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Home My WebLink About3409 SANTA CLARA CIR - Building Permits�nnnessocew�m+o: 3409 SANTA CLAFiA CI �'+*� owxeasru�eau+orm:FiADDELL, JACKSON' L FLOOD: .oaness 3409 SANTA CLAAA CIR COSTA MESA,CA 92626 �av�. xaiuxo �ooness: APCHRECT Ofl EHIiNFFA: ACX.OP fNO.'S ADUNE53: uc. no.: UHI: CITY OF COSTA MESA — BUILDING PERMIT AH-38 � PERMIT NO: M 086213 PLAN CHECK NO: N Z�' CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC JOB DESCRIPTION :.FAU CHANGE—OOT CLAIM VALUE: � CALC—VALUE: c«irnacrarsru� MC KENNA' S AIR SUPPLY ( 714 ) 879-4444 cartn�cToaswuuxo 761 N RICHMAN AV �sr FULLERTON CA uc.xo_ 626029 92832 urn: IJCEN5E0 COHfF�CTOXS DECLANITION: I heroEy tllim uMx pemlly d pmjury ihet I em 4cereed under prwisim� d Cheqer 9 (wmmeevrM Milh Seelion )OW) d D'msun ] d tM Busroa� eM Pmlmtlau Cods. ard mY 4oeros u in lutl laee enE alled. cmuc.No.:06�9721 uc.cuss:c Zp uc.No.: 626029�/ EXPr�04/98 Dete: �� I/ �7 Cawedar�/,G.i.�lL2 NyN//i�i /W��KO�L , �, OWNER BUILDEP DECl1N�TION: 1 hneby elfum uMm paWy M perjry ihel I em uemq Imn Ihe Caqrtlm license Lew la tlro lollow'vi9 reawn (�� 1.5 Bueiieae eM Ndenione Code: �rty cry a munry whid� �ui�es a permn �o camvun. al�er. improve. demd'sh, or repv erry shucWn, p'v b m saue�w, a6o repwe+�he epplireN la wrli pMnV to Rb e eyneE HelemaM Ihet M a eM ia licemeE W�a^� �a tM pwisiona d iM CanVedora lixrea law �Cheqs 9(wmme�np wuh Saqion )OW) d DMebn 3 ot ihe Bu�'uwa ard Rdea'vu Wdel «ihm he u eha e uemP iherelmm eM iM Wan la the eAeB� memqon. MY vidmion d Seaion )0�1.5 by eny epplirant Iw a permd eubpua IM eppfwn to a dW panMy d�w1 mae ihen fxe huMrad dd4n �SSO�p. � � I.moxwdiMpapeMam�snplo�mexinwapeamtheiademnpmamcn.w�doNewoh,eMtMatrwuroemimeMeE � w ollereE fa eab (Saclbn lou. Buiren ud Pmleaaion� Cotle: The Cauredon Lioenss Lew tloae m� eDdYb en owrwW wweM. xiw buiM a inpevna theeeon. eM Wq tlae+vuth wdk h'vnaetl a MnN a RYdpA hc a Iwr am empb�eet. pwkeE Ihel euen impmvemeMf are rot imerded n a1�saC Iw eeb. X, lawever, �M Wildi�q a inpivverneM ie eold wil�in aro yeu d complelion, IM o�.,�e.a�nfer win nava ine wd., d v�mo ns « en. ed m nwd «�wa+� �na wm� a edel. .. � I. ea ovmer d the V W�tl. em ssd��valY mmrer!^0 xdh 4mmed oon4aYae b mutrutl ihe pol� (SMun ]OM. Bueiirss eM v�are�. coro: rne c�unad. uro� �w me. �a wch m.� o�.nm a nwem .no n,a. v�o... me,so„ d,e .,m wnvecte 1« wd� wd�s wnh e mareaMa) IicMwE O�uem m iha Contmrlae lirensa lew). � I em exempt uMer Sxtim: B. 8 P.C.. br Nia roeaon: Date. �: I Eo M1ereby caniry rtw I em ewere A vM wdentarW IM requremart� d CeOanie IbMh entl Setory Code Seeiau 25505. 25533. eM 255N, vM thet I a vry Mum buiNup oaaqe�u WI / wll m� (eicle ane) need to mnply wIh eeid pete cads� eM IM reQuinmen4l« e pemiil irvmmvuetbn a moEifimionhaniM�i�iia tiyRiv�apenw�u Oinein. Raddxuil wm�ueun eppf�'vroen emmq liom IMee „�ea�,. o�e: ��: WOPKER'S COMPEN9�rI0N DECLRfl�TON: I Mraby dfirm wdar pxaAy d prjury wr d Ns Idbvriep Exieietions: � I Mue end wil meiMan e cenEi�ata W mroeM �o aMlJiwne b whae' wmpnWion. o pwided ta b� Senun 9)W d IM Lebar cod.. �or �ne o�ormeiK. d 0,. uat �« wl:u� uv. w� n 6.u.e. _[� I heve and wil meinlen xarFaa' mmpeneetun ireureMe. ro rpuired by SeCion �]00 d ihe lnbor Code. b iM peitormeMe d iM �� work lor Mkh Uu W�e b roued. M' wal<n' oom0�mion'vwrenca ranier eM W�Y wmber ma: c��: STATE FQND EXPIRES va�vr+�me« t2��-Q7 10/O1/98 mll! BOLTMII IIM� /Id �11 CU'IIC�b / IiM iM�tY iUI Y'M �IYIIQICQ �IIB �i100� b �PY.f � I dnly �hel in IM pafmmrca d �M work M whkh ihis pemtit b iseued, I WY nd anpby eny pxvon in any manner ro o to become wbjea io IM hvkera' mnWammian le�w d CWanie, aM yiss Ihtl ! 