HomeMy WebLinkAbout3462 SANTA CLARA CIR - Building Permits�op��euim+aMCySHERRY, ELIZABETH °NT` CITY OF COSTA MESA — BUILDING PERMIT pERM NO:�M ` 087634 �
ONNERSNAMEIFqlOWN: 346z SANTA CLARA CIR
A0°"�'COSTA MESA,CA 92626 P£RMIT NO: M 087634 PLAN CHECK NU: N GOVT: N SUPP: N
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P�` � �CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: OTH
JICH OP FNQ'S 1UONE54: VNT:
ca/rn�crarsruwE A—AMES PLUMBING 6 HEATING ( 714 ) 530-2440
camucroxsMuuao 9911 LARSON AV
mopEu GARDEN GROVE CA ��: 250307
92692 u� B
LICEN4ED COwH�fN$AeC�tTqOpNS DE)CL�HATION: I heraby dlim uMer panNy d perjury IM� I eIpm IriuceaiueE jw�ke�r pawivmpyaedy Cheqer 9
(commman0 V V b b b 4 d Onu"v� 9 W Ne eipima� yd Prafeadau Gpde, / m��. ]C Y� V b� 9 8
. NO.: UQ CtA54: C. 3 b ���7 /
�Dme� ' � � ` � Gameau: _ _ _
OW fl BUILOEP DECIAN�TION: 1 hereW dfirm urder penely d peryry ihet I em eRmnq Imm tM Comretlan l'mmee Lew ta iM
x+ip imton (Sedion ]W1 5 Buei�efa eM Rdaeebnf CaEe: MY ciY a counN xfiid� nW'vae s Dertnil to mretruc�. a4er. impeove.
Mmd'e�. a repsi erry sVucYiue. qar Io ib eauence. ebo rpuim iha epplimnt la eu l� pe�mil to fib a aipmd Mtemem Rw !n a she
n IiceneeE qmuant lo tM proveima d IM Conlretlon Lironx Lew �Cheptm 8(commend�p wilh Sedqn ]000) d 0'r+'vion 3 d Ihe
Bueiriev eM Prdeabm Code� m tl�et ha ar ehe is vemq �hxelrom ard ihe besie lar Me elbpeE eaamWion. My violelion d Sedion
)031.5 b/ enY Wd�^� tor e permE wbpUa IM epd�� �o e wil peroly d nd more Ihan I'xe hurdred ddlan I`��1�
� I.s�ox�wrd�MpapeM�mY�dW�e�hwa0y�����Pa��.'MIIEolhawa�k.vMNeei�uclurauiwlintended
or ollereE la eeb (Seclion lWd. Busirou end Proloaeione Cotle: The ConVeqon L"venaa LawCom nM epplyta en awner o/ pope'ly
M�10 bll�f IX��IIWP'G! ��18lB011.81b 1V�q �OBB tYt�l Wq�l �YIIfGd Of �IBIlB� Of I�V WQh h6IX �Mf OMT N(ipO�MB. �Oj 1�1BI YCh
II11C���l11b B!B fld NIBII�B� R OMYBd �V BB�O. M. �1OWb'M.1�IG blll{�III� Of RIG�M�M Y t0%� WIIM1YI pM YMf {1� W111�idM. a1B
owrwrbuitlar hiil heve tha WNen M pv.•iip M w eM1e did rid buik a improvs tor tM qnpove d aW�.
❑ �..� own« a m. ww«n. �^ ••�v ��:a wnn Yonua cawaia. m arimw m. o� (s.eion rou. anie�..m
Prdmiom Gode: The Caurapws lianae Lew don nol epM/ b an oxmr d pW^�Y who dnlds a'vnpw'a �Iweon md Mu
conirecn la wdi popea xx'nlNi e mqreaor(e) licemod Wnueni io iM Caurmaa liroms ler�.
� I em memV uMx SecYion: B. 8 P.C.. br INa �eaem:
Dme �
i do nmenv ronM �w i em e..a,e a.na u�d.�.mne u,e na���•m d ceuarce H.een m,e sek�v code s.a�+asws. rsv. ene
2553�. enE tM� I«vry hrture bWdirq ocwpem wJl / wil iwl (dacb me) �ed to wmply xih eeid tlms mM� aM �M �puirmmama for
epermillwoomuuciionwmadif�ionhomtMAi3Tu iyRrenepemenlDietntl.R»idaMielcaMiudianeppiretbnexeuempl/mmtlwee
Dma: AVd�
WORKEN'S CONPEN51T10N DECLMATION: I Mreby elfirtn uMu perolly d pe�ury aw W Ne IOYoxi�p Aetluelnm:
� � hrn enE wi1 meinten e ce�A'Wa d mnemt lo setliiw�e b MMcen' conpanution, n pro+idsd In by Sarmn �100 d IM leEa
Gade, la iM pMamerice ot tlw xvA ia MicM1 ihu pamu u uaueE.
