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HomeMy WebLinkAbout1089 SANTA CRUZ CIR - Building Permits Y 'mow" CITY OF COSTA MESA • }t"a t BUILDING DIVISION H ."1 r DEVELOPMENT SERVICES DEPARTMENT M98-00248 J � PERMIT PERMIT NUMBER (714)754-5273 • Fax(714)754-4856 MECHANICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1089 SANTA CRUZ CI Status: ISSUED ta Suite No Applied: 06/19/199 Issued: 06/19/1998 Vicinity: 1 Parcel Nunmber: 41206127 (1114-4\1:\k O Applicant TERRANOVE, DONNA Address: Phone: Zip: Owner RONEN, URI Address: RONEN, ELANA COSTA MESA,CA Phone: . 1089 SANTA CRUZ CIR Zip: 92626 Contractor BLUE HAVEN POOLS AND SPAS � Address: 00433 E COLUMBINE ST Y Phone:; /� ly�- SANTA ANA CA Zip: 92707 Yq y 03 • License:453445 _ Y Arch/Eng: - 91 Address: Phone: Zip: License: • SCOPE OF PERMIT CONSTRUCT NEW POOL&SPA: 1 HEATER, 1 GAS LINE, 1 WATER LINE,2 SW.,2 OUTLETS,2 FIX.,2 PUMPS FEE SUMMARY Quantity - -�' Quantity ISSUE FEE $22.00 Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $13.25 Repair/Alt Refrigeration Unit • $0.00 0 •Inst FAU>100 k BTU $0.00 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 0 -Compressors/Absorption Systems Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $0.00 0 15 To 30 hp 1 1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 • • Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers - Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0 Air Handlers< 10000cfm • $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical-Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES S35.25 • 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 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)7545626 • • DECLARATIONS ( r'1 WORKERS'COMPENSATION DECLARATION: I. 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 perfornancl 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: Cartier: Policy Number. (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shell forthwith comply with these provisio Applicant Signature: /1/.�74/YS.29 JJ<-/1—/t�il� Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES MD CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE($t W,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,MD ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions 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.8 f�J ��� Class F r// Contractor's Signature: .!I"7'tiYLY 2 / JA2 -r/tz� - Date: l/l-�,Y 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,CMI 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 DMsion 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 thrdughhls 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 does4norepply to an owner of properly who builds or improves thereon, end who contracts for such project with a contractor(s) license pursuant to the Contractors License'Laws.). ❑ I am exempt under sec. Q/ Business and Professions Code for this reason: Signature: .". Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-properly 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,Gip 2,Art 2,Sec. 341,Title 8,Califomia 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 Safely 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 0 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 materiels 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 a permit 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 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 Califomia 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 Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 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. SignaturrrLegal Owner(s)LTDgte .'1riN.lJ � �cc ' ei • -/tea!/ And/Or Authorized Applicant Date ODES INSPECTION TYPE DAIS ItEMA1.5 CODE I INSPECTION TYPE DAM INDIhJS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 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 q .• 4�J CITY OF COSTA MESA :4- BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT B98-00903 rIgt PERMIT PERMIT NUMBER %bongo se (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1089 SANTA CRUZ CI Status: ISSUED � Suite: Applied: 05/26/1998rr77r�lb Vicinity: Issued: 05/26/1998 Parcel Nunmber: 41206127 Zoning: R1 R1 Applicant LE, VINNI Address: Phone: Zip: Owner RONEN, URI Address RONEN, ELANA COSTA MESA,CA Phone: 1089 SANTA CRUZ CIR Zip: 92626 Contractor WEST ROOFING CO Address: 09612 SUTHERLAND WAY Phone: GARDEN GROVE CA Zip: 92844 License: 694940 Arch/Eng: Address: Phone: Zip: License: SCOPE OF PERMIT I/O EXISTING&REROOF WITH ICBG#3523 CLAYLITE TILE.SEE ATTACHED ICBG REPORT. FEE SUMMARY Plan Check: $0.00 Calc Valuation: S1o,000.00 Permit: $162.25 Claimed Valuation: $10,000.00 • Other: $0.00 • Inspection: $0.00 Total: $163.25 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: rtiP 5, 2 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 DECLARATIONS 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 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: Cartier: — Policy Number: (This section need not be completed it the permit is valued et 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 subjectto 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 provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL MID SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($103,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions 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.Y Class N Contractor's Signature: Date: 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 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 70313 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 end Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, end 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. 0 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 0 No (Section 25533 of the California Health and Safely 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 Catlfomia 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 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 Califomia 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 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 penally of perjury that I have reed 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. Signature Of Legal Owner(s) Date And/Or Authorized Applicant Data g00F s INSPECi1Q1LTYPE - GATE l IALS CODE! INSPECTION TYPE GATE =NS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 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 SiteI 204 Final Demolition 250 Final Building/Occupancy g_z4-01 2446-46 . •••.•• !JO 11Lt. rip-NG Vt "•ll ICBG Evaluation Service, Inc. n 5360 WORKMAN MILL ROAD • WHITTIER,CALIFORNIA 90601-2299 «.'