HomeMy WebLinkAbout3480 SANTA CLARA CIR - Building PermitsPP0.IECTPUDflESS: 3480 SANTA CLARA CI
.... OWNEII�S NAME: MC GRAW GRACE
nooxess: 3480 SA{�ITA CLARA CIR
COSTA MESA,CA 92626
ANCHIENGINEEP: 7 S 1— 9 3 3 3 flEG.NO.:
nooaess:
UNIT:
uxit:
PEflMITTEE: GRACE MC GRAW ( 719 ) 751-9333
nooness: 3�4g8'�0p SMANTA CLARA CI 9
❑LENSED CONTBACTOA QELLAPATIOt7i ��e��y allirm ihat I am ticensea unAerCpr�ovisio�n� �CFaD�er 9 kommencing wii� Sec�ion
�000) ol Divmon 3 0� Ihe Business and Professions Cotle, and my license is in lull �orce and eifecl.
CITY LIC.: SiFTE LIC.: CLASS:
Dale: Signature:
WOPNEHS' COMPENSATION DECIAFATION: I nereby affirm inat I have a cehificate ol consent m self-inmre or a cenificate of Workers'
Compensalian Insurance. or a certilietl copy �hereol (Sec�ion 3800, La6. C�.
POLICY NO.: E%P. DFTE:
COMPRNY:
❑ Cerli�ied caOY is hereby �umishe0. ❑ Cehitietl copy is �ile0 with �Ae city Builtling Division.
ate: ApDlicant: ''
2%EMPTION FBOM WOBNEflS'COMPENSATION OECIAflATIONl�Thissec�ion necd no�becample�etli��he permilisiorone hundretl�$100�arless).
I cerlily ihal m Ihe per�ormance ol �he work lor which ��is.permit is issued. I shall no� em0loy any pers n in any manner so as �o become
subie�� �o ine worker5 Compensatian Laws oi Calilomia� � �
� Signa�ure: v
NOTICE: Ii. af�er making Ihis tleclara�ion, you s�oultl became suble�� �o the ork rs' ComDensa�ion O�ovisions of the Labar
Code. you mu5i �arthwilh comply wiih such pmvisions or Ihis Oe�mit SAall be deemed rewked.
CONSTXUCTION LENOING RGENCY: I hereby alfirm Ihat [here i5 a con5imt�ion lentling agency tOr Ihe pedDrmanCe of �he work fOr
w�ic� Ihis permi� is i55uetl (Seclion 3097. Civ C).
LENOEP:
RDOflE55:
OWNEB BUILDEB OECLABRTION: I hereby atfirm ��at I am exempt tmm �he Conirac�ors' State License Law for �he followinp reason
�Seciion 70.31.5 Business anA Pmiessional Cotle: Any ciiy oi coun�y which reQuires a permi� to consimc�, alter, impmve, demolish, ar
repair any simcWre. prior lo ils issuance. alm requires Ihe applicant for such Dermit to Iiie a signed statement ihat he/sne is licensetl
pursuanitolhe provisians oil�e ConVactoK S�a�e License Law�Chapter 9(cammencing wilh Sec�ion 7000�ofDivision 3 o�the Business
antl Pro�essions Cade) or that helshe is eKemp� ��erefwm antl ��e basis lor the allegeU e�emption. Any viola�ion o� Section 7031.5 by
any applican� for a Oe�mi� 5u�lecis �he aDPlican� to a civil penalry o� no� more �han �ive �untlred Jollars ($500).
I, as owner of �ne pmDeny or my employees vn�h wages as iheir sale compensali0n, will �o ��e work, an0 the
❑ s�mcwre is not intentlea ar oflereU lor sale (Section 7044, Business an0 Pmfessional Cotle: T�e Contractors' S[ate License Law
does not apply Io an owner o� a pmperty who huilds or improves �hereon, and who does such work himsel�/hersel� or �hmugh
�i5 or her own emDloyees. provitletl tha� SUCh imD�Ovemen�s are no� in�entled or oi�efed for Sale. I�, �Owever �he building Of
improvemen� is sold within one year ol compleiion. ��e owner vnll have Ihe bur0en o� D�oNnA Ae/she aitl not build or impmve
for Ihe purpose ol sale�.