1 slauk bmane euEjw io tM Mwken' ownpa�n7aeiion qvnsiom ol Seaion �]00 d tM Lebor Code. I My IaNwnh mmpy� pwieione. Deie: �i'-'��—�% Aop:�aru: � �,l/�+�%"t"L� Weminp: Fellun ro��cun wa�kwi ronpwwtlon oovenp� h unNwNl, mtl �IWI rtlf�ct en �mployw roWMrul p�n�Mu �nL c/Wl nnu tp ro on� hurOrM fhouaW Odl�n lSfOq000A h tl01bn ro tM cwt ol m�owwWn a�p� u provltlM ror In Swtlon 9106 0! M� L16ar Code, /nMuf, ena ettumry'� /w�. CONSTflUCTION LEHDINO AGENCY: I Iw�eby dfirtn iuder peneAy d perj�ry ihel Ihae u e wMrudion bMi'q epmry br �M VeAortnerce d IM xvrk Iar whidi Ihc prmY O ewetl (5seun 3081. CM. CI. LENOEfl'S NAME: LENDER'S ADOXE%: 1 ee�ih �lat I heva ea+d Utia MP�reibn end aeis thm Ne eEo.a'etlortmtion u emm. I Wiae io eandY wGh M mY enE couM�/ ord'vwima enC eleb kwa reletirp lo build'vq canemimon end hmeW einAaae iapreaenimiven d Iho ely io entar upon �M ebwe-mentioned qoperry 1« impxiion Wrywes. DONNA TERRANOVE �m r�s � ��—C/,�—.,.�-� Dme: /� /J-1!% s9� re a mnwJros�✓nw�ae« (5151<6.WP) While-Buildvq d Selery; Orm�rFb: Cene�y-Appicenl; Pink-fievenue; GWEeniod-Nesereor PERM NO: M 086213 GOVT: N SUPP; N PURPOSE: OTH SQ FT: GROUP OCC: R-3 / COMMENTS: NO OTHER WORK AUTHOAIZED HY TAIS PERMIT *�+t+r**�+r****+rrr*�r*x�r*+r�r+r+r�t*+�**+r**r**�c�r�rr*�****+r******��t�r**�r�*+�*****+r**�r�***�r�ex�* Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING_---------- ---------_ACCESSORY HUILDING --------- FANT: FT IN REAR: FT ZN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ • PROV: PARCEL: 41206311 ZNE: REF NO: PLANNING NCSTES> � M iE if M M ik k iE ik ik iflF if if ik M i! k iFlf if 1t k 1E if ik M 1F iF 1E iF 1f k if if iF 1k 1kll� k 1F ik ik iF iF Ik 1f fE iklE iE* 1E Ik if'1F iE'k iF iF 1F if ik k!k iF iF iF 1F iF if iE if iF M k iF if iE D E V E L O P M E N T S E R V-I C E S R E Q U I R E M E N T S ZONING APPROVED _BY_ _ DATE: BUILDZNG APPROVED. BY.: DATE: �-i APPLICATION ISSUED__BY: ' DATE: �2-��1 ��1 **�r�***rr*****xr****** *******��t*�i��r* LEGALIZATION:N__.__ __ F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT ___ 13.25 25i SMIP/NON-RES PLAN ISSUE FEE 22,00 BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE TOTALS----> 13,25 22.00 0.00 35.25 35.25 .00 REVENUE DIVISION TOTALS--> COLLECTED: 35.25 OVER/SHORT: .00 BLDG PMT PLUMHING ELECTRIC MECHANIC FIAE SMIP/TOT GRADING PLAN-CHECK 35.25 ikiFififkMMitififitltMMlFiFiFM1FiFMifitIFMKMifMikiF%iFif1FlFiF1FiElfiEiEiFiFiFifNiFiElFMifikikikifMkiFMkikikiFikiFMMNMkkiEiEikiEifM1F I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST MEC 1 INST FORC-AIA/GRAV FURN <= 100 K BTU 13.25 13.25 END OF FEES 12-1)-1997/11:52 NA/535.2� fiCGTq:fli-�3i6967 PEkF1IT=086213 CONSTRUC710N AND PLANNING FOOL & SPA APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service�or Pole 52. Pool & Equipment Location 2.lSoil Pipe-Undr rnd.T d 53. Steel Reinforcement :.p��lectrical Conduitl3�jliry-Urulrgmd. 54. Forms . � 5 C � :�74.�Elec[rical Condtrir•Undrgmd. 55. Electrical Bonding ��:5::`.T,$teel ReinforcerAeiit� 56. flough Plumbing & Pressure Test '�" =i -�a�:�+Electrical UFEf3�6rnd. 57. APPROVAI TO COVER•GUNITE x �� 1 �'^ ` 58. Eloctrical Concl' t Undr rnd. � :�,,��ootings -i �1�, g ;�� 8�`, Foundation �� 1 V 59. Gas Pipe, O U�rnd., Test ' 79� Water Pipe�U��gY�d.^ 60. Backwash Lin�i,TfTrap, 17 Undrgmd. �A � 10: Structural Floor:Svstem r� 61. APPROVAL T�,S DECK 11.;Rroperty Sewer LineQ& Hou jwConnection 62. Backwash & Receptor-Final 12.�ewer Cap c: 63. Heater & Vent�Final , ^13. Roof Drains ^ 64. Plumbing System � Final �4. Rough Plumbir� .