLARIFIERS POLE LIGHTS - i I hereby affirm that I am exempt from the Contractor's License Law for •-- T6�%•s+ the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP - ' LuNSI mut-1 WN - - / Any. city or county which requires a permit to construct, alter, POLES METERED SUB - �7` improve,demolish or repair any structure, prior to'its Issuance,also re- WATER SERVICE ALTERATION PANELS' - MAIN - SUB - _- quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS - SERVICE - AMP - /'^ ss � IG" ter 9 (commencing with Section 7000) of Division 3 of the _ - 7 .r.+' and Professions Codeor that he is exempt therefrom and the _d - )' WATER HEATERS BTU OUTPUT - $0' '``•'or the alleged exemption. Any violation of Section 7031.5 by - "'"jplicant'for a permit subjects theapplicantto a civil penalty' SEWER CONNECTIONS - 01 at more than five hundred dollars ($500). • ,. ❑ I, as owner of the property, or my employees withwages as-their SOLAR TANK • COLLECTORS • . ' - ' .. -"- sole compensation, will do the work,and the structure is not intended _ - - ) •I '\ or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS" ISSUE FEE •N/ Contractor's License Law does not apply to an owner of a property - - APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or ISSUE FEE through his own employees, provided that such Improvements are not - Intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK . SUMMARY OF FEES - s • t{I\ is sold within one year.of completion,.the owner will have the burden __ of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING _ERMIT $ SMIP $ ❑ I, -as owner of the property, am exclusively contracting with AND DUCTING \ licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT ,, p and'Professlons-Code: The Contractor's License Law does not apply to - - , - - ISSUANCE $ ' an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects'with-a contractor(s) licesned pursuant to SYSTEM - -- - GRADING $ • the Contractor's License Law). 100,000 +BTU PLAN CHECK $ ❑ I am—exempt'under Section • B.& P.C,for this - / �•f - $ •\ BOILERS BTU ELECTRICAL $ / ��' /�. reason• "" - - PLAN CHECK $" MICROFILM $ - Date Owner SYSTEM REPAIR,ALTERATION TOTAL-FEE$ - I hereby certify that I have rea•this application and state that the above EXHAUST SYSTEM 0 MULTIPLE MECHANICAL $ LESS AD: Information is • rect. I a• ee to comply with all city and county - .PLAN CHECK $ VANCE PC $_ _� ordinances,and sL e,laW9 re iti. • onstruction,and hereby authorize / representatives • thhlf>c y o . ter upon the above menti•ne. s • property' spection •Lr Signatu e d ��*� /4117ISSUE FEE - - . , _ . —a , CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING • POOL&SPA Date Inspector Permit# Date- Inspector APPROVALS APPROVALS Permit# - . - 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - ' - - • 2. Soil Pipe-Undrgrn44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn -• . ._ - 45. Forms. - - -- - 4. Electrical Conduit-Undrgrn • ;1.16-E1 ._ 46. Electrical Bonding - -6 StiWHeinforce 47. Rough Plumbing & Pressure Test - - - • 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - - • 7. Footings - 49. Electrical Conduit-Undrgrn . 8..- Foundation . . 50. Gas Pipe, . .. ❑Undrgrn,Test 9. Water Pipe-Undrgrn 51- Backwash Lines. P-Trap, ❑Undrgrn ' - 10. Structural-Floor System • 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection . _ 53. Backwash & Receptor-Final • i 12. Street Sewer Connection -• 54. Heater & Vent-Final 13. Rough Plumbing - 55'- Plumbina System - Final - - • 14. Rough Electric-Conduit - - -56. Electrical-Final. - - - 15. Rough Electric-Wiring - - - - 57. Solar System-Final- _ • 16. Rough Heating &Air Conditioning •. -: . 