I, as owner of the pmpeny, am exclusively coniracting with licensed conlractors lo constmct the pmlect (Section 7044, Business
J antl Pmlessions Code: ihe Comracmrs' State license Law does nol apDly to an owner of pmpeny who bml0s or impmves thereon
and who [oniraqs lor suc� pmle��s wi�h a contrac�or(s�license pur5uani to Ihe ConVactors' Sia�e License Law),I am aware
ihat pmol ol Iheir Worker's Compensa�ion insurance s�ould �e pmvided b me.
'� � I am exempt under Section'. H P.' O 4 4 B. 8 P. C. .
m� mis reaso�: pyL WORR BY OWNER �
�ate: � /�%' ��7� Owner. To �t�J/ �
I Do hereby cently I�al I am aware oi an0 un0erstanA Ihe requiremenls o� Calibmia Health an0 Sa�ery Coae Sec�ions 255Q5, 25533, and
2553C and that I or any iWure buil0ing occupan� will/will not (circle one) neeU to comply wi�h said s�a�e co0e5 antl �he reQuiremenis lor a
permil lor conslmc�ion or moUitica�ion �mm �he Air Ouali�y Managemen� DiSiricl. Re5i0ential cons�mclion apD�icalions are exempi �mm
I�ese pmvisions.
oate'. Npvlicanl:
I here0y cerlify I�ai I have rea4 ihis aDPlication ana slale iha� Ihe above information is correcl. i agree �o comply wilA all ciry antl counry
ortlinances ana staielawsrelatinglo bwltling cons�mclion ane hereby authorizerepresen�a�ives at�his ci�ylo en�erupanlhe above-mentionetl
properly for mspection purposes. l.�
�a� ��' '�1 �� Signalure: /t—n—i4��/ �
�
Driver's License or Sociai Sewrity a:
16at�a6 W�i�e—Building: Green—Cotle EnlorcemenC Canary—App�icanC Pmk—Revenue: Goldanrad—Awessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05770
PERMIT NO: H 057700 PLAN CHECK NO: 02169-92 S GOVT; N SUPP; N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE; OTH
JOB DESCRIPTION ; 20LN FT OF CITY STD BLOCK WALL SQ FT: 20
CLAIM VALUE; 500,00 CALC—VALUE; 400.00 GROUP OCC; R-3 /
COMMENTS• SMOKE DETECTOR IS RE�UIRED IN THE HOME
�r*�e�t�+r*�*�r�t�t�r�t**�tx**�r**�e*�t��t�t* *�t*�e*�r+t�t�r****�e�r+t�r�r**�tx+t�r**�r�r�r*+t+t�r�r�r�e+t�t�*�*��t�*x�*
Z O N I N GS ERTEBQAUCIxRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT; FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL; 41205132 ZNE• R1 REF NO;
PLANNING NtST'ES> 20LF 6 HIGH BLOCK WALL TO HE CONSTRUCTED ALONG THE REAR
�t*���t****x ��e�e*****�*****�t�***�r*�*********�*****�**D*�r**��*�*+Yt�t****�r***+t�r*�r�r�r**
D E V E L O P M E N TV S E R V I C E S R E(j U I R E M E N T cS C
ZONING APPROVED HY ; —l��-�p/� � DATE; �—L—//�-
BUILDING APPROVED BY ; �� e��_ DATE: � �a7��
APPLICATION ISSUED BY
�)Fik iF if if if M iF ik k if iE if iF iFlE ik iF if if k
k�Fif if if if iF 1F 1F iF iFif if iF 3f iF k if iFlF iF
LEGALIZATION:N
HLDG PMT
0
if k �k iF 1F iF iF iF if iE iE iE If 1F 1F �f �P'iPIF iF k if if iF if if itr it iF k iE ik �f if iFif if if if iE �F �f �FlF 1E iF iE iE iE if k iF kiF�Fif !E
F E E S U M M A R Y STRUCTURAL SEGMENT;Y
PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 15,00 50
PLAN 9,75 SMIP/IJON—RES
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 15,50 0,00 9.75 25.25 25,25 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 25.25 OVER/SHORT; 00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