K] IM1M9MWIroiNGinwpkMdWmW�iMiMwLv.nrpuinEb/SBtllT3]OOdlMlebnCads.WlMO�am�ed�he
�xia.,nd,m.w�asa.�.a.Mr,.�a"Ni°T�iii"`aneoaw.r�w...: EXPIRES
Pd �� Ai6 }${�r�i5��— 0 3/ O 1/ 9 9
(Tni, esaion med ror bs cana'mee r �he P«mR k Mr wx huMd edbn Isrool r Im.)
I h� in Ne pMoimeMe d Ihe w«k br wliich ��u pmmn e ivued. I ehall mi emqry eiry pe�n in e�ry men�r vo m to
wbjna �o �n. wn..• canw��c� Iew. a c.uoirve. ene epree uut a �.nouk necane n+bjeC �o tne .nns.•
mpeiuNion� pJwiaioGm o/� �SsUb� 3ND d iM lebor COEe. I ah/ �j�on �r �U iMw pmieion+.
DU . �' I7 � ] 7/ AGWicenc �"��
am/n0� F�llun ro�xuro woilrw�'romp�ruetlon covsrep li unlawNl, and�hsll utlacf an xrplay�r ro cNMrol peneMu �M
elvll nM. W ro on. hundrH rMmnd ooll.n (tfoo,o001, In.Wltlon ro IM ewr or romp�nuebn, Mm�pi u provldM ror In
\ Sxtlon Jl(b oI fhe Lebor Cotls, Infwuf, �nJ �ttomey4 Ma
CONSTPUCTION LENDINO AQENCY: I Mrab/ elfi�m uMer penely ot pnjwy thet tM�a u e mru�rud'wn bndiip epancy W Ne
panormaMe d �M wA i« wnitli mo pimY ie eaued (&eunn ]09'!. c'v. cl.
LENpEN'S NAYE
LENUEH'S ADDNESS:
I eenEy tAm I hm mad Nc applKsiion enE Ms ihet Ns aLove'vdmration c emeri. I apree to eomply Milh M cy eed mumy adiranee�
eM a�sle bwe Maliq to Wldvg cwWumon and Iweby aW�vrse �epeaenlatiwf d Ih's clyb oNx upan iM ebo.e-meNionad popmry
'��^°�°^o"'o°°°'{ARLOS CASTANEDA
ome y- o - �g
(St5tJ6.WP1 Whne-BUYEiqmSelelY:GreamFle:Cenery-Appiran�:Rnk-Revenue:(3ddenroFMeeva
JOB DESCRIPTION ; F.A.U. CHANGE OUT SQ FT;
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
**x*****�**�*****�r***�**�*******�**���******��c**�****�r�*+�*�*�r�r+�***a�**�:���r+���r***
Z O N I N GS ERTEB�A�CIKRSE M E N T S
------------ MAIN BOILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT ZN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGAT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 92201338 ZNE: REF NO:
PLANNING NOTES>
i
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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 HY
BUILDING APPROVED BY :
APPLICATION ISSUED BY
iE iE iE iE iE 1E iE iElf if �F if iE if k iE iE iE if iE ik
LEGALIZATION:N
F E E S U M M A R Y
DATE:
DATE:
TE
�EiEiEjF1E3EiEfE iE
STRUCTURAL .iEG ENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 13.25
253 SMIP/NON-RES
PLAN "
ISSUE FEE 22.00
HUILDING-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/SAORT: .00
bLDG PMT PLUMbING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
35.25
iF iE iF iE ff iE iE ft if iE iE iE ik iF if iE iE Ik if iE iE 1k it if jk iE ik iE iF 1E IE �E 1f ik 1E fE iE ik �f it 1f �E 1E jE iE 3F 1k jE iE if !! 1F !t iE iE iE fk 1E �E �f iF 3E 1Elf iF iE if 1F 3f iF iE if 1f 3E iE if dk 3E iE
I N D Z V I D U A,L F E E B R E A R D O W N
TYPE QTY D E S C R I Y T I,O, N UNIT COST TOTAL COST
MEC 1 INST FORC-AIR/GRAV FURN <= 100 H bTU 13,25 13.25
END OF FEES
p4-OB-199B/82:02 PfVS35.25
RCPTtI:NI-C222112
PEkI'7IT : 087634
CONSTRUCTION AND PLANNINO POOL & SPA
APPRQVALS Permit 5W � % Doto Irmpoctor APPROVAL9 Pormlt �p Dnca Inepoc�or
1. Tomporory Eloctricol Servico or Polu 62, Pool & Equipmant Locotion
Z, Soll Plpo•Undrpmd. 63. Staol fio(ntorcomun�
3. E�acvlcol Condult Utilltv•Undrprnd. 64. Form�
4, Eloetrlcol Conduit•Undrgrnd, 66. Eloctrical Bonding �
6, Stool Rolniorcomont 68, Rougb Plum4(ng & Prouwo 7ott '
8, Eloctrical UFER Grnd, B�, APPROVAL TO COVCR�GUNITE
7, Footinp� 68. Elcctricol Conduit•Undrgmd.