.. A subsidiary corporation of the International Conference of Building Officials EVALUATION REPORT ER-3523 Copyright o 19971030 Evatuetion Service,Inc. Reissued September 1, 1997 Filing Category: ROOF COVERING AND ROOF DECK CONSTRUCTION—Roof Covering (202) ONE-PIECE"S,'TAPERED TWO-PIECE MISSION,FLAT 2.24 Flat Shingle Tile: SHINGLE,ROMANO' PANS,CLAYLITE',CLAYMAX°AND The finished tiles are 18 inches long,93J Inches wide and 3/is PROSHAKE"I CLAY ROOFING TILES t UNITED STATES TILE CO. etch thick.There are three its thRibs at aro pr inch wide end one 909 WEST RAILROAD STREET rils t then uis 1 full wide.Ribs are of the tile. a 3 inches CORONA,CALIFORNIA 91720.1908 apart it d run the fl 18-Inchsa edlength to tile. Eachis We has - Mro hell holes in the top.Installed weight of the blas is approxi - 1.0 SUBJECT matey 91/2 psi.They are designed for irctaJation with 9-inch One-piece's.'Tapered Two-piece Mission,Rat Shingle,Ro- center•to Center spacing and a minimum 3-Inch head lap. manoTeM Pand Paris, aylitee, Claymore and ProShake' Clay See Figure 1 for further details. Roofing Tiles. 22.4 Romano Pane:The finished tiles are 18 inches(457 mm)long, 11 inches(279 mm)wide,and s/16 inch(14 mm) 2.0 DESCRIPTION thick with two nail holes rear the top of the pan.The installed 2.1 General: weight of the tiles is approximately 9.9 pounds per square foot The roofingtiles we a vitrified clayproduct,manufactured (48.3 kghn2).They are designed for installation with Tapered for use as a A —� Mission tops as cover 1939 with a 13 Inch(330 mm)center to United States Tse Congerry, center spacing and a minimum 3-inch(76 mm)headcap. ing under fhe-1994Un-Urri/orm Buinligg and es a non. 2.2S Clayltte Tile: combustible root covering under the 1996 Accumulative Sup- plement. The tiles are machine formed, fired to various The tiles are the same shape end size as'T-shaped tae.The degrees and have a selection of binned-on colors.The rad- finished Wee are 18 inches long. 13 Inches wide and 1/2 inch ous colors are obtained by controlled firing of the kilns.Tile • thick with two nail holes in the pan side and one nail hole in profiles are illustrated in Figure 1.: the cover side.The installed weight of tiles is approximately • The tiles may be installed on roof surfaces having slopes is 5.9• pounds per square loot(28.8 kglrft7).They are designed to a maximum of 21:12.A soled sheathing conforming to the for Installation with an 11-inch center-to-center spacing end requirements of the code is required for all slopes. a minimum 3-inch headcap. Flashing complying with Section 1508 of the Uniform Budd- 2.2.6 ClayMex Tlls: Ing Code is provided et all roof valleys.Flashing and counter- The finished files are 18 inches long,13 inches wide and 13/32 flashing of not less than No.26 gage corrosion-resistant met- Inch thick with two nail holes in the top.The installed weight al must be provided of all points where the roof intersects of the ties is approximately 5.8 pounds per square foot.They vertical walls. Mone, where called for, must comply with ere designed for installation with an 11-mdh center-to-center Chapter 21 of the code for a Type.0 mortar.Ides in contact spacing and a minimum 3-inch head lap. with mortar must be immersed in water for at least two mire 12.7 ProShare The:The finisted tiles are 181/4 inches(464 sites before installation, mm)wide, 14 inches(336 nem)long end7/e inch(22 mm)Mid 22 Materials: with three nal holes located approximately 1 inch(25.4 mm) from the head of the We.The ties have an interlocking than- 2.2.1 "S"-shaped The: nal on the left side of the the.The installed weight the ties The finished ties are 18 inches long,13 inches wide and r/Z b approximately 5.6 pounds per square foot(27.3 kg/m2). inch thick with two nail holes in the pan side and one nail(ale They are designed to be installed with a maxlmkan 11-inch In the cover side.The installed weight of the tiles is aneroid- (279 mm)exposure and a minimum 3-inch(76 mm)headlap. mately 8 pounds per square foot and is designed for Installs- 2-3 Installation; lion with an 11-inch center-to-tenter spacing and a minimum 3.inch head LID. 2.3.1 General: Tees shall be installed in accordance with 211 Tapered Two-Place Mission The: Table 15-D-1 of the code.Approved tile des may be used as en alternative to naling.On roof slopes less than 3:12, the The finished Nes are 18 inches tong,curved to approximately tiles may be used only as a decorative material over other one third of a circle,having a chord width of 81/2 inches at the types of approved roof coverings,as specified in the code and bull end end 7 inches at the smaller end.The tiles have an ev- at the discretion 01 the building official.Maximum roof slope crap thickness of V=inch and an installed weight of approxi- is 21:12. mately 9.6 pounds per square toot(46.9 kghm2).They are de- Clay or metal birdstops or a 1-itch-by-2-inch(25.4 mm by signed for irstalation with 11-inch center-to-center spacing 51 mm)wood imp shall be installed at the eave to elevate the and a mirrmum 3-inch head lap. fast cone of tiles.Tiles are nailed along gable rakes to ten- EnIudoa rgerb 4ICAO Entvtian Strike,be.,ere lesedobb Spew6 Isiorm erkn M MIA satins 41010.ar0tring the aide epee Mks the tepee basset£rdsanbe repent at sir ah retuned as nprseadq encu way see Sears ea estliesity dtreuesaoareanimate.rereenefe- . See ler are*fate savesng1ort gab repair a boar yea ideredest km or ether aeeaakddata nada!!by tae. p&raa.7M 00 Eton Smith.be_Sebkaf es,M s redeye,id rear rode war ate Mt asee bact peons set/eat in a nee dog hie rr.jffeSThew ee es..emo h IC50 a� dea aSarin,lee.wren a fayaet Y I.aq"ffa6.l'ar ether man S the report tar c Y-peed eeea'day the rent gee Sidon Mrfelee,lee b me tatted to,aetaa..aatary Page 1 of 8 05/26/1998 11:28 9097349591 US TILE PAGE 03 Page 2 of B ER-3523 tinuous 2-inch-by-2-inch (51 mm by 51 mm) and 2-itch- 2.3.7 Tile Repair. Damaged tile is removed by breaking it • by-3-inch(51 mm by 76 mm)milers,installed side by side. completely out of the field and cleaning away all debris.Exist- As an alternative,a2-inch-by-4-inch(51 mm by 102 mm)nail- ing fasteners must be removed and the nail hole sealed with er,laid flat,may be installed along the gable rake.See Figures an approved sealant.Any damage to existing underlayment 2 through 6 for additional details. must be repaired prior to installation of the replacement tile. • 2.3.2 Flat Shingle Tile: Installation details are similar to Replacement tile is inserted into the open space,maintaining those described in Section 2.3.1 of this report except as fel- head and side taps.The de is secured with approved plastic lows: cement or adhesive,a No.11 gage corrosion-resistant nail or 1. A full bed of mortar Is provided under the exposed portion an existing wins tis fastener. of each rake We as a closure. 2.4 Identification: 2. At hips and ridges,a mission type Or o Y type hip and The letters U.S.T?are embossed on the bottom of each the ridge the is set and nailed In cement mortar or roofers'ee- near the nail hole on the cover side.Additionally,the tiles are went identified by meas of a tag attached b each shipping pallet 2.3,3 ClayMax Tile: Installation details are similar to those bearing the evaluation report number(fCBO ES ER-3523) described in Section 2.3.1 of this report except as follows: and the installed weight 1. Hips and ridges are provided with continuous 2-inch- 3.0 EVIDENCE SUBMITTED by-3-inch(51 mm by 76 mm)nallers to support ClayMax Reports of tests conducted in accordance with the Accep- trim ties. tante Criteria for Special Roofing Systems (AC07), dated 2. Mortar or weathert locks are not required at hips and July 1997,end installation instructions. ridges. 