15.00 ,50 9.75
if iFlE if iE iE iE iE iEiE iE iE iE iE iF iE iF iF iE iE �f �liE iF iE iE if iE iE if iF ikiF1E iF ik ik if �f iE if if iE �k 1f if fE if iF iE k if jFif if iE iE iE jf ikiE i(� k 1E k iF iE if %iF if �f !E iFiF iElF iF ii
I N D I V I D U A L F E E H 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
SFR �20 RES—CONCRETE HLOCK�NDLOF FEES � FT, 20,00 900,00
�
EXPIRED
� plete Inspections
�Z7�� �B '�
e
�
� _��:�.:"4''- ` _
L9Tc: _: �.o. _ '.�:�: _ .,
1 �
' CONSTRUCTION AND PLANNWG ,I . P��� & . ' ' �
APPROVALS Permit # Date Inspector qppROVALS Permit # ; Date in:dector
i
1. Temporary Electrical Service or Pole �. 52. Pool & Equipment Location �� '
2. Soil Pipe�Undrgrnd. _ 53. Steel Reinforcement �
rc
�`3. �lectriwl Condul U�lity-Undrgrnd. 54. Forms . . �
�4fElectrical ConduFYt�nbrgrnd. 55. Electrical Bonding � I �
'75�;:�i�al �'inforcer�y�t'� 56. Rough Plumbing & Pressure Tesc ' � `
�6: `€IUetrical UFER:6rntl. . / 57. APPROVAL TO COVER-GUN1aT'E '
._71footings �_� G�%l�L�=-/- 58. Electrical Conduit-Undrgrad. _ i �.;
/
= g. �.'�oundation r . 59. Gas Pipe, O Undrgrnd., Test _
�8. 1(Jatei Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrglnd. j
�1�0. Structural Floor SYstem 61. APPROVAL TO DECK �. �
7 i. Prbperty Sewer Lina& House Connection _ 62. Backwash & Receptor�Final � �
12. Sev�er Cap 63. Heater & Vent-Final -
13. Roof Drains `L �• 64. Plumbing System � Final � '
14. Rou9h Plumbing - 65. Electrical-Final . �
15. Rough Electrical.Conduit 66. Soiar System-Final
16. Rou9h Electric Wiring 67. Fencing & Access Approval '
77. Rough Wiring Sign 68. APPflOVEO FOR PLASTERING
18. Rough Electrica�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL '
19. Rough Heating & Air Cond�tioning FIRE DEPT. REQUIREMENT �
' - r��u � .. �
20. �Fough FactorY Fi�e{Slace ' '? �. L,= -+ _ .. tr y ? qppROS/ALS ' kermit # .
j ` � _
21. �ucis, in�tructur's,; . �.. _ - � .� •� • �0. Under9rovntl�Hydro �
22. Ducts�, Ventilating 'Y, , ' .T ,2; ^ 77. Product Piqing Q�As QOiI �
23. Gat .P_ipe�Rough &�Test � �;.r `�y � ,f ` ,. � 72. UndergroupdiFlush` > -
24. Roof-:Framing � • '�, p: � Y .� a�73. Undergrnd`Storag,eiank OGas rJOit •x�
25. Roof.Sheathin �z'` �' ` �' � " ' '
9 . t �.� �-.� � . � ^!�A •- i4.;Overhead Nydro ^ .
26. LBarCeiling (Stru�turaq & Monocoat � i : _ � .�^ a 75. �pry ChBmical - � ' . �
27. �Frame and Plashing ` � ' ' � '` 76. Di �� � � ' "� � -
�; ��,^ �+ v- Y Stand�pe
�28. Lathing &Siding n" _ i. i'z. 1.. 5�. ^� ••� y 77. =FIXED SYSTEM YFTNAL y _ . - �
29. Insulation , � � ' � � ` � '. 'ti�� � � 78.�FIRE PREV. FINAI . i
30. Drywail Nailing :'�o �` � ^ �r�,� �T `'' � � �' HEALTH DEPT. REQUIREMENT -
'31. Plaste� B`r'own-Coaf's , ;,, 1 ,•�' ,1 , � � ~ r " .�9.'FINAL INSPECTIOjV . T i.
i
'32. .Electrical-Power NleterdFinal • ,: a `. n; ' 1 �r r ,gp. �FOOD CERTIFICATE ISSUED _
y33. �inai..Eletlric� ; r � = x � � �* � -'1 \ �' ' Notes: � ' -
�34. Fina�He3ting�&Air.Conditionipg� �•.a,-. " l ;����'+ �i, `- , . .. . _
� .t •
35. F�inat GasiPipe�-Tesh,�` r. • ' � K y I �' �,� � � .�:.,. -_ � .
, 'Y � : '1 ' . .
.36. Hood.or CanoPY ; • .r.. � C ^ � � �. s" �� .
_ ,.