8, Foundatlon � 68, Goe Pipa, O UnUrgrnd., Tat
0, Wotor Plpo•Undrgrn�l, 60. Backwach Linoa, P•Trap, �, Undrprnd. �
10. St�ucturol Floor Svaom 01. APPROVAL TO DECK �
11. Proparty Sowa Lino & Hou�a Connoctlon 82. Bnckwoah & RocoPtor•Finol
12, Sower Cap 83. Hootor & VonaFinol '
13. Foof Droint p4, Plum�inp Synom • Flnol
1M1, fiauph Plumbin0 86, Elactrlcal•Finol
16. Rough EloctrlwbCondult 68, Solor Syatum•Finnl
10. Rough Eloctric Wiring 87. Fonolnp a Aacuas Approvol �
17, Rough Wiririg Sign gg, APPROVED FOR P�ASTERING
18. Rouph Elqctrlcal•T Bar Cailing 89, POOL/SPA SYSTEMS FINAL
19. Rough Haoting & Air Cond�tlonin8 FIHE DEPT. R[QUIREMENT
20. Rough Foctory Flraploaa APPROVALS Pmm4t ��
21, Ducte, In Structuro 70. Undorground Hydro
2Z, Dume, Vont�latiny 71. Product Pipinp �CJ GaR IJ OII
23. Goi Pipo•Rough & Ton 72. UndarOround Flueh
24. Roof Froming 73. Undorgrnd, Srorapu Tonk O Gos f7 011
25. Rool Shoothing 7q, Ovoihond Hyd�o
7B. T•8or Colling (Structwol) & Monoaoat 76. Dry Chomicul
27, Fromo cnd Floehing 78, pry Stoncl�ipo
28, Lathing & Sid��p 77, FIXEO SYSTEM FINAL
29, Inwlotion 78. FIRE PREV, FINAI.
30. D�Ywoil Nolling HEALTH DEP7, RpaUIREMENT
31, Plnator Brow� Coat 7fl. FINAL INSPECTION
32, El�ctrical Powar Matar•Finol 80. FOpO CERTIFICATE ISSUED
33. FlnalEloctric Notas;�-f?-�`[$' F��/��/ZL(J
34. Plnol Hoad�g & Air Conditloning � ! � �
-�?-48 �N
36. Finol Goe PIpu;Yatt
38. Hood or ConoPY
37. Flnol Focmry Firaploca
38, Flnol Plumbing
38. Wuter Sorvico•Final
40. G8� Sarvlca�Flnal
M11, So�or Oomoetic•Final ,
4Y, Bocktlow Provontar
A3, BDckllow Irrlgotlon
44. Landwopo Irr(put�on Systom
A6. Sound Attonuation
' 48. HO�dicap Rogulotion�
47, FINAL STRUCTURE & BUILDING . �
�� 48. FINALP�ANNIN� � �
49. Eloctrlc Rolo�sa to Ediion
50. Gn� Roloaio to Southorn CoH}ornlo Ga� Co
61. CERTIFICATE OF OCCUPANCY
No Dota
AVo�icant to fill in aIl spaces exeevt those within heavY �oreer lines and sign all aDo�aoriale eeclarations.
CITY OF COSTA ESA �Q NSTRUCTION PERMIT PERMI O. TRACT NO. LOT NO. UNIT NO. r-
ProjectAddress �y�a .7HriTfA�' Q/� �1:� �a�a� 4773 2/OB/80 � �. 1
,5'/fi .� � TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
Applicant's MailinoAAdress ��_ , ��q � ��..� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p,# � ' Zone
Owner's Name ������u Phone�L+L_L"_(QL�d> DESCRIPTION OF WORK/USE OF BLDG.
Address S Main Building: /accessory Building:
E Z
Afch/Eng. LicenSeNo. TYPEOFPERMIT GRADING FOVNDATION STRUCTURAL T Ftont Q
Add�¢55 n ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL g R¢d� N
Contractor'sNam Phone�� � OTHEa C Ri ht -' N
Address (m �i' 1 % J'�� �% A�O�./� PROJECT DESCRIVTION sq. F7. OCCUaANCv K 9 G
CONSTRUCTION TVPE VAWATION $ g Left
City License No. � ZONE GRADING GU.YDS. ACRES E
LICENSED CONTRACTOR DECLARATION Ping. Ref. # Paiking R2q./Provid¢d
Q
1 bereby a/fi�m tha[ I am licensetl untler provisions Of Charter 9(commencin9 Remarks: Planning Notes: ry�
�with section ]000) ot Division 3 ot the Business antl Pro(essions Cotle, antl T
my license is in full force et 4 n/ �
1 Licens C s � Li n e G S
Date �-� Signature PLUMBING FEES
\ WORKEftS'COMPENSATIONDEC�ARATION BdfSink ShOW¢�5 ELECTRICAL FEES
� 1 hereby affirm that I have a certificate of consent to seif-insure or a certificate
O oi Workers' Compensation Insurance, or a certified copy tnereoi (Section BackRow Preventer Service Sink
^ Automatic Washer Transformer ❑ 15-50 KW
3800, Lab. C.) Qu c_' / j� •�/��' I/� ❑ 50 + KW
Poliry No. d Y(J Company �� ��L Backflow Irrigation Sewer Cap Construction Pole $ub.