4.0 FINDINGS 2.3.4 Romano Pans:Installation details are similar to those That the One-piece"S,"Tapered Two-piece in Section 2.3.1 of this report except that Romanope Mission,Mt Pans are installed at a maximum 13-inch(330 mm)center-to- Shingle,Romano Pans,Claytte,ClayMex end ProShake center side spacing across the roof dope. : Clay Roofing Tiles comply with the 1994 Uniform Build- . Mg ProShakeTTN: ProShake Wes sines be installed In Mg Code"'ea Class A root coverings and with the 1996 accordance with Table 15-0.1 of the code. the ties Accumulative Ing,subject Supplement as noncombustible►cel u ov- APPrcv+d efng,surojtct to the ftftorHng conditions: may be used as an alternative to nailing.At roof slopes above 7:12 and less than 21:12,each file must be fastened with two 4.1 The tees are manufactured and Installed In steer- fasteners and a wind lock or nose dip.Tiles are Stalled from dance wi h this report and the manufacturer's In- right to left,maintaining a minimum 3-inch(76 mm)headcap. structlons. 2.3.6 All Tiles:All roofing felt urndefayrrrerro a ups,ridges 4.2 The tries are manufactured at the United States Tile and rakes are to extend over or under the nailer;provided. Company plant In Corona,California. Approved tile ties may be used as an alternate to nailing. This report Is subpet to n-su mination le two yes. • I. tine Laboratoriesof c& rtt eaafova, inc. 71 ' „ 3310 Airport Way r (I Oy Long Beach,CA 90806 (562)426-3355 v, I�) A) �� Mail: P.O.Box 47,90801 FAX(562)426-6424 TESTING Compression Test on Gunite CUSTOMER: MCBEE DON EXAM NO: 98-1-197978 5292 BRYANT CIRCLE DATE: 08/21/98 WESTMINSTER, CA 92683 JOB NO: 70521002 PERMIT NO: JOB NAME: DON McBEE: VARIOUS SITES OSH PD: ( SEE BELOW "SAMPLED FROM” OSA AP #: ADDRESS : FOR JOB NAME & ADDRESS) FILE #: PAGE #: 1 ARCHITECT: CONTRACTOR: BLUE HAVEN POOLS ENGINEER: SUBCONTRACTOR: RASKIN DOUGLAS GUNITE CO SAMPLE FROM: Wall of swim pool, Zagner, 1089 Santa Cruz, Costa Mesa, CA. MIX: 4 1/2 to 1 SPEC. STR. (PSI) : 2000 SLUMP: N/A CAST: 07/28/98 DATE TESTED 08/11/98 SPECIMEN NO 1 AGE (DAYS) 14 TOTAL LOAD (LBS) 92000 LBS PER SQ IN 3140 SPECIMEN SIZE 6 . 110 12 . 230 AREA SQ IN 29 . 32 SPECIMEN SHAPE: Cylinder COMPLIANCE: Lab #8222/Test Method: ASTM C39 SPECIMENS BY: Dale DELIVERED BY: D. McBee RECEIVED ON: 08/06/98 DISTRIBUTIONS: MCBEE DON, 1 CLIENT-FURNISHED SAMPLES .s test hcs been performed and report precured 'rased upon the specific samples; provided to us by above-client.:U?e ;ass me no responsibility for vanarions' )n' quality (composition, appearance, performance, etc.) or any ocher feature of similar subiect matter produced (manufactured, fabricated, etc.) by persons or under conditions over which /�✓ Tcc we have no control. ALL REPORTS REMAIN THE PROPERTY OF TWINING LABORATORIES OF SOUTHERN CALIFORNIA.INC.AUTHORIZATION FOR PUBLICATION OF OUR REPORTS.CONCLUSIONS.OR EXTRACTS FROM OR REGARDING THEM IS RESERVED PENDING OUR WRITTEN APPROVAL AS A MUTUAL PROTECTION TO CLIENTS.THE PUBLIC ANO OURSELVES. RECEIVED D SEP 1 71998 • �,, CITY OF COSTA MESA ;`ate•► BUILDING DIVISION l ""^ 1 ' DEVELOPMENT SERVICES DEPARTMENT trir4 • PERMIT PERMIT NUMBER " B98-02053 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1089 SANTA CRUZ CI Status: ISSUED Suite: Applied: 11/12/1998 Vicinity: Issued: 11/12/1998 Parcel Nunmber: 41206127 Zoning: R1 R1 Applicant: ZAGNER, GEORGE Address: COSTA'MESA,CA Phone: 1089 SANTA CRUZ CIR Zip: 92626 Owner: ZAGNER, GEORGE Address COSTA MESA,CA Phone: 1089 SANTA CRUZ CIR Zip: 92626 Contractor: ' Address: Phone: Zip: License: Arch/Eng: Address: • Phone: Zip: License: SCOPE OF PERMIT . LEGALIZE TWO 24"X 48"SKYLIGHTS il.C.B.O.#3933. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $350.00 Permit: $21.00 Claim Valuation: $350.00 SMIP Res: $0.00 SMIP Com: $0.00 Other $21.00 Inspection: $0.00 Total: $42.00 • • 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)7545626 DECLARATIONS 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 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 carder and policy number are: Cartier: 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 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 provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVEPAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S1o0,0a0),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECT1ON3TO6OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Cede,and my license is in full force and effect.Lic.# Class It Contractors Signature: Date: 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). Lenders Name: Lenders 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 Ucense 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 Ucense 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: z .d7 Signature: �� . tP' ) Owner ID verified by drivers license. $Fres ❑No D ars Ucense o./� Expir 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,wit 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,Califomla 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 ❑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 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business whlbh 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 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? 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 a ppermit for such construction or modification from the South Coast Air(Duality Management District or from any other air pollution control district or agency? 0 Yes 17 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 pan of the facility to be conatructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If'yes",the facility must moet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 II 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? ❑Yes 0 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 propertyfor . • rposes.I agree not toy ory allow ncy of any building authorized by this y;, ' = -.•actin. — i �-gn cure Of Legal Owner(s) . Date • •fOr Authorized Ap?t^'-iem ' • — =E•. ' Yr•. •f. van INflIW.S CDDE• IMSPFCTION TYPE SAM INDBALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 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 m a S 2446-46 ? 'C. TC rru,sHrs 2x4 �DD�4 0,,vT. /2 r C1 I. i i2)1•1° / 1!r Z1jeywG __ y 43,5-&24 4 roc _ D� 2Xa Ex Or tir 2.X4 Snip t6"©c ftp 2. SMeli,e r ib sFEt d • t 4)24;4(.4,, 3 skYc.e4rs -- .,.:05;-"---: .- • • SUBJECT TO INSP7P1CDS' R,EVJEW AND ,. .N , ON-SITE =c�:.SAL ._,:y-y ° ., iefi(48'. ' , ke // ^O 'i I b 9 ti ALN 2x6 r c0'� D '" . /Z Pct ) ' 'L/',o •i rvz ; io ►-► 435gZq oc. 'fro- DLA 2x4 2X4 Sm'D 4s4 EX1STlNG lG°©c Anise Sar e DR,t vsicee a ler. /i Mia 3 a SUBJECT TO INSPECTORS'RO�VAL - REVIEW AND AE ON-gm_ fait48. cc N � kit Spvey 5c E•v,4 tion/ • , i'/e://.2 tuAtC 5cHE2,4,f E. — S//`-ms0N e2/o 2o/sr f-i/1wo&ic 4,.. . _ .. 