58. Fencing & Access Approval , 17. Ducts, in Structure _ - _ - 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing ' • 21. Roof Sheathing - 22. Frame and Flashing _ - • NOTES: • 23. Insulation - , • 24. Lathing & Siding . 25. Drywall'Nailing .,26. Plaster Brown Coat - 27. Electrical Power Meter-Final • - - ' 28. Final Electric - ' _ 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test . 31. Final Plumbing . 32. Water Service-Final - . 33. Gas Service-Final . - - 34. Solar Domestic-Final • •35. Landscape Sprinkling System • 36. Sound Attenuation - 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING ' 39. Special Requirements Completed 40. Electric Release to Edison - . _ - 41. Gas Release to Southern California Gas Co. - 42. .CERTIFICATE OF OCCUPANCY No Date . Gunite ) ' RE. _AT OF INSPECTION ON Masonry ( ) Concrete ( ) talsik TO: COSH ("nosA / Address: `7 9/-2q OWNER: PROJECT: Swb,.imca, Cp Report No. Address: aaaa. SA1-(34t'jJ Cssi%1.viP�) Permit No. 5IRd7 Architect: . anmert. AjLs Contractor: LAvoar (dols Address: Address: c I Engineer: f?ga5ew kgame)r Subcontractor: caerpa/1e (Gunite) ' Address: Masonry or Concrete) Inspector: r. c-ifo>- Address: Mix Used:y'a- Slump, inches:-C)- Admixture:' -- Designed Strength, PSI : a•rOo ' The following inspection was performed in accordance with the approved drawings: Cu.Yds. No. of DATES Placed Cyls. Remarks eo i tic 13iRee 21t�3) g Getvp wines i+u31'e bah rZtv.,P 120, --in Ant Alwtih.Po To S-ieei, . Sire/ ) (�,h. %�.�. fad, crier( Cle.u]rytite J w n> krng,...5h4) tir.,�a- QC-Su L{ S Lta Copies of Reports to: (Indicate which Bldg. Dept. 6 furnish address of any not listed) I f7 4i, di Twining Laboratories °f CSoutJ to cafLfo=nLa. -1124.1/4, A 'A 3310 Airport Way / Mallon, Aanress P 0 Box 47 / Long Beach CA 90801 / 12131 426-3355 / (2131636-2386 / (714) 828-6432' TESTING BRANCH ornCE 1514-o Nonn HanJ✓- St'ePt.Seale Ann CA 92703 1>14I 531,2045 June 24, 1981 Examination: SC81-3976 COMPRESSION TESTS ON GUNITE CYLINDERS Max Sitter • P.O. Box 3454 Fullerton, California 92637 PROJECT SPA • ADDRESS 2222 Sarbrook, Costa Mesa SAMPLE FROM main drain • ARCHITECT CONTRACTOR Landers pool Landers Pool ENGINEER SUICONTRACTOR Reagan & Kramer Enterprise Gunite SPECIFIED • MIX 4.2-1 STRENGTH 2,000 psi DATE CAST 6/10/81 SLUMP SIZE 6-1/8" x 12i" DATE TESTED 6/20/81 SPECIMEN NO. A COMPRESSION 10-Day TOTAL LOAD, LBS. 78,000 POUNDS PER SO. IN. 2,648 • COMPLIANCE 10-Day test complies with specifications. MADE IV DELIVERED IT RECEIVED ON SPECIMENS Dale M. Sitter 6/11/81 DISTRIEUTION: �. is'i.'� is L.) MSitter - 3 T t.--Costa Mesa Bldg. Dept. 1 29 W81 • Neale Zuidema •LL REPORTS •at suaM'InEo As THE coN'IOENr'AL PROP[RT. OF CLIENTS. • THORIZ•TION FOR PUeuulmn or OUR REPORTS. CONCLUSIONS. OR El r R•CES lROo OR REGARDING THI.. 15 RESERVED PENDING OUP *KITTEN APPROVAL AS • MUTUAL PROTECTION TO CLIENTS, THE PUBLIC AND OURSELVES 330-12 ce° 2t ellt►.