❑ Certifietl caOY is hereby furnishetl. � _
��Certi�/ etl opy's ed with the city euil/d/ n Divr'Fi/oj �J �1 --' l, Bathtubs Sewer Connection Cooking Unit Meter ❑up m 700 amps
Date /'� I-�APPlicant r � /.ACLi�C�•""�
EXEMPTION FROM WORKERS' GOMPENSATION DECLARATION Clarifiers Sola� CollecL0�5 . Di5hwd5h2� ' M¢te� ❑Ov¢� 1002mp5
(This section neetl mt be completetl if the permit is for one huntlred ($100) or Di5hwd5h2�
less). Solar Pipin9 Dryers �Gas ❑Electric Sub Panel
I certify that in the perto�mance of the wo�k for which this pe�mit is issuetl, I
shall not empioy any perzon in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors �0-1 HP 01 %- 8
Workers' Compensa[ion Laws of California.
Date Si9nature Floor Orains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP �16-15+
NOTICE: If, after making tbis tleclaration, you shoultl become subject to the
Wo�kers' Compensation provizions ot the Labor Cotle, you must forthwith FIOO�Sinks U�inal Fixtu�ES MicrOw3v¢
comply with such provisions or this permit shall be deemetl revoketl.
CONSTRUCTION IENDING AGENCV /� GasService OuL12t5 Wdt¢�CIOS2L DEvic¢BOx¢5
I hereby attirm [hat the�e is a mnstruction lentling agency for the pe�fotmance POIC Light
of the work for which this permit is i5suetl (Section� 309�. �Civ. CJ �nt¢�cept0�5 � Water Heater �ut12t5 R2nge
Lentler's Name
Lender's Atltlress � Kicchen Sink . . Water Service Switches Sign
OWNER BUILDER �ECLARATION
1 hereby affirm that I am exempt irom the Gontractor's License l.aw for the Lavatories Auto-Wash � Garbage Disposal $tanding Sections
following reason (Section ]03L5 Business antl Professional Cotle: Any city or
counry which requires a permit to construct, alter, improve, tlemolish or repair P-Trap Laundry Trays Generator �0-5 KW �5-15 KW Trosh Compacmr
any siructure, priar to it5 issuance; also requires the applicant for such pe�mit
to file a signetl statement that he/she is licensetl pursuant to the provisions of Roof Drains
fhe Contractor'S Litenze Law (Chapte� 9(commencin9 with Section �000) of
Division 3 of [Ite BuSiness antl P�ofessions Cotle) or that he/she is exempt - '
therefrom antl the basis for the allegetl exemption. Any violation of Section
]031.5 by any applicant for a permit subjects tne applicant to a civil
penalty of not more Nan five huntlretl tlollars (g500). $ 3
❑ I, as owner of the Property or my employees witlt wages as thei� sole ReiOspection Fee $15 ISSue F¢0 .
compensation, will tlo the work, antl the st�ucture is not intentletl o� offeretl Reinspection Fee $15 ISSue Fee $ 3
for sale (Section 7044, eusiness antl Pro(essional Cotle: The Contractor's MECHANICAL FEES
�.icense Law tloes not appty to an owner ot a property who builtl5 or improves
tnereon. antl who tloes such work himself/herseH or throu9h his or her own goiler Hood or Type I ❑ DEVELOPMENT SERVICES REQUIREMENTS:
employees, prOvitleO that such improvemcn[s are not in[entletl or offeretl for
sale. It, however, the builtlin9 or imp�ovement is soltl witnin one year of com- Canopy Type II ❑ Zoning Approved By Dat¢
pletlon, the owner will have the burtlen of proving he/she tlitl not builtl or im- DuCt - Unde� C�i�OUnd Building Approved By Dat�
p�ova for lhe pu�po5e at sale).
❑ I, as owner of the property, am exUusively contracting with licensetl com Duct-Struciural Refrigelation System Application Issued By Dat
traclors to construct the project (Section ]044, Business antl Professions Cotle:
The Cmtractor's Li<ense Law does not apply to an owner of praperty wno Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU SUMMARV OF FEES
builtls or improves tM1ereon, antl who contracts for such prolects with a con-
tractor(sl Imense pursuant to me Contractor's License Law). I am aware that Exhaust System � Multiple � System Repair/Alteretion BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance shoWtl be provitletl fo me. P�AN CHECK $ PERMIT
❑ 1 am eaempt untler 5ection B. & P. C. for this reason FirepVFact. BIt ICBO # Fire Dampers PLUMBING S J�'� ISSUANCE $
oate owner Heating System & Ducting Regisiers PLAN CHECK 25% $ ENERGV P.C. $
1 hereby cerciry that I have read this appliwtion and state tnat the above ❑0.1000006TU �100,0008T GRADING $
intormation is wrrecL I a9ree to comp!y with ail city antl countY ortlinances ELECTRICAL §
antl state laws relating to bulltl�ng construction, antl hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of this city to 0^ter upon lhe above-mentioned pwperty for �py�
inspection purp e. /��_�.� MECHANICAL S TOTAL FEE $ ����
Signature .