71 _ ._—. % h S'nSon/ Fr N4ohm e 1 I --- - / oR Ea, [ 1 /to„ Il . /4W )-7A42-- 1 I,_ _ - ) ' �,� ,-.a.;4 BJ T TO INSPECTORS' N `� Z �'— ND APPROVAL �� II N. ,`�E ..._ IF u ,1 N,I. II I # - I _4 (ZX/D Fiqeig BvKRD $ Cbx Sfrccn c ea/q�e t/,v,4,4s ® a - OC, CCr DcS .4) (/lauNDreadata fre w/. //4 . x1 ' nnosay. e .6 "sr rfds,�zc-,r aft OC F.EG� 2%/Z L'o 'En . 1z 1c---4'z 40 s,6/, 4 J CITY OF COSTA MESA >°9or, ��, BUILDING DIVISION �1.r "�" 1DEVELOPMENT SERVICES DEPARTMENT41/44barargo ill PERMIT /C__ MIT NUMBER E98-00833 (714)754-5273 • Fax(714)754-4856 '77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT .lob Address: 1089 SANTA CRUZ CI Status: ISSUED Suite No Applied: 08/07/1998 Vicinity: Issued: 08/07/1998 Parcel Nunmber: 41206127 . Applicant: ZAGNER, GEORGE Address: Phone: 714-432-9929 Zip: Owner RONEN,=URI ' _ - ' Address .RONEN,ELANA - . . . COSTA MESA,CA. Phone: / ';1089 SANTA CRUZ CIR, Zip: 92626 ' , Contractor: ' • Address: , ' Phone:. . ,Zip: , -'(license: SCOPE OF PERMIT 'REF 698-01390, INST 6 LITES,5 OUTLETS AND 3 SWITCHES.' . . , ' FEE SUMMARY . Quantity Quantity' ISSUE FEE $22.00 - -Temp 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 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 $0.00 0 Lighting Fixts - $6.00 6 up to 50 kva/kw $0.00 - 0 ". Recept Outlets ' , .\ $5.00 5 - up to 100 kva/kw $0.00 0 Switches - . $3.00 3 - over 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 I 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 ride of 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 $36.00 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 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 DECLARATIONS ' 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 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: Carter: Policy Number. (This section need not be completed i7 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.end 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 provisions. Applicant Signature: Date: 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 provisions 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.A Class A Contractors Signature: Date: 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). Lenders Name: Lenders 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 subje a 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 t Contractors License Laws.). /R exen ! = Business and Professions Code for this reason: •I01 .r 1� Date: • ner ID- y drivers license et Yes 0 No Drivers License No. , Expires: V cation nershlp by(type o •- ment,i.e.-property lax 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: I Wit 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? ❑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 end 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? DI Yes 0 No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (11"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 0 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 reed 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 ins.:ction purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ur. R:.:1 ) _ D Or Authorized...00carlt Date r^^'// c , .' nr•, t' DATE INuALS CODE t INSPECTION TYPE DATE !MALS 1- - Fixed System Final Fire Prevention 206 Final Mechanical _ 1266 Pool Spa Final 208 Final Plumbing L� /� 200 Final Re-Roof 210 Final Electrical 17 /-1'dI5 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 i.� S7- �� CITY OF COSTA MESA °y ,� BUILDING DIVISION t'"1 '_"'1' ' DEVELOPMENT SERVICES DEPARTMENT P98-00492 �• PERMIT PERMIT NUMBER se (714)754-5273 • Fax(714)754-4856 PLUMBING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1089 SANTA CRUZ CI Status: ISSUED Suite No • Applied: 06/19/1999(gA ,� 'V r Issued: 06/19/1998 Vicinity: Parcel Nunmber: 41206127 Applicant: TERRANOVE, DONNA Address: Phone: Zip: Owner: RONEN, URI Address RONEN,ELANA - COSTA MESA,CA Phone: 1089 SANTA CRUZ CIR Zip: 92626 . . , Contractor. BLUE HAVEN POOLS AND SPAS Address: 00433 E COLUMBINE ST Phone: "tel SANTA ANA CA . Zip: - 92707 . • .AFI, VVE D License:453445 � ,p'` ` -4 - Arch lEng: r _It i Address: 94 v % Phone: .C� 'lam Zip: t License: SCOPE OF PERMIT CONSTRUCT NEW POOL&SPA: 1 HEATER, 1 GAS LINE, 1 WATER LINE,2 SW.,2 OUTLETS,2 FIX.,2 PUMPS , FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $22.00 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap , $8.75 1 Trap Primer $8.75 1 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors ' $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank ' $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo ' $0.00 0 Wash Basin Set $0.00 0 Drain,Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $5.50 1 Sink,kitchen $0.00 0 Water Softener $0.00 0 • Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $45.00 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 c e and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of is15 rmit. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS C- ;• WORKERS'COMPENSATION DECLARATION: i 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 tt pertorme f 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 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 provis s. G ,,/ Applicant Signature: (-11 A-A t 0.l A .A--,+.,A-4t_i Date: é -�/t d' - WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML RNES UP TO ONE HUNDRED THOUSAND DOLLARS(5100.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES, UCENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions 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.Uc.k ,// Class N Contractors Signature: �(f4—it rri.(� l-i4i4�Lv�d=�ci Date: t!i��9 me 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 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. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-properly 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,faisework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gm 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 0 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 hilly 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 ❑No (Section 85850.2 of the California 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 aermit 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 ❑No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:1 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 end Emissions. Signature: Date: CERTIFICATE OF COMPUANCE 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 properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Odner(s) Date ' /��T—o-�� ‘—_,64--ate-76,,--AA--- • 4 /9-911 ' And/Or Auth rized Applicant Date CODES INSPECTON TYPE DAM INifALS S0DE( I65PFCT1RN TYPF DAM N AL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 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 2446-4e �r IP� • 4 CITY •OF COSTA MESA r wt BUILDING DIVISION F r ""•'ice r DEVELOPMENT SERVICES DEPARTMENT ��.t, E98-00594 �•a� PERMIT PERMIT NUMBER (714)7`54-5m2773 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1089 SANTA CRUZ CI Status: ISSUED 2-J/? Suite No Applied: 06/19/1998 Vicinity: Issued: 06/19/1998 Parcel Nunmber: 41206127 Applicant: TERRANOVE, DONNA Address: Phone: Zip Owner: RONEN, URI Address RONEN,ELANA COSTA MESA,CA . ' Phone: 1089 SANTA CRUZ CIR - Zip: 92626 Contractor BLUE HAVEN POOLS AND SPAS Address: 00433 E COLUMBINE ST Phone:', SANTA ANA CA Zip: 92707 License:453445 SCOPE OF PERMIT CONSTRUCT NEW POOL&SPA: 1 HEATER, 1 GAS LINE, 1 WATER LINE,2 SW.,2 OUTLETS,2 FIX.,2 PUMPS. FEE SUMMARY Quantity Quantity ISSUE FEE $22.00 Temp 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 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 kvalkw $0.00 0 Pool/Spa $44.25 1 up to 10 kva/kw $0.00 0 .Lighting Fixts $2.00 2 up to 50 kva/kw $0.00 0 Recept Outlets $2.00 2 up to 100 kva/kw $0.00 0 Switches - $2.00 2 over 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 1 hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $11.00 1 - 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 ���� (o 4Q Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $83.2 \� fl Intermed Pole $0.00 0 lel a `�G� COMMENTS/SPECIAL CONDITIONS OW 9 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 coda9'„ nd all required InspectIons and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of th' p it. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS C ) 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 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 polity number are: Cartier: Policy Number. (This section need not be completed it 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 provisions. Applicant Signature: Xer")t,1RJ A. -til A-4_--/.'-tcc- —/i_- Date: � i'1/ 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(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I em licensed under provisions of Chapter 9(commencing with Section 7000)of DMsion 3 of the Business and Professions Code,and my license is In lull force and effect.Lie.# Class# Contractor's Signature: vTv iA Date: G/9 r9J 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 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. 0 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,faisework,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 DMsion of industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: DMsion 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 0 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 ❑No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pan 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 0 No 6 (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 end 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. Sipatuce Of Legal Owner(s) Date • And/Or Authorized Applicant Date CODEJ. INSELCTWNT'PE DATE ILLS CODE E INSPECTONTYPE DATE IMALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 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 ' 244646 t I CITY OF COSTA MESA l ;? BUILDING DIVISION Y ;' � - ' DEVELOPMENT SERVICES DEPARTMENT 98-01065 J• 2�#; PERMIT PERMIT NUMBER (714)7 5 4-55 2773 • Fax(714)754-4856 BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 9� Job Address: 1089 SANTA CRUZ CI Status: ISSUED `-"1-4/ Suite: Applied: 06/17/1998 Vicinity: REAR OF PROPERTY Issued: 06/19/1998 . Parcel Nunmber: 41206127 Zoning: R1 R1 Applicant: TERRANOVE, DONNA Address: Phone: Zip: Owner: RONEN, URI Address RONEN,ELANA COSTA MESA,CA Phone: 1089 SANTA CRUZ CR Zip: 92626 Contractor: BLUE HAVEN POOLS AND SPAS • Address: 00433 E COLUMBINE ST Phone: SANTA ANA CA Zip: 92707 License: 453445 Arch/Eng: Address: Phone: Zip: License: • SCOPE OF PERMIT NEW POOL AND SPA AT REAR OF SINGLE FAMILY RESIDENCE. FEE SUMMARY - Plan Check: $170.46 • Calc Valuation: $16,000.00 Permit: $262.25 • Claimed Valuation: $18,000.00 SMIP Res: $1.80 = SMIP Corn: $0.00 , Other: $0.00 • Inspection: $0.00 Total: $434.51 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 22-0 Rear 4-0 Left 50-0 Right 4-0 PARKING axistinq: 0 Required: 0 Proposed: 0 NOTES: • S D1 � 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: 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 performer&performerof 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: Cartier: 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 taws 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 pr sions. Applicant Signature: G-i4i—X---9.(J 4r—+%cLi Date: �/ 9 V WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SWILL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100000),IN ADDMON TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTON 3706 OF THE LABOR CODE.INTEREST,MD ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions 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.It /�� Class# Contractors Signature: /�b'--/1---rW 17---;A f (At t—' Date: 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). Lenders Name: Lenders 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 LJcense 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).): ❑ 1,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.). ❑ 1, 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 drivers license. 0 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,end 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 0 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 No (Section 65850.2 of the California Govemment 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? ❑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 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. Signature Owner(s) Date /� • 6/y-9y And/Or Authorized Applicant Date COOS 6 111,21.034/IME VOOEI I65PEf'.TnN TYPF PA¢ WM= 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 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 a • P-4' .:: 1 BUILDING DIVISION C-7- • 1.1 ......... ' DEVELOPMENT SERVICES DEPARTMENT PERMIT PERMIT NUMBER v B98-01390 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1089 SANTA CRUZ CI Status: ISSUED Suite: Applied: 08/05/1998 Vicinity: Issued: 08/07/1998 ParcelNunmber: 41206127 Zoning: R1 R1 Applicant: ZAGNER, GEORGE Address: _ Phone: ' 714-432-9929 . _ _ Zip: Owner: RONEN,IURI - - Address RONEN,ELANA\ . . _ /COSTA MESA,CA\ _ . Phone - `,v 'N / 1089 SANTA CRUZ CIRIR,1--,, - - Zip: 92626 �' ' V / -,. - / Contractor: ` / - ' //i' '.t, !,, //.-,� Phone: Zip: - - /' License '� Arch/Eng: , ;j/ - • , - • Address. • - Zip: - ' License: -- , SCOPE OF PERMIT ' / ,253 SQUARE FOOT,ONE-STORY ROOM ADDITIONTO ANEXISTINGSINGLE FAMILY DWELLING FEE SUMMARY - Plan Check: $105.46 _ - -----_ _ / . Calc Valuation: • sto,000.00 Permit: $162.25 __--- - , / 'SClaim Valuation:, • $10,000.00 ' MIP Res: $1.00 , 'SMIP Corn: $0.00 '` Other:' N$0.00 • - Inspection: N$0.00 Total: . $268.7,1 - PLANNING BZONING ' SETBACKS : - - MAIN STRUCTURE Front 20-0 - - Rear 18-0 - ' • Left' -18-0 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 • 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 DECb7RATIONS ' 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 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: Cartier: 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 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 provisions. Applicant Signature: Date: 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 provisions 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.