37. Final`Faclory FireR�ace'^ ""`� `'�'' ` ' ` ' � �
X i o-� r.,.n rh�. � �.
38. EinaL-Plumbing . , . ... , � .�. � ` � -
�39. Water Service�Flnai ' ' '' ' " ' '
� y 7. .
:QO. Gas Service-Fiaai . . �;��._ - � _�� ! . � •
- .
'47. •Sblar pomestic-Finak "• • - ' � t '2• • ' �
i ' y
42. 8ackflow Preventer', � , � �T�� . ' + - �, - . �. .� -�
43. Backflow Irri�ation �'� =�� � ��! � - `.
_ .��
. . r : _ .
�44. Landscape Irrigation,System�,y.rr�,- ,, �, j V �y �, � �. �r - � ' + � �•'
45. Sound Attenuation �'+'�- �r ' - , `'w ' ,i • ; i . .
.� r'� - s r r� • �
^ ti S't
�6. Handicap,Regulatioryc � r ,� r � . � cr i � - _ � .�
47.FINA•LSTRIiCTURE&BUIGDWG � ' -'.i.� � roc� �
r i � � . i ' . i �- .
48. FINALPLANNING� �'� `� . q•"'L�� .�,i � :i . .
49. Electric Release to Edison � + �, '� � P '' s. - -
-v r�
50. as Rele`3se to Southern California Gas Co , `j �' _ - - �• • .. -
� � ���
51. CEiiTIFICATE OF OCCUPANCY" • , ��; , , � . -
No. Date
�
PARTY WALL AGREE[7ENT
��i���:rti�Y�� � .
������i�����
1�S AC�tP.Pi+II�21P� �de and e�tered into this �j day of
�'t���.! q�G�� bY and betveen U KA P�F �`'�� C� G���/
Aereinafter r�ferced to as •LAtID aFEu':t'. ana � b ST! N So /� c9/e
hereinafter referred to as 'AD�TAC@7P PROPPRTY ONE�R•. ��/�neS /r�.Sor�
it is hereby agreed that a party �*all vill be oonstructed on the
property line betveen 3
i' �_�+-/ZA c� (Z
��$ Z Sf�N K f� FA s-L c � 2.
in the City of Oosta Mesa, Cauity of Orarge, State of California. as per
map reoorded in Hook Z4 • Page `f9-SUof Miscellanea�s llaps. in the offioe
of the C,oiu�ty Recocder of said Camty. The Qarty vall st�all 6e ��; tted to
encroac3i �
IN wI�h:SS I�REOF, the parties have estered into this Agre�ent the
day and year first above vritt�.
:.n .....is•
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E� � i/ � �G
� � � ro- • •.�r s•� • . r.•
L�/./�: .' -��. i//i
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� i� L � �/1�7 ,S�rn �ie/ �'i�-;�'!/�!) 'S;�j ��
P4C . � r� 9a�ay :�,����,?%e
� � /�� S.UB�CRIBED AND SW081�t � � � y
�D57� �FS� �� � '�O BEFORE IvtE TF•Il�a
�Z�� � DAYQ�� �g 9 Z
�.
�-�..,-.� �y
1VUTI�RY P'�Je3Lt �
�
____- ..; .
_� NOTE :.,.
' ���p ,�ptgt`aNE PQAN:oYG DTEPARTMENT,
�}q 13` { S"� ��
� p�,�VED
��� p Cp5fA MESI'' �.
Y:. � �ayNtis�� o�T.
`�' ,� SO {� ��' ��
,. ., �,. ��nl � `! Z�
�
Permit # ��
THIS NUMBER MUST
ALL INSPECTION �
�����v��
City of Cosia iviesa Buiidirg Dept.
� `�Y .�jJ�� uF;TE �/�19 �i
� J J
THESE PLANS iidUST 5�= ;1pJ JGy P•± ALL TIMtS �Yi?.KE
NU CHA�'GES �ViTNC:i� FRl^F, .",PPRO'dAI QF DEPT.