.Drivers' License or 55 q/ - - Reinspaction Fee $75 Issue Fee $ 3 PLAN CHECK 25% $ .
CMF 0865-46, rev. 10/84 White - Builtling; Canary - Appllcanh Pink - Accounting; Goltlenrotl - Assessor
CONSTRUCTION AND�PLANNING � POOL & SPA . � . �
APPROVALS Perrriit.# Date Inspector qppROVALS Permit #� ' ' Date' Inspector
,.� .
1. TemporarY Electrical`Service or Pole � 52. Pool & Equipment Location .
2. Soil Pipe-Undrgrnd. �� 53. Steel Reinforcement
3. Elecvical Conduit Utility-Undrgrnd. 54. Forms �z�� '
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding �
5. Steel Reinforcement 56. Rough Plumbing & Pressure �Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-G�FJNITE �
7. Footings � 58. Electrical Conduit-Undrgrnd:'
8. Foundation; 59. Gas Pipe, � Undrgrnd., Test: ��� +
9. Water Pipe-Undrgrnd�.��� 60. Backwash Lines, P-Trap, C�Undrgrnd.
10. Structural F�loor System 61. APPROVAL TO DECK ��q� .
i i. Property Sewer Line & House Connection 62. Backwash & Receptor-Final'�� �
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains' � 64. Plumbing System - Final
74. Rough Plumbing • 65. Electrical-Final
75. Rough Electnical-Conduit 66. Solar System-Final - �
16. Rough Electcic Wiring � 67. Fencing & Access Approval ' ' -
17. Rough Wirin9 Sign � - 68. APPROVED FOR PLASTERING ,
18. Rough Electrical-T Bar Ceiling 69. POOUSPA 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 73. Undergmd.StorageTank OGas OOiI
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. Piaster Brown Coat 79. FINAL INSPECTION ,.
32 Elecvical Power Meter-Final 80. FOOD CERTIFICATE ISSUED � . t� �
33. Final Electric Notes: � � �
i.
34. Final Heating & Air Conditioning ""
35. Final Gas Pipe-Test � '
36. Hood or Canopy •
37. Final-Factory Fireplace '
38. Final Plumbing •!b.$L L�/�i .
39. Water Service-Final � • -
'40. Gas Service-Fin'al �
41. Solar pomesticFinal - � , �
42. Backflow Preventer � - -
�43. Backflow Irrigation _ � - �
44. Landscape Irrigation System � � , '
45. Sound Attenuation ' � � • �• .
46.� Flandicap Regulations - .
� '
47. FINALSTRUCTURE&BUILDING � ' �
48. Special Requirements Completed - .
49. Electric Release,to Edison � _ . .
50. Gas Release to Southern California Gas Co , " , , , -
51. CERTIFICATE OF OCCUPANCY - . . . �
No. Date - - - �
.� '
PPOJECTAOOHE55: 346'2 SANTA CLAAA CI
OWNEP�SNpME: MC SHERRY ELIZABETH
�'RDOflESSr j 4 6 Z SANT.S, CLARA C I R
COSTA MESA,CA 92626
AflLH/ENGINEEfl: S S%— G 1 S S qEG.NO.:
nooxcss:
uxit:
uNiT:
venmiTree: pETRONELLA ROOFING ( 714 ) 548—] 645'
nooeess: y626 NEWPORT
COSTA MESA CA 92627
LICEN$EO CONTHRCTOB OECIABFTION: I h¢reUy allirm ��at I am li[enSeU unAer pmvision5 oi C�aO�e� 91�ammencing with Seciion
7000) dl DiviSian 7 0l the Busineu anU Pmlessions COGe. antl my lic¢nse is in lull lorce an0 elleci.
c�rruc.: 32605 srareuc.:00460707. cuss:
oa�e'. � ' / -� - � / signatur . _ ' �
�EPS' COMPENSA710N OECIABRtION: I here y affir I have a cenilicate ol consent to self-insure or a cehificate of workers'
Compensation Insurance. or a certilie0 copy ihereof on 3800, La�. C).
Poucvxo.: 1079987-91 EXP.OFTE: O%�OLI9Z
comrnNr: STATE FUND
❑ CertAieO coOY is here�y lumis�ed. � C¢tlifietl copy is IileO wii� Ihe ciry Builtling Division.
q O ��/J �
. [ � /� � ! � ADOlicant/ �?�-f � .�
E7(EMPTION FPOM WOfl8Efl5' COMPENSPTION OECUflA aN: sttii0n neN irol G¢ compleleU il �he permii is �of ane huMreC (Sllp) or less�.
I ce�ify I�at in Ihe Oahormance ol �he work lor whic� ih6 permii is i55ue4 I shall nol emD�oy any person in any manner so as to Oecome
sub�¢q to ihe workers' Comoensation LaxS o1 Cahfomia. . .
Daie: � Signalure:
NpTICE: II, afler making �his 4eclara�io0. you shaultl become subletl to ��e Workers' Compensa�ion provisions of lhe LaLor
Cpae. you must fonAw�ih comD�Y w��A such O�ovisions or ihis oermil shall be aeemeA revakeE.