%Et, Twining Laboratories 0,-gout€ttz Cauift1=ta, L,u• • - - 3310 Airport War 7 Mmling Acdre.ss P 0 8o• 47 1 tong Beach. CA 90801 1 17131426-3355 ' (213) 636-2386 /(7141828-6432 TESTING B841:66 Of C) 1514-0 Norm '1-'n,' 51, -: S A, ) C>1:7/03 1711)53'-2045 June 24, 1981 Examination: 5081-3975 COMPRESSION TESTS ON GUNITE CYLINDERS Max Sitter - P.O. Box 3454 Fullerton, California 92637 PROJECT SWIMMING POOL ADDRESS 2222 Sarbrook, Costa Mesa SAMPLE FROM shallow end, transition, main drain (Cyl. #I) (cyl. ILII) (Cyl. #III) ARCHITECT CONTRACTOR Lander Pool Lander Pool ENGINEER SUBCONTRACTOR Reagan & Kramer Enterprise SPECIFIED MIX STRENGTH 2,000 psi DATE CAST 6/10/81 SLUMP SIZE 6}" x 12'1" DATE TESTED 6/20/81 6/20/81 6/20/81 SPECIMEN NO. I II • III COMPRESSION 10-Day 10-Day 10-Day TOTAL LOAD, LBS. 94,000 103,000 90,000 POUNDS PER SQ. 1N. 2,840 3, 108 2, 717 10-Day average: 2,888 COMPLIANCE 10-Day tests comply with specifications. MADE BY DELIVERED BY RECEIVED ON SPECIMENS Dale M. Sitter 6/11/81 Max Sitter - 3 ITT.; 2u 19W `costa Mesa Bldg. Dept. Neale Zuidema •,L REPORTS .RE S.ew,n\D •s t"( CORIIOINruL POOOCRTr C• CI IF NIS AUTHORIZATION FOR PUBLICATION OF OUR REPORTS. CONCLUSIO.IS, OR u. TR•C1S •RO•• oP nr..•#Or TI/EM $ PISERVED PENDING OUR w •s •PPPOv•L •s • MUTU•L PROTECTION TO CL,Esrs. THE PUBLIC AND OURSELVES 330-12 Applicant to fill in all spaces within heavy border lines and.sign all appropriate declarations. 11.111r . CITY a RCoSTA MESA PERMIT NO. - s TRACT NO: LOT NO'. •BLDG.NO. P ' - -' ' "CONST UCTION PERMIT rE ` 73 4718 S/ /EI ' 51 .50 TL Project Address 2 Z 22 A. 5A C4 .Maas k_ LP J Cs ` TYPE OF CONSTRUCTION " 1 Owner 1.^C to L�A/01,1 Suss -W-IG• Phone NEW 0 ADD 0 ALTERATION � _ I (Address - - - - ❑ REPAIR 0 CONVERSION ❑DEMOLISH • - . Arch/Eng. License No. - ❑'OTHER ZONING REGULATIONS DESCRIPTION OF WORK WAT 9I �ArIJAL A'P'$ - 4 'Address - - ' -cosset Rs�60, �1 r2 LW� ZONE PLNTGo. REED Contractor {�� L < [--(eC - Phone '3 rj Z(q$ TYPE OF PERMIT' SETBACK C/LST. PROPERTY Address 21IS N. MAINE Sr. Sc ats PuJW ❑ GRADING 0 FOUNDATION 0 STRUCTURAL ' SIDFT YARD ' "' ' ' - LICENSED CONTRACTOR DECLARATION ❑ TENANT ELECTRICAL ❑PLUMBING ❑MECHANICAL SIEDE YARD - - - - — - I hereby affirm that I am licensed under provisions of Charter 9 (corn- RIGHT - mencing with section 7000)- of Division 3 of-the Business-and 0 OTHER -. -. - Professions Code, and my license is In full force and effect. REAR YARD(TO P/L) PROJECT DESCRIPTION License Cass C 1d .'OJI License No5 - 'PKG.SPACE REQ. PROVIDED - bate 9l$19f - Signature �ICIt2_ct 4/2140.0 - SQ. FT. . - . . . . - - - _ WORKERS'COMPENSATION DECLARATION OCCUPANCY_CONSTRUCTION TYPE STREET WIDTH I- PARKIPEE$ I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION ZONE ZONING APPROVED BY - DATE - . certificate of Workers' Compensation Insurance, or a certified copy • - --- - SPECIAL CONDITIONS: - - - --eof(Section 3800, Lab. C.)• /� GRADING CU. YDS. ACRES - I"NpM4rli 4400 Ogg company4A4 COAL. &Num • . . - _ . i ratified copy is hereby furnished. Assort-ardor CQ1• -REMARKS: ' .- . . . - .. IS Certified copy is filed with the city Building Division. P. • `� 9 Ro ' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - " (This section need not be completed if the permit is for one hundred . . ($100) or less). - - - - P certify.that in the performance of the work for which this permit is _ -.issued, I shall not emloy any person In any manner so as to.become PLUMBING • . PLAN CHECK . • .- ELECTRICAL PLAN CHECK r ibbject to the Workers'Compensation Laws of California. - UW ELLING - GHHAVE Date Signature BATHTUBS SHOWERS 50 FT SO FT • ' . NOTICE: if after making this declaration, you should become subject TOILETS - • URINALS "" GENERATOR 0-1 KW_1-10 KW - - • to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW 50+ KW - revoked..