� X 65. Electrical-Final :15. Rough Electricai-Cooduit •. 66. Solar System-Fti*al . �6. Rough ElectricWirin�{t � 67. Fenciny & Acc��nproval ,�17. Rough Wiring S�ign � 68. APPROVED F�7ki�PLASTERING 18. Rough Electricai��T Bar Ceiling � 69. POOUSPA SYSTEMS FINAL� 19.�Fiough y_gati6+g &�Air Cond+tiaqing ��- x y �; ,�+; � y{��:p,�P7�EQUIREMEP}�S < t*) ^ (ti � a 's1 k :� ;r; 20.=Ao�h Fa�ctaol� F+r.�4ilace ' �." =�" M S�-+ :�+� f: qpp'�pv�P;2�+F p�rmit #'� r 5' r. � x � * '-. ^7:: .. `t"3�7 2L�ucEs• i , . tru u � ; �. .. � � �; q ,� �tx 70.FUndeigncamd IY�dro * 22.,'^Duets, �6e",�tilatin¢:� i r: � O �a: C' H* . 71. Prod '�iPin�Gas �Oil 23. �Gas'Pipe.:k`ioJ$h 8t.'i�*est �-.-�. ��, X''' r c^ Ss 72. Undergraund F,�jus .� j� 24. Roof Fre,�ming ' X ' r, : ��* • 7�,� Undergrr�d. Sto'7a�e Tani� O Gas ❑ Oil � 25.,RooiShrathin Y{ � " �'�{ " '` 9 � x � 'r, ]a: f4�. Overhead Hyd�g�� +c 26.r3-Ba� Ceiling (Stc¢Cturail & M�iScoat X O %+ _ O s 7$, Dry Ch ` ical `•' � x ,� 27.`Framearad Flashi R �� ^ "` :" �* S F'm * ^ ;: ., �s � q:'J r �+: :�x 76. Dry Stag,c�piPec�.-� .� O nl �• 28. latfiing^ Siding�t '7�; � n` I 1, FIXED`$Y�ST �FINA��'' �' � ., 29. Insulati �'�: S.. i` � I f T � m +> x�� Q?s ,>� ,� ;� � S * 78. FIRE PREV. fifNpL x � 30. Drywalltl5ailing ��« .� i e F• � � n 5 NHEALTH DEPn . RE�UIR�EMENT � .� . :. r. �� 31. Plaster &owlj�Colj",,�� ;•_';,'._,`�� ,��. � I ��; ' 79. FINAL'I.N�PECTION { 7 �, n c � • . . i -'C7: , . 32.-Electrical�Pov�r (uteterF,ina� � �� t� 8(i� FOOD CERTIEICATE 16SL1Ef7 'S �-. ti � r :n • < r -y 7n �: -y O t� ,`� 33.�inp11 Electri�y. ,�� S i;�„� � *; i * f�tes: � hr; r r� r ,.. � _ ., � 34.;fina'ZHeating iriCpnditioning �! z L?g � �e � N i i..�^� r. � ! .-� « •-. , r� 35.• Fina� Gas PipC-Te�x `-' .. X.� � � m� �,�^; �� n�+ ' 36.�io�orCanopv��n xr -- a� I *7 x� �n: - . - 37. final'Factory Fir�'p�jcG^ ' ' ` � '* �'" `'� " '�^' .� !'v k �7 Y �LW '✓1 .r :r 7 � 38. Fina7�Plumbing ti6� T� � �- 't� � I �s'- H�:u o � k� :C 39. Water ServicO-Finalx � ' z� 4 ti' * r -� < '/. i: i ;t �w • Y:l*7 F 40. Gas Service-Pinal .�. m n�,F., .j r� ` � ' tk - • N$ x� �� 4t. Solar �omesucFina� � .^•. �w -� I � .r ;r ��3 7 +' X� < L-r "1: Y �:,] � ' 1�1 ��/ �{ ..� 42. Backflow Pre�enter�, ,,; 1,..a �; ,._, ,� j �� i -. � iT1 �O X F + 43. Backflow Irrigation* • 4 �'� � n � *' '� ' r. -� c �I: :!� k :L �'1 �^ 'U C ' S Tl : .. �: .. � �: � , i.. r :44.�Landsca,Ve IrrigatioB System�� rr, * :4 Z��r � �, p �, 'rJr� x Z F 45.'Sound 6ctten'�atior* • • * � t�: '*. �*tr F m m v; � 'r7 > c n S # P7 ^ k � i . r.tn ••r. K 46..:iar}diwp'Regulaciops S .. ,� ;� � y .*, G �; * 37.�IMAL STRUCTURE & BUILDING �� t"' � � � n `� 7 � O 48.�EINI�L PLANNING; �"`" * " � ! ,� „ ,� �y �_' � S c',A9.��lectric ReleBse to Edison � • ' i ''• tr � �C�. * ~ � �� I .: <�. o � y n u ��0. 6as �elease to Sout(iem Califo��Gas Co M � � w. S �o "� �,; � '51. CERTIFICATE OF OCCUPANCY � � '" � No. Date AOPlicant to fill in all spares excevt those within neavy ooraer lines anE sign all aDPropriate tleclarations. CITY OF COSTA MqES qCOcN-ST-•RUCTION PERMIT PERMIT NO. TRACT N0. LOT NO. UNIT N0. Q(Q9 5I I 6/B� ') �/ ']�il�%/4 C�� /l� 3 335� 6.io.r7� � Project Address ` e w+c ApplicanYsMailingAddress/'�`�.S%/fli�f/CRE3ic/Q.`.zu'�ii/ivE TYPEOFCONSTRUCTION NEW Aoo aLTEaATION REPAIR [�` Phon�+J /�^��6 � CONVERSION ❑ DEMOLISH ❑ OTHER q,p.# Zone Owner's Name ^� DESCRIPTION OF WORK/USE OF BLDG. Address �� rA \�AaA C H S Main Building: Accessory Building: Arch/Eng. License No. TVPE OF PERMIT ❑ GaaoiNG POUNOATION ❑ STRUCrURAL T Front . p Addr¢ss ❑ TENANT ❑ E ECTRICAL ❑ PLUMBING ❑ MECHANICAI A Rear N Contrecror'sName Phone ss�� O7HER �EQOCIF C Right N /�YT]///6AY1PCs1 G�4 SRII/.