CONSTflUCTION LENOING AGENCY: I here0y allirm Ihaf l�ere i5 a ConS�mt�i0n IenUing agency �Or Ihe DetlormanCe oi lhe work for
wnicn inis permit is i=sue0 ISection 3097. Civ. C). .
LENOEN:
FODHESS:
OWNEp BUILOEP DECIAqp�ION: I here�y aflum that I am exempt Imm Ihe Coniractor5' S�dte License Law for the following reason
(SectiOn 703L5 Business an0 Pmlessional Cotle: Any city ol counly w�i[� repuires a permii to consimcL aller, impmve, demolish, or
repair any simclure, prior Io iis issuance, dlso reQuires Ihe applicant �ar such permi� lo tile a 5igne0 slalemeni ��a� �elshe is licensetl
pursuant lo Ihe pmvisions of the Contracbrs' Stale License Law �C�aO�er 9(commencing with Section 7000) ol Division 3 oi Ihe Busine55
antl Prolessions Code) or ihai he/she is exempl I�erelmm and the Uasis lor t�e alleBed exemption. Any violalion ol $ection 7031.5 by
any apDlicant lor a permi� Sublecl5 ihe appli�ani Io a civil pendlty ol nol more thdn five �unOred aollars (5500).
I, as owner of t�e D�openy or my emyloyees with waAes as tlleir sole compen5ation, will Co ihe work, an0 t�e
I❑ slruclure is noi in�¢naeG or ofh�etl �or sale (Sec�ion 7Ma, Buvneu anG Professianal Coae: T�e Conlratlor5' State License Law
aces rwt applylo an owner ol a p�openy wlw Duibs or improves tlierew, ana who Ooes sucb worX himselOherseU wlhrwOh
�is ar her own employees. proviae0 Ihat such impmvements are no� intended or aHereO lor 5ale. Ii. Oowever t�e 6uil0ing ar
' impmvem¢n� is s01U wilhin one year o� tompleiion. I�e owner vnll hav¢ Ih¢ �urden oi proving �¢/SAe ditl n0i builE or impwve
lor Ine ouroose oi salel.
I, as owner ol Ihe Oroperry, am exclusively contrac�ing wiih Iicen5e0 conlrac�ors to constmcl lh¢ pro�ecl (Seciion 7p44, Business
❑ and Pmlessions COJe: ihe Conirac�or5' SIaIe License Law Ooes nol apDly t0 an owner of pmpetly who builEs onmpmves theBon
antl who conVacis br such prolec�s with a coniractor(5)license pursuant �o Ihe Conlraclors' S�a�e license Law�.l am aware
Ihal D�oo( o� Iheir Worker'S ComOensalion insurance should �e piovided lo me.
� I am ecempl untler Setlion'. B. 8 P. C.
�or Inis Bason:
Date: Osner:
I Oo bereDy [enily �lut I am aware ot an0 uMerstane ihe repuiremenis ul CaliforNa Health ana Safery CoOe Sections 15505, 15513, an0
2553q an4 i�at I or any �Wure �uil�ing occupan� willlwill na� (circle one) need lo compiy vn�� saitl state cotles anA IAe reQairemenls tor a
pe�mi� �or conslmciion or moailicalion Imm ihe Air �ualily Management Districl. Pesidential consimction applicalions are exempi imm
Inese pravisions.
�ale: Applicam:
I �e�eEy ceriilylhal I have reatl �his applicalion anG stat¢ Iha�i�¢ aboveinlormatio� is correci. lagr¢eio compty vn1A all ciry anC counry
ortlinances antl siale laws �elating lo bml0ing �onslmQion and hereby aN�oriie Rpresenlaiives of Ihis Cily to enier upon Ihe abOve-meniionee
O�oper�y lOrinspecti0n purposes.
' a�ie' � ' 9 `�
� � � • / Signatu .
�Driver's License or Socal Seanry x:
164��a6 Whne—Bwldmg', Green—Codo Enlorcemenl'. Canary—ApPlicantl Pink—Fevenuo: Caoldonmtl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05388
PERMIT NO: H 053885 PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRZPTION : T/OFF RESHT, REROOF W/BUILT UP & COMP SQ FT: 4,000
CI,AIM VALUE: 9,000.00 CALC—VALUE; 4,000.00 GROUP OCC: R-1 /
COMMENTS• SMOKE DETECTOR REOUIRED IN THE HOME
x�t*���*�ie*�t*��r*�r��****rt**+t*aF*��r*�r*+t***�**�*�r��rt*�*�*�*****�t+t**�*�r+t�**x�*�**�r*�***
Z O N I N GS ERTEB�AUCIKRS6 M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN R$AR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING RE - PROV: PARCEL; 91205129 ZNE: REF NO:
PLANNING N TES>
i
iF iF iE �f iE �k iF iF ik if kiF 1E iF 1f iF 1f iE if if iE iE k iE �E �E k if IE iF iF 1E iF iFiE iF 1E k k 3! ik ik if iF if 1f if if iF iF k k iF iF iFlF IE iE k iF IE �f iE if �F iE IE�E.iE �f af jE if IE if 3f iE 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 AATE; �'=�
BUILDING APPROVED BY ; AATE: ' - Z��
APPLICATION ISSUED BY; DATE;I;.' G
If if iElF iFiE iF 3F if 1k k iF i! 3E 3E if� iF 3f if 1F �F 3f �f �Eaf �F if if if if af �F�F'�'iF'1F�jf �E
IE�k�E1flE�fiFifiFiEkiklfiFiflFklElEiEkififiEkifkifiE�EiF�FkkiElfiEkiF iFfE�f�flt�tkiFiElEiEififikifikiEifif±E�Fikif;�lEiE'IfifiFiEkiE�ElflEif
LEGALIZATION:N F E E S U A A Y STRUCTURFiL SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 63.00 50
PL� $MIP/NON—RES
ISSUE FEE ;'�
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DDE
TOTALS----> 63.50 0.00 0.00 63.50 63.50 '/ ,00
,;.,.