- - - CONSTRUCTION LENDING AGENCY KIT.SINKS - • DISHWASHERS MOTORS 0-1 HP 1-10 HP r0 IO op I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS ' 'SUMPS - - • (INC.SOLAR) - 10-50 HP 3-,50+ HP • i 0 Sb formance of the work for which this permit Is issued_(Section 3097 • ' -' -' FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES ' Lender's Name _ _ _ _ - Lender's Address - - - DRINKING FOUNTAINS -- GAS TUBE SIGNS ' ' OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS- POLE LIGHTS ' - ' I hereby affirm that I am exempt from.the Contractor's License Law for , the'following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL PTRAP ' - +LUNEIRULIIUry . „ Any city or county which requires a permit to construct, alter, POLES METERED SUB improve,demolish or repair any-structure, prior to its issuance,also-re- WATER SERVICE ALTERATION - PANELS 2_ ' MAIN SUB quires the applicant for such permit to file a signed statement that he - - • iIs license d pursuant to the provisions of the'Contractor's License Law GAS SERVICE OUTLETS • - - .SERVICE' -2 a4 (24/244 3 AMP(Chapter 9 (commencing with Section 7000) of Division 3 of the 'ness and Professions Code) or that he is exempt therefrom'and the WATERHEATERS BTU OUTPUT - - ' ' . ,4,w lfor the alleged exemption. Any violation of Section 7031.5 by -Str - 1 applicant for a permit subjects the applicant to a civil penalty -SEWERCONNECTIONS - - ',ot more than five hundred dollars ($500).❑ I, as owner of the property, or•my employees with wages as their- SOLAR-TANK COLLECTORS - - . - , sole compensation, will do the work,and the structure Is not intended - -- - - 'ISSUE FEE "--' - _ " or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. • Contractor's•License Law does not-apply to an owner of a property - y APPLICATION APPROVED-BY ED'BY who builds or improves thereon, and who does such work himself or ISSUE FEE DATE through his own employees,-provided that such improvements are not intended or offered for sale. If, however, the building or improvement MECHANICAL' PLAN CHECK SUMMARY OF FEES is sold within one year Of Completion,the owner will have the burden - • of proving he did not build or improve for the purpose of sale). BUILDING - - • HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP S • ❑ I, as owner of the property,' am exclusively contracting with AND DUCTING " -- - licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT • and Professions-Code: The Contractor's License Law does not apply to • - . ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU • PLUMBING $ . • tracts from such projects with-a 'contractor(s) licesned pursuant to SYSTEM • - _ - GRADING $ the Contractor's License Law). 100,000+BTU :PLAN CHECK S • _ . ❑ am exempt under Section • B.& P.C.for this BOILERS BTU ELECTRICAL S moi'SV S reason -' - -- _ MICROFILM $ (V SYSTEM REPAIR,ALTERATION PLAN CHECK $ Date- Owner - • - MECHANICAL $ TOTAL FEE$ I ' • I hrrtify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE _ LESS AD- infoormatiomation is correct. I agree to comply with all city and county - PLAN,CHECK $ 'VANCE PC $_ .I ordinances and state laws relating to construction„znd hereby authorize - representatives f this city to enter up n the above m nt ned ., CI property for ctio /me& SU I Signature _ "— +"�`�•� / ISSUE FEE - - • - - _. _ CMF 0865-46 'White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor • ' CONSTRUCTION AND PLANNING POOL&SPA1 ) Date Inspector - Date Inspator APPROVALS Permit# APPROVALS • Permit# _ 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn _ _ 46. 