��J 7?1E i55UAhC[ GR GR:,'JrW� OF :: "cRi!i% �iA pPPF.OVAL OF
V PLANS ANU SP�CIPV::TI�JS S�'fALL:'6i PE CC�453'}ieSED i0 EE A
f1j �ERMIT FCR. `Jii h! Ai=Ff(�\�� L!'i. F.:sd V%.Y::ii:ii. GF k7iY OP
i TH�E PFOVVSr"Oh5 �CF T�N'I.S CDUE. NC ¢-Eai7lda'i%E-,iL4i.,R:; YO GiVE
� U'.rVCi:Ja'7 T(� b1C.L'ATi CA C�.4<'.:67 -r� r'�:�Yt3:^:� CF :HfS
� .c'J£ SrtALL fsG tNFtifJ E� tP V Sv FAr d5 7HE WUtiK 6A USE
� � YINIC�H I i AUT}{OR1 E$ IS AVJF� �L
J � rHE issuc,nc� , F .�: r c.+sec� �ror; F��n�.�s nra�
!Y1 �i "FECI�!CAlk?745 S°J�/+l1 Rc-�� n�q. 1 td.tE C9il� i.•;a .G'zi�"�AL
` � � � M TrIERG,Lf ��EfF. "�.J � ky � ^.f Cu� . �-aG�n.'*�i M nF'E�R.�BGF� EN
�. � �Pi N :eNJID �a,ilff�a��C�. �R, :F�iC7M �'c4E�,'�tilTJt�G
I � Jfh� C�E51hq4�htlSE'$t'�6 . HP3ir� �Fd �idEi'i'cl4��J,cIRiYF.i£�al
� � �, 1C7L/P 'ION �OF �FWIS'CP"Jc O ; �tDc NN 9: �46Rr6WDIWAYWC'E9P
I i1ECIlY
�caocra 1 I 1 ����ocMa
3ti S�
�,IC��GL. G� 2
��K��Ei�C:�icJ�
RE U{RED
�[11DLMCE •�i19 �� R i�SPE TI�NS
3y � CAlla
�
,� 754-56�
J or
STREET A _
CemeatCopingOutional —�
Channel Block With 13/8 �i �
Horizontal Top o( all
Fences
For Fences 5' o� Less
Vert. Bars 3/8"yS at 4' -0" O.C.
For Fences Higher Than 5'
Vert. Ban 3I8"� at 32" O.C. �
Fill Cells Solid With Grout
Where Steel Occurs
Reinforaing Steel Shali
Conforn+to Sec.A-15-39
A.S.T.M.
All Steel to be Lapped �
24" or to Code
NATURALGRADE
TWO 3/B"O BARS
CONTINUOUSTOV
6 BOTTOM
HOR1iSTEEL MUST BE TIED IN
VLACE AT TIME OF TRENCH
INSPECTION.
TYPICAL 6�� CONCRETE BLOCK FENCE
0
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F�- W 10T H
� SEE CHa
9 BEIOW
o�
FOOTING REQUIREMENTS CHART
WALL HEIGNT 6 � 5
WIOTH 14�� . . . . 14�� . . .
THICKNESS 10�� . 10��
DEPTH OF EARTHTOOTH .-. 24" 20"..
SPACING OF EARTHTOOTH.. 12' 14'.
City of Costa Mesa, California
8uilding Department
.. , _ . �_=.✓!�en Nov. ec.
GENERAL- NOTES
MORTAR: p�e Port Plastic Cemenf, and
T�ret Ports Sond
GROUT; One Part Cement TAree and
One Holf Parts S�and
COPING: One Port Cement, Three
Parfs Sand
CONCRETE: Weil Mixed f.2-I/2:3-I/2
Max. of 7-I/2'Gal;ens oi
Woter Per: Sack of Cement
. .. �
GROU7 MAY BE POURED FROM THE TOP
OF TME FENCE IN CELLS WHERE STEEL
OCCURS.
CELLSAND AREASdF HORIZONTAI.�REIN�
FORCEMENT SHALL BE CLEAR; CLEAN &
FREE Of ALL MORTAR DE6HIS, ETC.
H GF E4RTHiCOTH
�/? iHE HEIGTH Of' FENCE
BELOW BOTTOM OF FOGTiNG
SCALE: I/2�� = I'
AOP�icant to /ill In all spaees exee0� those within �eavy bor0er lines antl sign all apo�ooriale aeclarationz.