# Class# Contractor's Signature: Date: 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 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 plicant 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 e Contractors License Laws.). •1 m exempt. Business and Professions Code for this reason: _ / nature' /._-�/L�S ". . , ) Expires: Ver" atlo• • 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,Califomia 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,ora 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 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 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 Califomia 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 a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 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 Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 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 propert • ' ssp—pecpption purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. S7/ '1" `yam' — Sig.. re Of Legal Ow- =r(s) Dat A •.•r Autho ' cant . Date III ,.,,a INSPECTON TYPE LATE IC= LODE, INSPFCTIONTYPF DATE NI®ALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 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 /A-LI-IP v 244646 I r - y y • CITY OF COSTA MESA • ; 4BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT _ B98-00760 PERMIT PERMIT NUMBER (714)7'5+4-52773 • Fax(714)754-4856 BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1089 SANTA CRUZ CI Status: ISSUED Suite: Applied: 05/04/1998 Vicinity: Issued: 05/04/1998 Parcel Nunmber: 41206127 Zoning: R1 R1 Applicant: ZAGNER, GEORGE Address: 1089 SANTA CRUZ CI • Phone: 714-432-9929 COSTA MESA CA Zip: 92626 - Owner: RONEN, URI Address RONEN,ELANA COSTA MESA,CA Phone: 1089 SANTA CRUZ CIR - Zip: 92626 . Contractor: • - Address: • Phone: Zip: License: Arch/Eng: Address: ' Phone: Zip: License: SCOPE OF PERMIT • CONSTRUCT 6'HIGH BLOCK WALL-190 LINEAL FEET FEE SUMMARY Plan Check: $56.71 Calc Valuation: $3,800.00 Permit: $87.25 Claimed Valuation: moo Other: $0.00 Inspection: $0.00 Total: $143.96 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: a/e: 64% veIl 4r4on-7 5(24gpd EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or it 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 • DECLARATIONS WORKERS'COMPENSATION DECLARATION: p .� I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain ayertlllcate 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. • 0 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 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 provisions. Applicant Signature: Date: 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 GYMIPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In lull force and effect.Lic.# Class 4 Contractor's Signature: Date: 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,CMI 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 e Contractors License Laws.). ❑ I em exemp BLsec. �---7�Business and Professions Code for this reason: Signatur ' . Owner ID verffi by drivers license. Yes --❑ Drivers License No. Expires: Ve' tion Ownership by(type f doc ant,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 0 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 Flre 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? ❑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 placation apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 No (Section 85850.2 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 es 0 No B (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 wit I state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described proper ms action purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Own (s) ^� Date And/Or Authorized licant Date INSPECTION TYPE DATE IKONS CODE I INSPECTION TYPE BATE MALI 4'1 16 Fixed System Final Fire Prevention 208 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall Sit 4/4$ 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 244646 7.1 1I Ii. I. 1 . I ..1 I .I. 1 i sf'vre 1 Cto'Z C/RGt4' ' I j I i I sI I , . I I ; : : /089 • I I I 6vnc r � I I I i j/ J � j II f �Hk , • • • . .. I. •I •.I. I ... I / • /'. / I ` I I .. ... - .. i i . I . I-. 4 I . . Vii. ! _ . I I i 1 tto I ... . _. I .r . . O'7 o ; I • I ; . i I I , _ -- . . . I I 1 , I / I i .i I i 6 I 1 I '..� ; L% i I I ;,...1 ! I I e C� I I Lits , SO / ;/ I I ` 1. . I. .. I I CITY Cr COST i � I I ••I '- I .%' „ : Il • • . � I . ! • -- P.L �;i� C1GIC1'Y, f ; \ I I I I I I I SU JE T T J D'-DGI DErT• REG,. ; cits. i �� ,EAT I , 1 i 1 4 I ! I I I , I • I I , 1 v I I _ --1 I I c�� 1L F '�_- '_' 1 ' I I W -- .. : !IS: grr:ll "e� (n e,•J3� LCT I I I I l I I m 1 I PLOT /o<AN/I ' I �: t; ' s i CBILIN !4 g' gl r/0S, NC u2--- -. ._.. . . .. F LOT- - - I. � , $ VEY I \' Z� A .:-- ._.. ._-... . ... ... . .. . .. _-... ! aI 'p 1 ---- -'-- L- , _ . I M AY BE REQUIRED-I 1:�y n Iwo I - in — 1 1 I 1 H :lu , --,-- - n n _ Sia 1-,,,,! 1 .. . . . , • . . , : . . • . . . ; ' 1 • i 1 I LI I I : I ' ' , : • ! • • ; ; i • las - •;ter.4 Blatt ! i ' ' • . I 1 ' . 4/co 1/4 A r A a • I : , , . a • , I- ; — - - -- ! ! • I 1--- ! -1 I. • I ! !- ! ! : ' ! 1 • . : : • ! : .. 1 ; • . Cte:Poice,:o etre- jaGotic- Anse c . . ' ! ! ._ .. ; --- I .-- - - - i ! I ! C'e7Ais rR LI,crej ...L.1(s,4e op, 7-ire.: ! 1 •-• 1 P iagatE4rr ! eiA.rj.e- . . ! : . ; • „ 1 ci Jr 4;1E1- 1 11 7 1/4 1 , •,0rA i in-,6"r-;ele : /gin! art' ! . , ! , • . . . • •• 1 - 1 ' . ! - - , i ni Rif-vs ,' ! 4 7 cs^)9 • .5-Ai.../in C icade I &Jack_ i ..- -t .. . . a cos 7-',9 A-1.4--tr"A, : e-A-LI 92 6-44e1 l • •1 • I 4 1 ; 1 . -- . c , • . : — ..- - i ii I 1 1 .cyr, • , . , • ' • I • - , 1 ! i II 1 I I , . : • i ; I 1 , -- - • • --- -- ---- - - - - - - -- --- ; - - I1 • - - - , I , 1 1 ! - • , , , ._ .. .... . . . .. . _ .. . . .. iI . 1/2_ ... . . . . . I • , , ---- 1-_,:-,--1k. -- - - - • . • ites- 1', • 4: . . 1 • ! ! . ! i /4 4 I • ; ; . t -- • - - I _-_1 ,-.--- ; ! , , - • - ore I - . . . . • • * --0, •• i 7194 raiipAi • . ! ! I islk W E ,440 e co #4.7ts.r,:p .. . . 1 -. t -N - . - U ; ; . • • N ° -- ---- - ..--- --- - --- _ .._. N , - , 2 Er 5:i; A ! >Ch. I ?i i•lig fit'. ' ' : > I _L. 1 • 4-; ei 2 s! .,b 1--- • I I , , Et:N.1k I I - • il . • - - I • I 1-. =.Er .:... ilk I ,_,..i • 1 . I • !Th I • • • TYPICAL 611 CONCRETE BLOCK FENCE , l ® " - CemenlCopingOptional 1:7j _ - GENERAL— NOTES • Channel Block With 1.3/8 " ., - ii jjj Horisontal Top of all ' _� ,. MORTAR: One Part Plastic Cement, and Fences _ Three Parts Sand For Fences 5'or Leu a! o ii II -UI,- GROUT: One Port Cement,Sand and Vert. Bars 3/B"¢at 4'•0"O.C. d _ One Half Ports and a = COPING: One Part Cement, Three Parts Sand For Fences Higher Than 5' i r0 '�� �SI �'�_. CONCRETE: Well Mixed yen. Ban 3/8"� at 32" O.C. rt _ ---- - 1:2-1/2: 3-1/2 , Fill Cells Solid With Grout i�� > Z „ Ii I Max. of 7- 1/2 Gallons of Where Steel Occurs > — Water Per Sack of Cement Reinforcing Steel Shall I f �' I in GROUT MAY BE POURED FROM THE TOP �_ I. OF THE FENCE IN CELLS WHERE STEEL r Conform to Sec.A-15.39 w o • ■■ •,� A.S.T.M. II Z ~ _IIt- 1I'�C CELLS AND AREAS OF HORIZONTALREIN- 2 w rf _■■ FORCEMENT SHALL BE CLEAR,CLEAN& I. •I All Steel to be Lapped pe - FREE OF ALL MORTAR DEBRIS,ETC. 24"or to Code !II I - - � . . - - . NATURAL G/R,AD • : . E 1 • ,•,07411w. v., .. .... I� ..