'Electrical Bonding _ - 5. Steel Reinforce 47. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE ' 7. Footings . 49. Electrical Conduit-Undrgrn. 8.. Foundation ,. 50. Gas Pipe, ❑Undrgrn,Test • 9. Water Pipe-Undrgrn51. Backwash Lines, P-Trap. ElUndrgrn ' - ' 10. Structural Floor System 52. APPROVAL TO DECK ' 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final .12. Street Sewer Connection _ _ 54. Heater & Vent-Final' • 13. Rough Plumbing - 55. Plumbing System - Final ' " - 14. Rough Electric-Conduit • -56. Electrical-Final - 15. Rough Electric-Wiring - • - 57. Solar System-Final . , 16. Rough Heating & Air Conditioning -. - - - 38. Fencing & Access Approval - • 17. Ducts, in Structure, - • • 59. APPROVED FOR PLASTERING - 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL - 20. Roof Framing 21. -Roof Sheathing .. 22. Frame and Flashing NOTES: 23. Insulation . - 24. Lathing & Siding • . - • • 25. Drywall Nailing. . -. • • 26. • Plaster Brown Coat 27. Electrical Power Meter-Final "-' - _ ' 28. - Final Electric - . - - . , 29: Final Heating & Air Conditioning - , 30. Final Gas Pipe-Test - _ - 31- Final Plumbing _ - 32. Water Service-Final _ . , 33. Gas Service-Final . . - 34. Solar Domestic-Final • • - - - ' 35. Landscape Sprinkling System - 36. Sound Attenuation . ' - 37. Handicap Regulations - - .. 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed - ' 40. Electric Release to Edison - . 41. Gas Release to Southern California Gas Co. • ,. 42. CERTIFICATE OF OCCUPANCY . No Date • 2 5/05/61 99.64 TL COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR O(RUCTURALPERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 RE EQ,BY 'PERMIT c/ o ,r tFor Applicant to FillinCompletely—Use`e Innkk Only GGLFJJCL ,/ y� a ./ ADDRESS 9....-2.22 BUILDING : 8 eal A.P.NO. .4n..-.c/3 -42. OWNER OR I cd\w , A AD DRESS as as 5/9-yg,e,OOk TENANT UNIT OR MAILING (^ SPACE NO. ADDRESS 2"3.-Z� r{i'tZUL .) Tp O. LOT 4_2_ BLK. �n ` TEL 111jO CITY Ce' itA- L v`le�� NO./7S-2311 CONSTRUCTION NEW ADD ALTER 'REPAIR MOVING DEMOLISH LENDER // BRANCH {� Q � ' A • OWNER �1S Se- 4 ADDRESS ARCHITECT y�j //, �TELg� USE �-Q Qi VALUE$ lam OR ENGINEER F— F�2AJ -P—4 4e�/ NO.OJ�— p ADDRESS Less el c--7,0.4%,-....„..., ee€ i ZONE le TYPE ' GROUP — APCONTRACTOR 1 44 \&I-c altd./EX'[ALJp7ty/�.BYPROV ED DATE ADDRESS t�J both ((t✓gs �_ {/ TE F CITY �N E:24.4_,.... / NO�' 8.?1f � APPROVED SETBACKS - g LIC. NO.O ,5-3_-_- 6,90,3--r) LIC. NO.11R 3 (FROM C/LSTTR ET) ,�rt �� ���� 4 OF LOT NOW ON LSIZE NO.OF OS FRONT /15 FT. /7Vs+C./Y;P�J) Q USE OF /-�-�//��) f /0 ^ EXISTING BLDG. R.SIDE /j.lFT.0 FSeparate permits are required for L.SIDE 2 6FT. O G electric,plumbing and heating work. REAR /�!C/FT. 0// FW USE OF BUILDING AND WORK TrO BE PERFORMpD PLANNING ACTION O e • • Q j� yez, ADDAPAPTTREO Sfra VED ,s —S —c 7APPROVED —BY ,e/et J —c9/ W 0 I hereby acknowledge that I have read this application and state o' Ix that the above information is correct and agree to comply with B. all laws regulating building construction, and I shall not employ' - i Z any person In violation of the workman's compensation laws of the State of California. 