✓a 92J�� PROJECT DESCRIPTION 5c�. FT. oCCUP v � Address (mailing) � (� CONSTRVCTIONTVPE VALUATION$ S S Left CityLicenseNo. �_/NZ� ZONE GRADINGCU.VDS. ACRE � LICENSED CONTRACTOR DECLARATION Ping. Ref. # -Parking Req./Provided E I hereby affirm that I am licensetl untle� provi51on5 of Cba�ter 9(commencing Remarks: /J - A I !�� PlanninJ NOL¢5: M with section ]000) ot Division '3 of the Business antl Professions Cotle, antl � t s�A �'� 1� /� 'v `ST Ed `sn"1/ my license is in full force an etfect. , � '- O,/2 � T �icense Ciass C^ icense No.3G/O Y � �rN •� 'ti at R NE /N �'F S DateS�' S'g t' �t/-1��.•�� Q�p p � PLUMBING FEES WORKEFS'COMPENSATION�DECI'A TION Bd/Si�k ShOW¢�5 ELECTRICAL FEES I he�eby affirm tM1at I have a cer[ificat¢ of consent to self-insure or a certificate oi Workers' Compensation Insurance( or a certitietl coDY thereoi (Seccion gackflow Preventer Service Sink . ' 3800, Lab. C.) -` "- P.utomatic Washer Transtormer ❑ 15-50 KW PolicyNo.T��Z�-/ Company S��h� �� Backflowlrrigation SewerCap Cans[ructionPoleSub. ❑50+KW eCertifietl copy i5 hereby fumishetl_I _ CerY ietl copy s (iletl with the.city��Bqlltling D' 'si�yJ on. Bdthtubs Sewer Connection COOkiny Unit Mete� ❑up to 100 amps Date �� I6 �� H APPlicant /C¢/ LL/wrr�Y- EXEMPTION FROM WORKERS' COMPE SATION DECLARATION Clarifiefs Solar ColleCtors DiShwasher Meter ❑over 100amps (This section need not be completetl if the pe�mit is to� one huntlretl ($100) or � less). Dishwasher Solar Pipin9 Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work fov whlch this perm�t is is5uetl, I snall not employ any person. in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors �0-1 HP 07 %- 8 Workers' Compensation Laws of CaliPornia. Date Si9nature Roor Drains Swimming Pool w/Spa F.A.U. ' InaSolar �9-15 HP �16-15+ NOTICE: If, after makinq this tleclarafion, you sM1oultl become subject to the Workers' Comp¢nsatian provisions of Ihe Labo� Cotle, you must forthwith FIOO�Sinks U�inal FixtU�ES MiC�oWave tomply with such p�ovisions ov this pevmit shall be tleemetl �evoketl. CONSTRUCTION LENDING AGENCV GasService Outl¢LS W2t¢fCiOSEt 1 tlereby affirm that tM1ere is a mnst�uction lentling a9enty for [he pertormance D¢vic2 BOx¢5 P012 Li9ht ot the work for whicM1 this permit i5 issuetl (Section 309] Civ. C.) �nte�c¢ptOfS Wdt¢t H¢2te� - Outl¢LS Ran9e Lentler's Name Lentler's Atldress Kitchen Sink Water Service Switches ' Sign OWNER BUILDEN dECLARATION 1 I hereby affirm that I am exempt from [he Contractof's License Law fo! the LdvdtOfiES AptO-WdSh GBfb2 2 Di5 OSdI following reason (Sec[ion 7031.5 Business antl �rofessional Cotle: Any city or 9 P Standing Sections county whicn requires a permit to construct, alter, improve, tlemolish or repair P-Trap Laundry Trays Generator �0-5 KW �5-15 KW '� any structure, prlor to its issuance, also requlres the applicant for such permit T�ash Compactor 1 to file a signetl statement that he/she Is licensetl pursuant to the provisions of Roof Drains Ihe Contracto�'S License Law (Chapter 9(commencing with Section ]000) ot Division 3 of Ihe Business antl Professions Cotle) or that he/sM1e is ezempt �the�efrom antl the basi5 for the allegetl exemptiOn. Any violation of Section 7031.5 by any appli[ant for a petmit subjects the applicant to a civil �nalty of not more than five huntlretl tlollars (g500). $ 3 LJ I, as owner of ine property or my employees with wages as their sole Reinspection F¢B $15 Issu¢ Fe¢ com0ensation, will tlo the work, ana the sVucture is not intentletl or offeretl Reinipection Fee $15 luue Fee $ 3 for sale (Section 7044, Business