„..b.,..:.•A / 4 S . .. TWO 3/8"et BARS W, , - . . . . O , - , • - CONTINUOUS TOP&BOTTOM elflI . WlOTH TO 16. 0 C. MAX. Ino f/ 0 SEE CHART L4 .I HOI't7ZSYEEL MUST BE TIED IN BELOW - ss -6C. DEPTH CF CARTHTCO1H PLACE AT TIME OF TRENCH /4'r r I ` i/? THE HEIGTH OF FENCE V, INSPECTION. BELOW BOTTOM OF FOOTING e • 1..4.C.11..J4.112•• SCALE: 1/2" -: I' FOOTING REQUIREMENTS CHART I WALL HEIGHT 6 ' Sr-4r 3' WIOTH 14" 14" 12" . . . 12" THICKNESS • . •. . •. . .10" 10" . _ . . 8 " . 8 " rnrn• • DEPTH OF EARTHTOOTH . . . 24" . . . . 20" . . 16" . 12" SPACING OF EARTHTOOTH. . 12' . . 14' 16'. . 16' A L City of Costa Mesa, California \ ;.REG. Building Department ffa� w ! ._ _.T r evPSec Nov.e2 t` a PARTY WALL AGREEMENT THIS AGREEMENT, made and entered into this 11¢h day of tirte /y�� by and between • !ft. «-r k 2R-, —ta_ / hereinafter referred to as "LANDOWNER," and Lo r r uIre • 13c-k c-1 t\ hereinafter referred to as "ADJACENT PROPERTY OWNER." It is hereby agreed that a party wall will be constructed on the property line between /OraA9r 1;e-cc-A l c�.uz (arc. Fc2ccof cosi ve nal, ?Was s of Adjoining Properties) /© 5 3 SaL &wet Ce, , --- in the City of Costa Mesa, County of Orange, State of California, as per map recorded in Book 26-6 , Page 5-46 of Miscellaneous Maps, in the office of the County Recorder of said County. The party wall shall be permitted to encroach I " I IN WITNESS WHEREOF, the parties have entered into this Agreement the day and year first above written. LANDOWNER / ADJAC: T PROPERTY 1JWNER (Si. azure) ('pS naWre) — 6N✓ 1.0✓✓a4IC • Ornn _ Name (Typed or Printed) Name (Typed or Printed) /4F9 f4 car.-)a ez 1083 3t4&. era efei_ (Address), (Address) Gc .5-(779 ic-f e rA f2G 26. NOTARIZATION REQUIRED 1906.46 PARTY WALL AGREEMENT THIS AGREEMENT, made and entered intointhis /4 day of �/59/1:-eto Net , by and between # `� er/.1"Po ti� hereinafter referred to as "LANDOWNER," and Aereik(e c hereinafter referred to as "ADJACENT PROPERTY OWNER." It is hereby agreed that a party wall will be constructed on the property line between 11121r arce-e-tA ecr-f-`2 (3d . (c f/zst /f-e1sz- 9Z6?C (Address of Adjoining Properties) 762 \,..Si9.01J,4 S 79 , Uos7,4 /1&s71-- 6 o2 in the City of Costa Mesa, County of Orange, State of California, as per map recorded in Book 2� , Page S/G of Miscellaneous Maps, in the office of the County Recorder of said County. The party wall shall be permitted to encroach IN WITNESS WHEREOF, the parties have entered into this Agreement the day and year first above written. LANDOWNER ADJA ENT PROP RTY OWN ' " ( (Sign. ure) ' rignature) e htYule`'- a (..t92Y0 e Name(Typed or Printed) Na//m,,a (Typed or Punted) 76 IALCI,S 4(red (Address) &J� fy.PJQ pi2-r: 92CP-6 (Addresnn, : r eg�/�l n_L czoc).62.6 NOTARIZATION REQUIRED 1906.46 evil • PARTY WALL AGREEMENT THIS AGREEMENT, made and entered into this �4 14 Q� day of ante ; 1991 , by and between (// rC 4 1 hereinafter referred to as "LANDOWNER," and Thf 'iao.._itcckie_ hereinafter referred to as "ADJACENT PROPERTY OWNER!' It is hereby agreed that a party wall will be constructed on the property line between • 7e2J'1. lenAe l9nc2.- &K( &'ka t /-ems 92426 (Address of Adjoining Propenes) 4-1nas Ar_ehu_e in the City of Costa Mesa, County of Orange, State of California, as per map recorded in Book 2 , Page S4J� of Miscellaneous Maps, in the office of the County Recorder of said County. The party wall shall be permitted to encroach IN WITNESS WHEREOF, the parties have entered into this Agreement the day and year first above written. LANDOWNER AD C 'ROPER Y eWNER (Sig :cure) 0.` �� (Signature) T i/p and ai-harez-&cL/el Name (Typed or Printed) Name!typed or Printed) 4og cica-c-4 (CC,2 /0i0 &alliat ack Te_ser_C'{9:2426 �pa,ddress) (Address) , /7:474,42 ca._ 9°a z6 NOTARIZATION REQUIRED 1900-46 OrnstAL ' c ri.2 /leis-a SAV9d RE-t----7 raj 4'22-& ca co a/ -e - C--ecor Avr--,/ .O-4c or9 v.- a /080 f9,Cei os f✓ ' ( e C 1lv/ B 9e -oo76-o1 r2), age Zarg 4r_e� .0e-v-le-A'. 6-9A //Le f er7.Z at /0J'9 f ' Gnu' Vit-. deGCon- P � -64° E -7 7� /4,,/( /c7o.�.'4r4fr 6K " . /act " -P d4�o�1c Ana'/ a ii -4 _7 asci P�. _fr ch7 %-" rc?teC l/2-*.6 7.'12� e7- t, ijt ce a “44Go/t2d' ca/Le5 rn .5e at IliJlvZ /.C-c-c ,std 62--eti G42--/ a• /-edee(A.y _&,e r,.eae cc / CDA-CC-40<S o/ Act 7p a-tj LIZ-LZ 7// cJ? 14+_ /262/1 ��( _ a r'C�P 4c ee_„2 „, ,r& VIfrt /',PGbrs2,(�. t c-c ,Cl � � J /499 1 A eh< a- e1 1 • PARTY WALL AGREEMENT "C THIS AGREEMENT, made and entered intointhis /4' day of ri /9 P , by and between /% re f Z7fztiht hereinafter referred to as "LANDOWNER," and hereinafter referred to as "ADJACENT PROPERTY OWNER." It is hereby agreed that a party wall will be constructed�pon the property line between 1°� fad P?tc2 9 C c Ce9d /ice/st C2 9ZCZc L_ (Address of Adjoining Properties) /9 2� / : /Oq� (6t �c4� eacz dl act '<arcam 72G2C in the City of Costa Mesa, County of Orange, State of California, as per map recorded in Book , Page 514C of Miscellaneous Maps, in the office of the County Recorder of said County. The party wall shall be. permitted to encroach IN WITNESS WHEREOF, the parties have entered into this Agreement the day and year first above written. LANDOWNER ADJAC NTP OPERTY OWNER r igna •re) (Signature) t� PAP/ 6 -CAA) nDIi 1"( AP/ 614 /Name (Typed or Printed) �O Name (TTypped or Printed) /� ,� //',` /�_tt J C cc. ` 72 t 2 re ci I 00 t�1 �_LS 6 ` C_,A r r (Address) (Address) o/Xc /fe gam,t c Q(Z Z NOTARIZATION REQUIRED (k 1906-46 CITY OF COSTA MESA REQUEST FOR OCCUPANCYTRACT NO, (eV32> DATE 4)6 2.8, 19/90 LOT NO, ADDRESS /059 S Cfh)2_ 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 of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he-she-they) —�•�fl®L� (was or were) Ce-9—iC_-- /advised that this tract has not been given final inspection nor has it been accepted by the City of Costa r✓.esa as having complied with the conditions of approval which were imposed by the city at the time the final tract map was approved. • The city assumes no liability for the enforcement of the conditions necessary • tor approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. BY Pureb ser X BY eve open and or authorized representative BY — 7, Lender F_ BLUE HAVEN POOLS Z a,ueg aco.,2Ce 1089 SANTA eltU , C/,e, C6S7-44 MESE} '-131- 9929 S-/z-9$ :BUYS YEfl AD.DRESS CITY RES. PHONE CONTRACT DATE ` 'MAPO:MRFRAGE TA sn sr ppytyEORI-IOT -_-- _--.,_-TRACT JOB PHONE !Owner ientliContreoux.eoknwitedse - that Obey .ore 'responsible qor she - I L ,I I . y . , . fr �Ri'4EHit. . . , • . _ . . . FC°mmalor Owner iFe nue!Porno idol'by I I 1 I I. `� LCv Pence illeplecer enttbY I . -. 1 O/.Y/ - / - • - i y. I Tree lgemovel:by I I --- —^ --'-'-- ----" - '- TreeiHauling by I I/rg-`lirralO Pc'�' •_� �i�.y�y�lqq� Nz-Off- I ' MPR -1 . • r /�• / . Dec 'ay Y I rr nsm..�ITfuK" -1 -Tr .. ... `'i -��I L//C/(� F ilei.a.a alT.rb .. . . . . Mee,. -v i �„ n r„tc0;1R'D PER•' , Expeneion.uoim°mv I I I❑' 'I[JIGI1��i'+"A"I"'111121 + `1 iT-NO. . _ , _ • [yI I.T IGT+�?T ,G°T`lly'aN P IjRE ANDf OR PUB iC Gee Linel•IPermlb lbyl I I ❑' �� - - • - , Heater'Vent inamv I I I --�.211., •Q171NfR.