REVENUE D NISION TOTALS--> COLLECTED: 63,50 OVER/SHORT: �` 00
BLD63P00 PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOO GRADING PLAN—CHECK
... �
k iFiE iE 1E * k iF If 1f iF k it iF k iE k it ik iF if Ik k if !F iF IF iE 3E ii �f iE i! 1k IF if iF k iF k iE iF IflE 1E 1klF�f if if �F iE if if iE k iF if iF fE if ik if iE iE if �E it�i!'�f 1F 3f iE ik iE iF 3k 1F i4
I N D I V I D U A L F E E B R E A K D O W N r'"
TYPE QTY D E S C R Z P T I O N UNIT COST TQTAL COST
:i'
SFR 4000 REROOF BY VALUE REENDEOFI EESN020N& 1,00 •� 9,000,00
'.I JJ';•' '„•-C���;--; -.
C4TE:VD'i�4'a.; ..:r� , -i'.
CONSTRUCTION AND PLANNING (' POOL & SPA �
APPROVALS Permit# �� �Date Inspector qppROVALS Permit# Date Insqector
` 1. Temporary Electrical Service or Pole ' 52. Pool & Equipment Location
2 Soil Pipe�Undrgrnd. ;� �¢ 53. Steel Reinforcement
�-3•�€IsFtrr'.cal Conduit��l t lity•Undrgrnd� �� 54. Forms '
;�... -" '_- ��,,.
�.4,`Electrical Condui4�Ug,drgrnd. 55. Electrical Bonding
[a5: "St�el REinforcemerif•- '-C 56. Rough Plumbing & Pressure Test
ru " t •rin
:'6:`Elgctrital UFER��r,�d. `'" 57. APPROVAL TO COVER-GUNITE -
�7��:Footings r.:i �� 58. Electrical ConduiFUndrgrnd.
.. �
,e8;;foundation :r 59. Gas Pipe, O Undrgrnd., Test
•y'9`, ater Pipe�Undr.�grnd. - 60. Backwash Lines, P-Trap, O Undrgrnd.
;�lO,iS�tructural Floor Svstem � 61. APPROVAL TO DECK
1 L P�operty Sswer Ling-& Houce Conn_ction 62. Backwash & Receptor�Final
12. Sewer Cap �- % 63. Heater & Vent�Final
z. a • a �.
13. Roof Drains ;� ��� 64. Plumbing System � Final
14. Rough Plumbirig� � 65. Electrical-Final
15. Rough Electricaf�Conduit 66. Solar SYstem-Final
i6. Rough Electric-Wiring 67. Fencing & Access Approval
77. Rough Wiring �ign 68. APPROVED FOR PLASTERING
78. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINA�
19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
20. �Rough Factor'y �ire'place � ,;p, :��=. �j � «,f :;, ,j�ppROVALS+.-�Permit #
� � .r " �
21.�UuC�S,inSTrtiCtu�O� � - 'l:. ~ . _ S� � ' . i
_ � , ;= a � .,r. 0. l"7ndergCfiu�d'Hy�ro
22: Duci3,VGniilating:s . �� .y �� S eL> "r �.-71. ProducGPipingOGas ��Oil
23.-Tas�Pipe+Rou'gh &'Fest �m ; � �, s ,_.F, � `7p• Underground FlusFr � - _
�. :_, .. . . ' _ 1.V - `, . "
24. fioPf• Framirig. y i. '. � .^; �� � �.73a'Undergmd: Stora<,�eTank �O Gas ❑ Oil
25. RoQf Sh3thing '� � >� ` � � •'�'F �7q;:pyerhead Hydro��'�' ��
'�•a i.. � iVa x ♦
. . � . l� i .. '
26.'��Bar Ceilin9 (Stru�tural) &;Monocoat x �.�,. . 75._•DFy Chemical ' � � _ •�;
27�FrameandF�ashingr. _;�„4 � _ � �` � 76:�D'ryStand�ii�e f - ` '_
�
�. > > S �•J
'28.�,Latf�ing&5�dinq..;., -,h.l ;r ; Y . ... - 77,: FIXE�SYSTEMFINAL. y �
>29. Insulation � 'x' � " " �' r `� � � �' t 78.�FIRE PREV. FINAL ,,,
,:30. DrywallTNail.tii9 °„ ' '� + ' � � : . a � HEALTH,DEPT..BEQUIREMENT