CITY OF COSTA A� CyO�NST UCTION PE T Pf� MIT NO. TRACT NO. LOT NO. UNIT NO. A P�y 2one
ProlectAddress �Q`� ����• ��rc G� "- ���0 g: Y 9�
� TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR S Main BUildin ACCesiof Buildin
Applicant's Mailing Address E Front Z
❑ CONVERSION ❑ DEMOLISH ❑ O ER T O
Owner'sName � Phone� � DESC IPTIONOFWORK/USEOFBL� ��� �V� �-�— ����u— ,A Rear N
Address �r ���% �4N�'y. _�� �? i. L v� M � rJ .} ( Ob�� �L�.- FLP /�,�e � Bt'Y �
�_ S I�I TVPE OF PEFMIT GaaDING FOUNoqTIo�V nAL � C Right N
Arch/Eng. License No. ^ K G
Address ❑ TENANT Jey ELEC�ICAL ❑ PLUMBING ❑ MECHANICAL g Left
R
!��Q' -� � OTHER 4 �m �� Ping. flef. # Parking Req./Provided Q
Contractor's Nam Phone _LJ_V_=g,Ci [�
/� i'ROJECT DESCRIPTION Sq. F. � 70 oCCUPA v
Addresslma����� I v- i{ �[%96 Qr4^��+�. � �I ..,__�..,'— PlanningNotes: M
��—�.-�� CONSTRUCTIONTYPE � � VALUATION$�5�_"�� T
City LiCense NO. p �� �'�-S� �� ZONE GRADING GU. VDS. ACRES $,
LICENSED CONTRACTOR DECLARATION
1 hereby atfirm lhat 1 am IiCensetl untle� p�ovislons of Cha�tar 9(CommenCinq Remarks:
with sectlon ]000) ot DiviSion 3 ot the Bu5ine55 antl Professions Cotle, antl
my license is in fuu torce�p eftecL ELECTRICAL FEES
License Class G' �� � Lice9,Sa �fS � �
oate�d' � � Siqnature ��� V-a!>���� �/ PLUMBING FEES AutomaticWasher Transformer ❑ 15�SOKW
WORKERS' COMPENSATION DEC VIRATION 62f Si�k ShOw¢f5 Construction Pole Sub. � 50 + KW
1 nereby atfirm tnal I have a certificate of consent to selbinsure or a tertlflcate
Cookin Unit Meter �u to100am s
o/ Workers' Compensation Insurance, or a certltietl copy tnereof (Sectlon BackflowPreventer ServiceSink 9 P P
3800, Lab. C/�, J � ��� DishWasher Meter �over t00amps
Policy No. ✓`�� ��� �Gomoany �/�'��) �-�-"' � J B3ckflow Irrigation Sewe� Cap
�Certitietl cooY �s hereby furnizhetl. S��o, Fy 1 Dryers �Gas ❑Elettric Sub Panel
Certifietl copy is tiletl with [he city Builtlin9 Divis on. �p Bathtub5 Sewe� COnneCtion
Date Applicant Fan Motors 061 HP �1'h - 8
E%EMPTION FROM WORKERS' COMPENSATION DECLARATION ClaliLi¢f5 $oler ColleCtOrS
�(This section neetl nol be mmpletetl if tne pe�mit is tor on! huntl�etl (E100) or - F.A.U. 100. $018� �9�1$ HP �16�1$+
less). Dishwasher Solar Piping
I certify that In tbe per/ormance ot Ihe work fo� wbich thit perT�t Iz lssuetl, I FI%tu1¢S
snall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave
I Workers' Compensa[Ion Laws of California.
� oate Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light
_ A NOTICE: It, after makin9 this tleclaration, you shoula become sub]ect to the Outlets Range
IY/ Workers' Comp¢n5a[ion p�ovisions of tne LabOr CoOe, you mu5t tor[hwith FIOOfSInkS Urinal
V� compty with 5uch provisions or thi5 permit shall be tleemntl revoketl.
CONSTRUCTION LENDING AGENCV GasSefViCe OUtI¢IS WatelCloSel $Witch25 Sign
�1 hereby a/firm that there is a construction Ientling agency for the parformance � -
oi the work for which this permit is issuetl (Section 3097 Civ. CJ Interceptors Water Heater Garbage Disposal Standing Sections
Lenaer•s Name Generator 00.5 KW �615 KW -
Lenaer's Atltlress Kitchen Sink Water Service Trash Compactor
OWNER BUILDER DECLARATION - �
I hereby atfirm lhat I am exemp[ from the Contractor's Licenze Law for the Lavatofies AutO-Wash
following reason (Sectlon �031.5 Business antl Professlonal Cotle: Any tllY or -_
munty whicn requires a permit ro construct, alteq improve, tlemollsn or repak P-Trap Laundry Tra'ys
any sbucWre, prior to its issuance, also requires [he applicanl for such permit � .