antl Professional Cotle: The Contractor's MECHANICAL FEES License Law tloes not appty to an owne� of a property who builtls o� improves thereon, antl who tloes such work nimself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provitletl that such improvements are not mtentled or offinetl for BOiIE� HOOd O! Typ¢ I ❑ sale. If, however, the builtlinq or improvement is soltl within one year of com- �ynopy Type I I ❑ Zaning Approved By Date D�etion, the owner will have the bu�tlen of proving he/she ditl not builtl or im- DUct - Und2� G�OuOd ' prove tor the purpose of sale). Building Approved By Data _ ❑ I, as owner o/ the prooerty, am exclusivery contractin9 with licensetl mn- Duct - Structural Refrigeration System Applifation Issued By Dat � Iractor5 to con5truc[ the pro�ect (Section ]044, Business antl Professions Cotle: , The Coniractor'S License Law tloes not apply to an owner of property who Duct � Ventildting ��-100,000 BTU ❑100,000 BTU $UMMARV�OF FEES builtls or improves thereon, antl who contracts to� such projects with a con- _ � tractor(s ucense purouant to the Contractor's License Law�. I am aware mat Ezhaust System ❑ MWtiple ❑ System Re ' ir/Alteration BUI�DING PERMIT $��—_ SMIP $ proof o� meir Worker's Compensatlon insurance shoula be provitletl to me. PLAN CHECK $ PERMIT ❑ I am exempt untler Section e. & P. C. tor this reason FirepVFact. BIL IC80 # Fire Dampers �( � R `. nS pLUMBING $ ISSUANCE $ oate Owner Heating System & Ducting Registers m le e Insp pLAN CHECK 25% $ ENERGV P.C. $ I nereby certity that i have read tnis appiication and state that the above ❑0-100,OOOBTU �100,OOOBT ELECTRICAL $ GRADING $ information is wrrecL I agree to comO�Y �+�th all city antl county ortlinances � antl state laws re1 n9 to builtling construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ --�- sentalives ot t cit t enler u on the above-mentionetl propert for inspectionp ses. Y P `�� Vate� i-� MECHANICAL $ � Signature DateJ TOTAL FEE $ Drivers' License r SS � Reinspec[ion Fee $15 Issue Fee $ 3 PLA '. HECK 25% $ CMF 0865-4fi, rev. 10/04 Wbite - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor � CQNSTRUCTION ANq,PLANNING POOL & SPA AP�'ROVALS IP,ermit# Date Inspector pppROVALS Permit# Date Inspector 1�' Temporary Elect[ical Service or Pole . 52. Pool & Equipment Location V 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 1 i '�, 58. Electrical Conduit-Undrgrnd. S. Foundation +�" �. 59. Gas Pipe, O Undrgrnd., Test i 9. Water Pipe-Undrgrnd. 60. Backwash Lines. P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK � 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final '�1�4. Rough Plumbing„e. 65. Electrical-Final 15. Rough Electriral�Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING- 18. Rpugh Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Flea'ting & Air Conditioning FIRE DEPT. REQUIREMENT i r 20. Rough�FacioryFireplace APPROVALS Permit# � '' 21. Ducts,%in Structure 70. Underground Hydro . �%1 22. Ducts;'Ventilating 77. ProductPipingOGas ❑Oil 23.�Gas Pipe-Rough & Test � 72. Underground Flush . " r 24. Roof Framin�. 73. Undergrnd. Storage Tank• � Gas ❑ 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 FINAC , 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 � r`. � . rn 33. Final Electric Notes: , , %�.� 34. Final Heating & Air Conditioning � ' �� 35. Final Gas Pipe-Test • � . ' 36. Hood or Canopy 37. Final Factory Fireplace . � � 38. Final Plum6ing �' ' . � , � 39. Water Service-Final . - �.' � 40. GasService-FinaF � .� i. 41�. Solar pomesticFinal r �.