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 al Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: IS am exempt from the provisions of the State of California Business y VALUATION PERMIT FEE $ O0 and Professions Code,Division 3,Chapter 9. S/j P r$ 00 D n Permtur�`crp � 00 ' PLAN CHECK $ 3 9 00 0 l Per Or .._ $ 1 A) ' TAX $ g"'41 2 t3 or rf U V Authorize nt Date TOTAL PAID $ 99 ,9-.7 2,222 shy gg O\<- ' COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION'F6, ,iLWOW&PERMIf8747 Ttd ' P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 r RECFBY 'PERMIT B For Applicant to Fill in Completely —Use Ink Only /, ///777 N- 5108 1 ADILDING DRESS /6 --2,267 �WR'c�/LrLU A.P. NO. („(/9—(0�/3.—a/,a OWNER OR �J ADD RESSd/2(ZfS 2Z`z / r7f+�+� TENANT /7 _WNW t/. j erkep I.A.C. UNIT OR MAILING ,. LL •/� //„_ � .SPACE NO. ADD RESS,�s,3/ G, aid.I.,,-- /STEL TR�vrip- LOT Z/� BLK. CITY C 0,7 NOL%7S--2,3// 1? 7 CONSTRUCTION//_ _ /Caw C NEW ADD ALTER (REPAIR MOVING DEMOLISH /jp/r7G//'� s� ,11.— LENDER BRANCH /�/� /J� ADDRESS / 70.2 /Uq.-. N14141 Sr:S' OWNER W(/C�jl�k.d��v�j ALUE OR ENGINEER/`/, ` eanse. ' /9,,NN Sim. USE I� s`�V A (/I/TWO $S/y(�� ADDRESS /4 N. 019.64 . - ce 't/GC ZONE �r TYPPEE I GROUP r'� --3 /' �+ APPROVE /Z/S e0 CONTRACTOR PfJ,a C� A45-[7 BY �( I! DATE / ADDRESS MC- [. r 7C/ q .�J CITY Coll N0.TEL4W.1-+472.... FSTATE 2 p CITY APPROVE/TB KS iLIC. NO. 3478/6 LIC.NO7tit a.0 W SIZE NO.OF SLOGS. (FROM C STR ET PL OF LOT NOW ON LOT FRONT FT. Q USE OF cn EXISTING BLDG. R SIDE FT. h F Separate permits are required for L.SIDE L1 electric,plumbing and heating work: REAR FT. idireiel EW„ USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION 'C Q 4N DATE APPROVED _7 AP / // !--n R/ a W aI hereby acknowledge that I have read this application and state • m that the above information is correct and agree to comply with 6• all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of 2 Wthe State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. ry D the State of California eusi Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR CO Chapter 9, and that sue icenses e in full fore d effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the rovisions the 4fa' orniusiness VALUATION PERMIT FEE $ pONantl Professions Co Divisio Chayt PLAN CHECK $ /2434.5 tc Signature of Permittee $ S/ 000 TAX $ 3. 47 U Authorized Agent Date or rI �yr _ / '7P7 TOTAL PAID $ 2t 07 OWNER McKINNON-BIBB PROPERTTFS• INC'. DATE 11/13/80 JOB ADDRESS 2222 Saybrook Lane BUILDING PERMIT NO. 49905 GENERAL CONTRACTOR J, p, Mac _ is. DESCRIPTION of WORK ,., •.,,,_e t..„ APNo419-012-19,22LOT 42 TRACT 0856 FIRE ZONE VALU $ 12 404 00 INSPECTIONS Signature Date TVPE \7 GROUP p-1 ZONE R4 Sr PERMITS ISSUED C- �1rieiarzgu . a-'LSUBCONmRACTOR re WATER Date I Number Signotu Plum•in• ROUGH PLUMBING �/ 2-2-9 igo • PROP. SWR. LINE f�HOUSE CON. m SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND E I POWER 0ROUGH WIRINGNearing and Vent. TRENCHES ' FORMS III STEEL REINF. Li FLOOR SYSTEM BONO BEAM in STEEL REINFORCE TII -- - SHEATHING FRAME AND FLASHING LATHING - IN OUT n PLASTER. BROWN COAT STRUCTURAL, FINAL 1 c /, p HEATING. , NR AND A.C.. FIN AL ��� `,�?/ I a,� t prat, E.---f/I _11(c. , P' 'NG. FINAL AND GAS TEST ` 'iy G !