to tile a signe0 statement that he/sne is Iicensetl pursuant to tne provisions ot Roof Drains }
Ue Coniractor's License Law (Chapter 9(commencing with Saction 7000) of
Oivision 3 of tne Business antl Protezsions Cotle) or lhat he/she is ezempt Reinipection FeB $15 luue Fee� $ 3
there/rom antl the basis tor the allege0 exemption. Any violation ot Seclion
7031.5 by any applicant for a permic subjects the applicant [o a civil
enalty o1 not more than tive huntlrea tloilars (5500). ' DEVELOPMENT SERVICES REQUIHEMENTS: .
�1, as owner ot lne proDerty or my emPloye¢5 with wages as their sole R¢InSpec[iOn FBB $7$ IEUe F80 a 3 ' r,
compenialion, will tlo the work, antl the st�uclure I5 not Intentletl o��ofteretl ZOning App�OVed By DetB
lor wle (Section �044, Business antl Professional Cotle: The Contractor's MECHANICAL FEES Building Approved By �� Date
License l.aw tloez not apply to an owner ot a property who builtls or Improves
lhereon, ana who OoeS suctt wOrk himselt/hers¢It o� thrOugh hi5 0� he� own BOil2f HOOd O� Typ¢ I ❑ APP���tion luued By Det —
omployces, provitletl tha[ such improvemen[5 are not Intentlatl O� offeretl to�
Sale. It, however, the ouiltlin9 or imorovement is sola within one year of com- C2nopy Type I I ❑ SUM R �EES
pletioq the owner will havC the burtlen Of provin9 M1e/she tlitl nOt builtl o� Im- DuCt - UOd¢� C.iroufltl
nrove tor the purpose oi sale). BUILDING PERMIT $ SMIP $��
❑ I, as owner oi the property, am exclusivery contractin9 wlth Ilcensetl ton- Duc[ -Svuctural Refrigeration System PLAN CHECK $ PERMIT
Vactols l0 cons[Iuct the p�oj¢ct ($ection 7044, Business antl Pwf¢ssion5 COtlE:
The ConVacror'S License Law does not apply to an owner ot property who Duct- Ventilating �6100,OOOBTU ❑100,000 BTU PLUMBING $ �SSUANCE $
builtls or improves lhereon. antl who contracts fo� such oroiect5 wit� a r.on- �
tra<tor(s1 Lcense pursuam to vne ConVactors License Law). I am aware thac ExhauSt System ❑ Multiple ❑ S stem Repair/Alteretion P�N CHECK 25% $ ENERGV P.C. $
proof��( thelr Worker's Compensation Insurance shoultl be provltletl to me.� ELECTRICAL $ GRADING $
❑ I am exempt untler Section e. & P. C. for [his reason Firepl/Fact. BIt iC80 dk re Dampers
PLAN CHECK 50% $ MICROPILM $ �
Date �_ owner Heating System & Ducting Registers jOf1S MECHANICAL
I hereny certiry that I have reaa this appllcation antl state that the above ❑6700,000 BTU �100,0006T $ TOTAL FEE $
Intormation is correct. I agree to compry witn all city antl countY ortlinancez � PLAN CHECK 25% $
antl Slate laws relating t0 builtling wn5tructlOn, and hereby aulhOrize rep�e- � c
sentatives oi lhis tlly to- enter n e above-mentione0 property for � pIQ
inspection pur . ' �/
Signature Date� `�4'
Dr�vers' �icense or 55 gf. - Reinspection Fee 575 laue Fae S 3 � O1 �0�17459-0001746D Ti�T 54.�� �
0865-46, rev. 5/88 Wn�te - Builtling; Canary - Applicani; Plnk - Accountin9: Goltlenrotl - Assessor DATE: 10/19/SE TI11E� Z3:02 �
!
i ' 1 �
CONSTRUCTION AND PLANNING `,' � POOL & SPA -
APPROVALS Permit # Date Inspector p�ppROVALS Permit # Date Inspector
�.