� : _ , 42. Backflow Preventer � � � - - I � 43. Backflow Irrigation , _ x � � � �i(j , - � � 44. Landscape Irrigation System h�comGlete �nSPe4ttiO ..' - � • '45. Sound Attenuation 7 �� S�g ; i� '��. � 46. Handicap Regulations � ' ' , r � 47. FINAL STRUCTURE & BUILDING t' � � ,�'. � � � ' � . ,48. Special Requirements Completed . -� � � . � 49.' Electric Release to Edison �- � , 50. Gas Release to Southern California Gas Co . I; 51. CERTIFICATE OF OCCUPANCY No. Date CITY OF'COSTA ME(�SA C S AU-C'TI�O^N�%P RMIT Project Address .7 �D��iTLy %7� .�� 1 �=, Applicant's Mailing Address Owner's Name c� /� Phon ya iaid Address � y � � Ji�',il/Ti�+ C��g�j¢�/�- � ArchlEng. License No. ' Address T Contractor's NaR��✓%'e�� - -I�el.f-�fj,I �7 �C9�1one �� Address (mailing) SS S �/�'i/P_..�,�' ,�//l� ��5�� Ciry License Na. ��D y-i3 L LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensetl under provisions of Cnarter 9(commencing with section 7000) of Division 3 of fhe Businezs antl PrOfes5ion5 Cotle, antl my license is in ful torce ntl effect. �� LIC2052 B 5 C 1T5 IO. Date Signature � WORKE 5' GOMPENSATION DECLARATION • 1 hereby affirm that I have a certiticate oi <onsent to selt-insure or a certificale � of Workers' Compensation Insurance, or a Certlfietl cOpy [here0f (Sectlon ` 3800. lab. CJ „ _ � ^/ / �"`� T� Policy No. ��J � y� L. Company J �4- �Certifietl copy i5 hereby fumishetl. �7 � Cert'f'e0 c py �ef wiih the city Bu%iq% .D' is. n/ 1/� Date Applicant l b F Y� EXEMPTION FHOM ORKERS' COMPENSATION DECLARATION (Thissec[ion neetl not be com0�eletl if Ihe permit is fOr One huntlretl ($300) or less). I certity that in th¢ performance of the work (or which this p¢rm�t i5I55ueQ I shall not employ any Oerson in any manner so as to become subjec[ to the Wotkers' Compensation LawS ot Califomia. � Date Si9nature NOTi[E: Ii, atter making this tleclaration, you shoultl become subject to the Workers' Compensation provisions of the Labor Cotle, you must forthwith wmply with such prov6ion5 or this permlt shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV 1 hereGy a(9rm thaf lnere i5 a construction lentling agency to� the pe�tormance of the work for which this pe�mlt iz issuetl (Section 309� Civ. CJ LendeYs Name - L¢Otl2t'S fitldl255' � OWNEf38UILDER�ECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the followin9 reason (Section �03L5 Business antl Professional Cotle: Any city or ' tounty wM1icM1� requires a petmit to conztruct, alteq improve, tlemolish or repair any structure, prior to its issuance, also requires the aoP��ant for.such permlt to tile a signetl slatemenf that he/she is IiCrnSetl pu�suant to the p�ovi5ions ot the Contractor's License Law (Chapter 9(commencin9 �+ith SectionJ000) of Division 3 ot [he Business antl Professions Cotle) Or that M1e/she is exempt tM1erefrom antl [he basis tor Ihe allegetl exemption. Any violation ot $ection ]031.5 by any applicant for a permit subjects the appliCant to a civil penalty of not more than five M1untlretl tlollavs ($500). ❑ I, as owner ot the pro0erty or my employee5 witit wage5 a5 their sole [ompensation, will tlo the work, and the structu�e is not intentletl o� ofteretl for sale (Section ]044, Business antl Grofessional Cotle: The Con[ractor's License Law tloes not apply to an owner of a property who builds o� imp�ove5 thereon, antl wM10 tloes Such wo�k himself/herself or Ihrou9h his o� her own employees, p�ovitletl tha[ such improvements a�e not Intentletl or oReretl for sdl¢. It, M1owever, the bulltling or improvement is soltl within one year of com- pletion, the owner will have the bu�tlen Of proving he/she tlitl not builtl or im- prove for tM1e purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensetl con- traciorsto construct the project (Section 7044, Business and Professions Cotle: The ConVac[or's License Law does not apply to dn owner of property who builtls or improves thereon, antl who contracts for such projects with a wn- tractor(sl I¢ense pursuant to ihe Contractor's License Law). I am aware that proof of tneir Worker's Compensation insu�ance shoultl be provitletl to me. ❑ I am exempt untler Section B. & P. C, tor thi5 reason Date I her¢by certify tha information is correc antl state laws relatii sentatives of this ci inspection purposes. Signature ___� Drivers' License o� 5`. CMF 0865-46, rev. 10/B4 Owner have reatl this application and state that the above agree to comply wlth all city antl county ortlinances o builtling co mn, antl hereby authorize �epre- to en/[er�/up n th above-mentionetl P�operty' /for �/// /. il �..L _ nafw �'l � �W.� White�-. Pink - Accounting; Goltlenrotl - A55essor $15 Showers Service Sink Sewer Cap Sewer Connection Solar Collecrors Solar Piping Solar Tank Swimming Pool w/$pa Urinal Water Cbset Water Heater Water Service A uto-Wash Issue Fee Hoodor Typel ❑ Canopy Type I I ❑ Refrigeration System ❑0-700,OOOBTU ❑100,000 System Repair/Alteretion Fire Dampers Registers Issue Fee FEES $ 3 $ 3 A.P. # S Main Buildi E T Front B Rear A C Right K Left S Pln9. Ref. # Planning Notes: Automatic Washer Canstruction Pole Sub. Cooking Unit Dishwasher Dryers �Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generetor DO-5 KW O5�' Zone Accessory Building: Parking Req./Provided ELECTRICAL Transformer O 15-50 KW ❑ 50+KW Meter ❑up to 700 amps Meter ❑over 100amps Su6 Panel Motors �0-1 HP �1 h- 8 InaSolar 09-15 HP �16-15+ Microwave Pole Light Range �LStanding Sections 5 KW Trash Compactor FEES Z O N 1 N G R E Q M T S I Reinspection Fee I$15 � I Issue Fee I $ 3'� DEVELOPMENTSERVICESREQUIREMENTS: . � Zoning Approved By Date Building Approved By Date Application Issued By � Dat SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ � PERMIT PLUMBING $ � �SSUANCE $ PLAN CHECK 25% $ ENERG� P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTALFEE $ `'��0�! PLAN CHECK 25% $ CONSTRUCT�ION AND PLANNING POOL & SPA APPROVALS Permit'# Date Inspector qppROVALS 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 UFER Grnd. � 57. APPROVAL TO COVER-GUNITE 7. Footings �' � 58. Electrical Conduit-Undrgrnd. 8. Foundationf 59. Gas Pipe, O Undrgrnd., Test _. 9. Water Pipe-Undrgmd. . � 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 71. 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 OGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing ' � �' 1 73. Undergrnd. Storage TanK O Gas ❑ Oil 25. Roof Sheathing . 74. Overhead HYdro 26. T-Bar Ceiling (5tructural) & 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 i. 31. Plaster Brown Coat 79. FINAL INSPECTION ` �: : 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 'T 33. Final Electric Notes: ' 34. Final Heating & Air Conditioning � - 35. Final Gas Pipe-Test 36. Hood or Canopy � 37. Final Factory Fireplace � . . � a 38. Final Plumbing '7-�� [,E� ' . .. _ _, . . - � 39. Water Service-Final� ' i�` �- 40. Gas Service-Final , � ' , - ,% r. � 41. Solar pomestic-Final � � � M �� 42. Backflow Preventer '" � �- -�' �� 43. Backflow Irrigation ' . � �. . 44. Landscape Irrigation SYstem � �� 45. Sound Attenuation � � r, 46. Handicap Regulations . ' , �� 47. FINALSTRUCTURE&BUILDING , � �� ' ' ��`' 48. Special Requirements Completed , � � 49. Electric Release to Edison 50. Gas Release to Southem Califomia Gas Co � '• � 51. CERTIFICATE OF OCCUPANCY • No. Date `, ,\. . ,!. �\�: CITY Or COSTA P�ILSA R�QUr�ST FOR OCCUPANCY TRACT ivo, 66 LOT IvO, 64 �,�,-�gg 3409 Santa Clara Circle Costa Mesa, Ca . 