/yin EL (IC, F INAL C 4f,(fj, BUILDING. FINAL .9.4 , . , r 156.67 It �, 'OSTA MESA BUILDING-SAFETY DEPARTMENT . • APPLICATION FOI. .RUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA'92626 j. popppp RECEfal PERMIT /, /�//Q For Applicant to Fill in Completely-Use Ink Only ! (,/q Li F%7!7/J ,BUILDING - A.P.NO. `( —1�1 �- q 1 ADDRESS 1 �jJ. COSTA -, OWNER OR ), BUILDING /f �r/1�ty �Q 'f ADDRESS /� /-O� hr TENANT AV-V41,31,334,1 _f3taa1 tlCatifl(� INj C. UNIT OR MAILING ��_ SPACE NO. • ADDRESS 2.73.7 1_ Cc.4tr H' Y * Q V-S LOT4jv BLK. J TEL.) CITY C012611/4)4 12S : l•L NO. /,752')11 \© CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER /� BRANCH• !/ OWNER ADDRESS �j�J VALUE ARCHITECT a� �` (,0� 4 TEL USE4 ."T'"�Itayt. . $�2y1/4k OR ENGINEER t �j ,N`O. (q /� 1 Q ADDRESS R%R opa... 1 ,ff^ isievartitt (Strew ZONE 3 YPE y GROUP R _ I ..� ,,� APPROVED CONTRACTOR/ L """""" J BY DATE ADDRESS kbb/��� ���"""��J TEL. ^'- -- CITY NO. , FtAPPROVEDCITY APPROVED SETBACKS gLIC. NO. LIC.NO. Na OF BLOTS. (FROM C/L STREET). ^ 4 SIZE LOT I NOW ON LOT FRONT FT. g4 V -/ Q • USE OF n C � EXISTING BLDG. R.SIDE FT. (� h F Separate permits are required for L.SIDE FT. /I//, ti C electric,plumbing and heating work: REAR FT. i�/- C~ USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION Q . Q �j DATE `-1 S:l�(lAncit3E'-, pcJt.L 'OgrrA OT t2M j APPROVED W Q ' ' t v LWreTO(LI t —BYPROVED DATE yA a SiVaige TVl t�-.1-AtC,. - • - Li, •� Ly 0O I hereby acknowledge that I have read this application and state 0 s' y, that the above information is correct and agree to comply with L all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of w w the State of California. n /J [/ 'Z 32y SO. FT. f 7> 907 — N 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 o Fa Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: -- am exempt from the provisions of the State of California Business y and Professions Code, Division 3,Chapter 9. VALUATION PERMIT FEE $ 64 h �j �Q/// 44v......_ PLAN CHECK $ /•I Q G Signature al��Q/o(. •�i . • to , Permittee $ TAX $ /0 O—T U. or • i O U Authorized Agent Date �"." `���' TOTAL PAID $ DS Y OF COSTA MESA BUIL SAFETY DEPARTMENT POST IN CONSPICUOUS PLACE ON THE JOB • DATE ISSUED p /,'- i3 - 8o PERMIT NO. tug — ons-- /9,a:. it47Q BUILDING ADDRESS 2z7-a Sw brook L.I.. TRACT LOT BLOCK t!0 r 6 k NEW ADD ALTER REPAIR MOVING DEMOLISH OWNER Mc k l;it .lit 0 A.t _ Pro, . USE • eylotiatte 44.4- rem_ ' FIRE ZONE TYPE GROUP 3 u,v /4"' SETBACKS Front Yd Side Yd. R L Rear Side Yd. R L Rear BUILDING INSPECTION RECORD TO KEEP BUILDING PERMITS VALID, WORK MUST BE COM- MENCED WITHIN 60 DAYS WITH ROUTINE INSPECTIONS AT LEAST EACH 120 DAYS THEREAFTER UNTIL COMPLETED. STRUCTURAL INSP. DATE Trenches ❑ Forms 0 Floor System Steel Reinf. Sheathing Frame and Flashing Insulation Lathing — Dry Wall Nailing - -- - Plaster,Brown Coat Sound Attenuation Handicap Regulation 4 FINAL PLUMBING Soil Underground Water Rough Plumbing Prop.Sewer Line and House Conn .- -- \ - Street Sewer Conn.Water Service Sprinkling System �1 Gas Test FINAL 1 HEATING, AIR-COND.AND REFRIGERATION Ref r. Lines,Pressure Test Ducts, Underground Ducts,in Structure Ducts,Ventilating Rough Heating and Air-Cond FINAL ELECTRICAL f 4 Temporary Service or Pole \ ` Underground � Power Meter • f Rough Wiring FINAL Do not occupy this project1/4until final,inspection has been made and occupancy has-been approved Building Final Special Requirements Occupancy NOTICE • 24-hr. notification required when the job is ready for inspection. You must furnish PERMIT NUMBER and the JOB ADDRESS FOR EACH RESPECTIVE INSPECTION. CALL:,6 -.,273. APPRO V " " CMF0559-46 rnR INCPr(:TInNR rAI I 7Fd-FF971