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement : �
;3yElectrical Conduit O;tilily-Undrgrn.d�. , 54. Forms ,
�4.,Elect�ical Condui�-Und�grnd. !,'_�1 � 55. Electrical Bonding ,
5.'Steel Relnforcement �.i " , 56. Rough Plumbing & Pre55ure Test
i
6� Electrical UFER �Gry�d., 57. APPROVAL TO COVER-GUNITE � '�.
i
7.IFootiings _, ' p 58. Electrical Conduit-Undrgmd. � , ��'
S.� Foundation �., . ; 59. Gas Pipe, � Undrgmd., Test -
9.�Water Pi:pe-Undrg'rnd. ��� �Y� 60. Backwash Lines, P-Trap, O Undrgrnd. �"
; �
10. Svuctursl Floor System -=i � I 61. APPROVAL TO DECK . �
11. Property Sewer Line &�House Connection 62. Backwash & Receptor-Final '�'
�• i
12.,Sewer Cap . � � � 63. Heater & Vent-Final �� •
�
13.�Roof�Drains i ' � 64. Plumbing System - Final
� ii
74. 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 F{eating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,i'n�Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Produc[ Piping O Gas ❑ Oil
23. Gas Pipe Rough�& Test 72. Underground Flush
24. Roof Framing • 73. Undergrnd.StorageTank OGas ❑Oil
�
25. Roof �Sheathing , � a�d g �./V• 74. Overhead HYdro �
J
26. T-Bar�Ceiling (Structural) & Monocoat 75. Dry Chemical � •i-
27. Frame ahd Flashing 76. Dry Standpipe
28. Lathing!& Siding 77. FIXED SYSTEM FINAL "
i
29. Insulation 78. FIRE PREV. FINAL �-
�
30. DrYWaII�Nailing � • HEALTHDEPT.REQUIREMENT . �- �,'
�
31. Plaster Brown Coat � 79. FINAL INSPECTION �'
J �:
32. Electrical Power'Meter-Final 80. FOOD CERTIFICATE ISSUED �
33. Final Electric � " Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test , �w'
36. Hood or Canopy ,
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer ,
43. Backflow Irrigation Inco lete Ins ections �--
44. Landscape Irrigation System ' �'� ,
45. Sound Attenuation '
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING '
48. Sper,ial Requirements Completed
49. Electric Release to Edison -"
I
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY ' . ' ' .
No. Date , •,
2955�
COSTA MESA BUILDINCrSAFETY DEPARTMEt�T
P.O. BOX iRW � COSTA MESA, CALIFORNIA 82826
For Applicant to Flll In Completaly
TYPE OR PRINT
BUIL�INO ...,._ _ _" _' _
COSTA MESA. CALIFORNIA
144 South La Brea Avenue
e..,,vie� onm� u��n��_
E.
144 South La Brea
JAN -7-6�;�00 187 � **{' 1 �R.ilt
cn^.�
APPLICATION FOR PERMR
BUILDING
Fo� otfr� u,e o�y
a[e� sr
ZONi
L[O�L
3
ZONINl3
NO. Of YYL OI NI
�LApI q CYILDIN4
NOTQ: NO HAV! OV[RNAN6 BNALL BE LE88 THAN
�C.TNO. ZO�.OIH Ng� 936-1104 90'T091DHSR8ARP.L
BAVEH
SIZE Ho.o��tnas. Q ALLOWHD fU.B.C.RECUIRBMENT'.
OF LOT now oN
YARDH MPROV6D YARC9APPROV6D
U5H OF MAIN BUILDINO ACCE880RY BUILDINO
EXISfINO BLDO.
�(PPOM C/L9TR6[T)
�erewcec una �nor t n FRONT FT. Rr.
c6nrER o� YTrtc[T RQAR YA D
BID[YA DI L�Ff La� RIOHT S� R.YIDH fT. RT.
DESCRIPTION OF WORK �. em rr. Fr.
1 HlNHBY ACKNOWL6006 TNAT I MAV[ RRAD TNIB APPLICATION
AND BT�TB TM�T TN6 ABOV6 1� CORR6CT AND AORe[ TO COM•
PLY WITH ALL CITY OpD1NANC0 AND YTATt LAWY R[OYL/�TIHO
BUILDINO CONBTHUCTION.
BIGNATIIRE OP
PERMITTfi �
AUTHORIZ[DAO[N ^
vwn. #
owTe
� • i ' a
w
�
� /�9pBo. �. /3 0 �
0
TX6 AMOUNT 9H N UND6R VALUATION I6 POp TNR j
lU0.P098 OP [OTABLI8HIN0 A PEflM�T �88 ONLY. Z.�
VALUATION �
PERMITFBH � �' p
:,�11�J�9y 3G - w
TOTAL fEE S /�d �