9 DATE April 16, lq] 1 The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City oi Cos'ta Idesa. The undersigned, by executing this agreer�ent, acknowledges that (he-she-they) Ronald B.Burgess (��.^,.�ar-�:erE) Marilyn A„Bur�ess advised that this tract has not been given final inspection nor ::�e it been accepted by the City of Costw ifes^ as having c�plied with the conditions of approval which �aere imposed by the city at the tune the iinal tract map iaas approved. The city asswnes no liability for the enforcement of the conditions necessary for approval otner than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless £ron any claim resulting in damage or personal injury to the undersigned by reason oY tne aforementioned uncompleted condition. BY��.�� ,�� Purchaser -Rona ruce Burgess BY ` eveloper and or authorized representative DESOTO ESCROW C0. BY LenQer OWNER HE 10B ADDRESS GENERAL COP AP No. INSPECTIONS SOIL GAS W ATEfl J�(�% /�/� H�- liOUGH PLUMBING Santa Clara Circle MISCELLANEOUS ROUGM HEATING AND AIR CONOITIONING TEMPORARV SERVICE OR POLE UNOERGROUNU � POWER � ROUGH WIRING TRENCHES � FORMS � STEEL REINF. FLOOR SVSTEM SMEATHING FflAME AND FLASNING F4 DATE o_��_ FIRE ZONE VA SUBCONTRACTOR z . aU Z Z Q ON am J7 J N p] J J m Q U � Za w� aw W Z J Q m Z J � ww �_ z� w� N Q �O �09l9 COSTA MESA BUILpING-SAFETY DEPARTMENT P.o_ HOX 720o COSTA MESA. CALIFORNIA 92626 �!OV i7_-69P41p00 457+� *�*124.50 cnsa APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Complefely RECEI D DATE CEV D DATEISSUED noo ess 3409 Santa Clara Circle '� - $EP 2 G 1969 PERMIT ! OWNER Heltzer Enterprises-Costa Mesa A.P. NO. �- :.�U f� MAIL BUILDING 'J � /s�` ADDPESS 74� N. La Brea E1V2. ADDRESS J (r cir� L.A. Calif. No� 937-2171 TRACT 6638 �or 6�* BLOCK CONSfRUCTION United California Bank N w n o n v LENDEF eRnNCH � Main Office 6th and Spring OWNER AODRESS VALUE (/-p ARCHITECT F. Gon2ales rE�532-6878 S 0 OR ENGINEER N . ADDRESS 1336 E. Chapman Ave.,Orange�(�.81. ZONE TVPE � GROUP � CONTRACTOR George J. Heltzer �u ASSOCS. ByPROVED DATE ADDRESS Same &ra above TEL. ZONE NO.OF USE OF NEW 0S. W 8 C cirv No. Puar+s BUILDING Sin le Fam. STATE 'zO].O9H CITV 1707 �ARDSAPPROVED VARDSAPPROVED LIC. NO. �IC. NO. MAIN BUILDING ACCESSORV BUILOING SIZE NO.OF BLDGS. (FROM GL�REET) OF LOT NOW ON LOT FRONT fT. FT. USE OF EXISfING BLOG. S E FT. FT SIZE OF NO. OF NEWBLOG. ROOMS STORIES L.SIDE FT. FT. EXTERIOR WALL ROOF COVERING COVERING REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. 9LDGS. Residence with attached garage �AA # DATE C.V.P.� APPROVED Plan No.lb& 402 APPqOVED �D I hereby acknowled8e that � have reatl this application and state that ihe above information is correct antl agree to comply wlth all laws regulatin8 building construction, and I shall not amploy any person in violation of the wotkmen's compensatiOn laws Of the State of Calitomia. � ¢ I hereby certity that I am ptoperly licensetl as a contractor untler /�� SQ. FT. �� 3 d the State of Californie Busi�ess and Professions Cotle, Divisicn 3, THE AMOUNT OWN UNDER VA�UATION IS FOF Chapter 9, antl tnet such liGenses are in tull forca entl etfect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a am exempt trom the provts�ons of the State ot California 8usinass a VALUATION and Protessions Cotle, Divisio� 3 hapter 9. Q p n /� PERMIT FEE $ / Signature of �///�i� �� O�/ � �� ,SV E Permittee !l S PLAN CHECK $ Authorizetl Agent �J y�/ s� u , TOTAL FEE $ IO / /� C ar.