•�31. Plaster BiowqCoat� \ ' . � ' ;'�; '� r7g�-FINAL IN P�ECTION .�; • - �
'�'32. �Electrical�Po�er Me'�e�r�Final �. :, , • I =;, � 180.,FOOD CE�iYIFIEATE ISSUED�� ��
33. �Fina7 El�ctr�c r ° �� - ` "Not�s: ` •
n, .,� �r. .x �i �r - n�
�,`34..-Fin�l Heati�gt& F:It;`C�ncf itionipgy �l `'' � � � ' �i �� ' , �
� � tc � �'
35 � Final Gas Pipe-Tecr, � v � . � ti �:. , , r'. !� �_ ' �• _
� � . r v � �
LL36. -Hood orwCanoPY;,• t � �L ; �:� - -. R ;. ( ,��� �� i. *' �; ��c, � ' •,v - -
� 37.CFina� Factory FiceQlace :�i�' �' x `T7 � � ' � ' � _
n ! .�I
y ,�, � � . • ;r �� � C '=: ��
`38. Fin�{Plumbing t N i •- � ' . S � • . '
^39. Wa4u Service-Final� � .� - p - �c �� - �� '
�i � I h
�40. Gas Service-Final ` '� ' � �' ` _`� ' `� "
. �ti*..�. , � � �, ��.�, �„� ,
547. Solar pomestic�Final�� - • �. - �, ' c� � �r � -
42: Backflo4v Preventerz '� � � • h�� 1 '
�. '� y =
43. Backflow Irrigation� .�;<t : + A � '- • ' �
w< � -
�44. Landscape I�iigatioP SystemJ��; �_` ,�. ; ; a ^ N �;j � j� j
i 7.,
v . ,.
�45�'Sound Attertuation � . - �.�' • �: ' L+ ' � � - - . �
�� .-> . r - _r -
'46:,HandicaQRegulatio"hs � * T' ' "�" ! ' {: � ' A
�47:.FINAL STRIICTUFiE & BUFLDING � '� •� ._ n D� -
(/tr�►► �
48"fINALPLANNING „`�.` .,:�:'. �� ' - ,�
� � '. , . - .
_49�:EIeeLricReleasetoFEdison . � �' ��, • . ^
�
"50. Gat #ieleasc to Southem Calijomia Gas Co �` ; i ; , � ,, '` ' `' � �
�
51. CERTIFICATE OF_OCCUPANCV ^ - ' `" ' ; "
� v , ,.r _.
No. Date
29554
COSTA MESA BUILDING-SAfE7Y DEPARTMEM
P.O. BOX 1200 GOSTA MESA� GALIFORNIA 8262E
� �
For Applicant ro Ffll In Completaly
TYPE OR PRINT
woo�n°esa° 2 Santa Clara Circle
COSTA MESA. CALIFORNIA
d ARCNITECT
Y BTATH
E.
�R GeorQe J. Heltzer & Assoc.
144 South La Brea Avenue
AnReles, California 90036
201098 No 936-1104
I NO.o►�LDO/' _
S Y6TlACK LIX[ �110M
iFT I.rJ � � RIGFfI'
oesceiPnoN oF wo�uc
WALL I ROOP
�
�
1
JAN -7-69�N5�00 18�iff **�* 108.�L
APPLICATION FOR PERMR
BUILDINf3
Fo. offrro u� o��y
BUILDINO
ZONING
:oxa xo.o. ucsorNcw es. w
R1 �uni 2 em�mno Attach.Ga
ocscn�moH Lot 29 Tract 6637
w, r. No. None
NOTR: NO BAVQ OV[RHANO SXALL B8 LE88 THAN
DO' TO SIDB S RBAR P. L
PJIVEG
ALLOWHD (U.B.C.RECUIPlMENTI
YAROH MPROVHD YARDB MPROVfiD
MAIN BUILDINO AGGHIISORY BUILDINO
VAR. �F
DATH
UD6 OP GUIIDIlIY Al1D WORK TO SH P[RrORM6D � � � a
i7
Plan 403EX - Lot 29 �
/G 9d 8,. ,•�. i3 ' � ° �
0
� HtRrtOY ACKNOWL6DO6 TMI1T 1 NAV[ RfAD TM16 APPLIGTON lM6 AMOVMT OM N UNDBR VIILU�TON IB ROR iN8 j
ANO BTATB TXAT TH6 ApOV6 1{ CORR6GT�AND AOR[[ TO COY• �URP09[ 01 tDiI�BLIBMINO A P6RMIi RH8 ON�Y. 1�
PLY WITH �LL CITY OpDINANC[t AND YTAT[ LAWY R{GYLATIHO y�UAT10N �
OUILo1N0 CON8Tf1t1R10N. � —
81GNATURE Or PERMIT FEH
PERMITTH s�� �G�✓� 6 � w
AVTHORIZiD AG (j
� /
TOTAL FEB �O O �