� -- --. _.. _ ... . r �U1 T 1 tty ! I c 4 Electric iNuokuO•y - '= , - --- - .__ _ I '•fl P.Trap:4'Purmlto'by , I I ®-� 1f>_D ,„..,.EC%ON TP1!CITY:DRAINAG$-�,.r. ..�'___. F I _ 'tits —tow DATE: . 9b l f i , . I • oz � ill?;..?: entEfR: - - OATS:._+14- . . • . sod CO 0 M014 0 7'RANSPOic TION:_ -- —r • - o y DING PERh�IT MUST BE OBTAINED• •- V -SITE CRA N3"ED 1 t�'— _ . . -I 0 - D ON 11 �lON(� - o • 1 1 ,G SAFEN m m < !V�- I -1, -i N E POOL i X 3 2- I \r7C� Q I a 1 t m D. SPA -7 X •te ay4 t t 'v , ki ' F c> r-. .; 1`lu r �... .t �� SQ. FT. y z _ — � , - - j a • PER.FT. 9b• �2 i e 4.11C' i �� f 1 I i� t1 r DECK 4-75o 1x1 p:i'F i� 1 .s • 11 DRAINS • z " ! rs ! .4 I ;.fin. `# I --22 / - ' I ' '/ i or i ' r.; GAS �_ u Y ' x • I 7 ELECT 7 fro y ---,--17.• !� 1' • -;. . .... - ! HEATER y60 K i r a �: $' i � 3- ?f. U r- I t s21.7 .i .. }J FIFER leu pf ct, `r1. 1-yy PUMP T �PUMPI - .r r`. • ' , �_ • \ ! ' T ' Jr., \s` / ASF• rl �' nt7P If _. I •i ;tr.,._1 }�ia. —1/ \ ` ' ,utter I t RBE r 11 i l ;I \ ' / ddd ? I FACING ` - '-,-_ -1 iyl t '- i • 'tee; x '\�I I4 PLASTER W P t( D I ISION O-.N: _I e • -10 -, .. I .0 a • i 'I' I ' I CITY OF ice.` q.MESA/{ ,1�1 I-{. \ \ �. I y ;= .' APPR • rl ` r 3 I 1.! • Ot t a_ ` t.:stel atpa s�gspedficetonsMUSTbekeptontMsj�ata_ f_�jil'° •1stlu\ • .- i, t- :Eska 8:4changes f alteration i�.AD NI A: r: ' .+ t -•I ! :y,'.@f,,t: City of staMesa. I ` !. 1 ` . I I r \ _ A: ieestampnnofth' and tans SHALL NOT be held to rmitorI .t 'app 3 Ta1 1 ! of he vio4lion of arty provisions of any City of Costa Mesa Ordinarhce and/or r. e law. I •'' {- A /A- p T:::c,e ntam and permit .1 i • lire b limitation and become null antl 1 '.11th- 1 J in e-' I ' h I \ t_i _ V I...reser`ed ISe!.E4 flt}S.. rve,par USC.5303Av1hing60.ays of issu nce-',� 1,- .I I -.0•• ,ipick • p 1 • \ 3 r, i � . � ..-Ail i ' \H � �' i Z jt, _. A -� f t ' t»..�� ! Villi '! Q i ate - _ - > - J .,�12 7_I . \ 1 iceIo l/B" :9' I • O r I '7.((�/ - . . // �,,1 • /,gyp-\\ ' I r �� , ialeemen hL A/ M`LL L7( I • i • ,_ ' / �� i ti I 1 S P • NR VIE 2 - • rt. . _1 f i, . , ILL � 'CODE Y — • subJe. o St• .`•I Plan note wk N-,, , �-• �� „� 'P ' I iF I I IM LLrWA[I• I _ n t N., 4-2r:1-I=' L t\ 1 `/C„U`^' PuMP (FILTER IMEATBR - Damn H: Raskin R.C.E. 57577 i • - C I •03...„,... 1 • G Pool ng' a nflg Inc.. . . fr .`1 ; Pi{Ci_ t� -_1 1 GAs IEJeE'iER -----U � S/N6u.).- METER �� • F\� ! e '4 _ .v .. N. EAHRST DecKinD Strata its tor iilW�tratitm ONLY. . . ._ ` " /flLCV.dP . 4T_j3 z•—Custor er understands:bey are to twelve___:- __------_--.-— ---.1 .. .ii 1I .0 sq. :d deckiirigis. 3 SKIMMER uppsR ;LIGHT f COr1tr30t. Access: S/� IPe d/ z. lDivinp!Boerde ` , i DEEP MALLOW ;e':eoard II'IOven,W:L. END Flip •011'0301,11 11'tOver WNL. _ ,1o•leoerd 7'tOver.W;L• - I J '1r1Bo•td,3'IDvn,W,L. __..--.._. . •STD.IEORM:NO.1T 3O9 — .�__.----- — - - MOT TO SCALE - ' . -_. ciOWNER NELSON. CARL 0. DATE 10-8-70 JOB ADDRESS 1089 Santa Cruz Circle BUILDING PERMIT NO. 32326 C -RAL CONTRACTOR Obmer-no 1der DESCRIPTION of WORK Add Patio and Det. Shed At .10. _ LOT 26 TRACT 6638 FIRE ZONE VALUE $ 1.800.00 INSPECTIONS Signature Date GROUP J TYPE V ZONE R-1 SOIL SUBCONTRACTOR PERMITS ISSUED GAS Date Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. 0 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND �q POWER 0 71, //zy�-7�y0 ROUGH WIRING I/f-7 Heating and Vent. TRENCHES FORMS 0 STEEL REINF. 0 .alre f//re) FLOOR SYST BOND BEAM n STEEL REINFORCE in �J(/ // SHEATHING %V/� p/6/Td FRAME AND FLASHING LP" -'NG - IN n OUT n P ER, BROWN COAT , STRUCTURAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL ,t, _,ehla 10_g-j, 3/ 71/7 PLUMBING, FINAL AND GAS TEST H ELECTRIC, FINAL171f' 14,Y4/7 J RIIII DIN'. FINAL 32326 PAID ' OCT -8-70cN,OO 398* ****27.00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely �J'q // �j RECEIVF�D`�Se /DATE RECEIVED DATE/ ISSUED BUILDINGADDRESS nOOp 1 �5,(�/)f KJ�//l/Y�C��rCC )` l F • �' /CT ( 6'_�- / O /C/'—k- D OWNE k I O. /✓/Eis C/ A.P.NO. -- 3 ,a MAIL pq ,�"� {y- p /J� BUILDING ,. / AD DRESS/OO/ Siff-4//-4 Oi�,IL3 tie. ADDRESS 1UA I S C-idai[ Cc. z �' L/{ dO CIT �CL &S Q. No.6- _iS // TRACT 6633 LOT a4 B OCK Z Z < NEW ADD ALTER REPAIR MOVING DFMOI ISH ZCONSTRUCTION RC710N ON LENDER // `�� /e/f q -1 m pG�ifVL� Ci \/I'`� -1 O BRANCH h� -I OWN E -I ADDRESS -------- CO ,,I,-a180, VALUE A Ir J CO ARCHITECT TEL. USE �A�Q^�^"1 ��D\ OR ENGINEER NO. J O Q FIRE WCC ADDRESS ZONE TYPE GROUP O. w APPROVED n,{ J O CONTRACTOR LVW/Vt. /� BY • . DATE/� /IJ CCI Z J 2 ADDRESS W w TEL. Z NO.OF USE OF NEW(' d.- Pj_n i ZH CITY NO. � IPl�1NS 1� BUILDING 1^� Q/[,J in STATE ,r- CITY _� YARDS APPRO VV€D YARDS APPROVE IJ • NCC LIC. NO. ' LIC.NO. • ACCESSORY BUIL iliikG - D O - I (FROM C/L STIEj 7111,SIZE NO.OF BLDGS. q W z� / OF LOT I NOW ON LOT / FRONT T.E -r (a FT. USE OF EXISTING BLDG. „,sA S I R SIDE ad FTLQrt SFT. I- SIZE OF `/ J NO.OF * d,,�JL' Z NEW BLDG.�`J �/` ROOMS I STORIES / L.SIDE / r� SFT. 3)-FT. ,II Q EXTERIOR WAL �iy/i ROOF pp_ C) // V COVERING 'i/glop OW COVERING S-O�QK _REAR 9 FT. 6 (f AFT. _ J USE OF BUILOINAND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 1 MAIN BLDGS. ACCESS.BLOCS. < 9 r�- r / VAR.# DATE p /11 //- 1 0 - / V If 3/2/ C.U.P.# APPROVEDI- /) / l zAc,C /� BICi�J'. /! X( (O ' . AY APPROVED C r)ATF 110/ 3/ / 0 O / in UI hereby acknowledge that I have read this application and state ✓ that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ I- any person in violation of the workman's compensation laws of (q the State of California. // /�/'`��T//�(I / 4‘4,A13147 rree I hereby certify that I am properly licensed as a contractor under ��" SQ. FTV 3rW (� y(J(ys O the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDERA7ALUATION IS FOR S Chapter 9, and th t such licenses are In full forco and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 9 am exempt fro th provisions of the State of California Business — m VALUATION and Professio s Cod& Divisio 3,Chapter& r�� n PERMIT FEE $/ O Signature o /J /J �, r m Permittee \ ��CY-- � �,t//� ry PLAN CHECK $ E Authorized Agent !/ s� '\ •� ;Y u. o TOTAL FEE $i /s OWNER HET(P7.FR FNmRRPRISES- C. M. DATE 9-26-69 JOB ADDRESS 1089 Santa Cruz Circle BUILDING PERMIT NO. 30881 C ERAL CONTRACTOR game DESCRIPTION of WORK , , . , ; t; , h. Ao. - LOT 26 TRACT 6638 FIRE ZONE VALUE $29 563.00 INSPECTIONS Si.nature Date IGROUP I & J TYPE ZONE B-1 SOIL M s 44-1-76 SUBCONTRACTOR PERMITS ISSUED _ _ GAS ! ��f Dote Number Signature WATER•(p//l►LS? 11,1So "-1---76 PI":binq ROUGH PLUMBING CFP--;#1,115F l _ �/, '� SZ� t�� �a PROP. SWR, LINE y1HOUSE CON. V M5/i-I-6- 7D V r t aR-% .5' t5? SPRINKLING SYSTEM VV MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER 0 ROUGH WIRING 6y-/ '7-7�, / Heating r Y TRENCHES FORMS STEEL REINF. , -- / y-36407 S �jrZiG1 ' �„ ;l_-G/'//7.' '74,17 7/ FLOOR SYSTEM Y-/W-10 , C/ IlCC <n /-i:1 7!1 // BOND BEAM n STEEL REINFORCE n / -- SHEATHING SHEATHING J'/. ifp FRAME AND FLASHING r�� rit /0". 7,t LA-4ING — IN AI OUT V 4 •//44/, 7/,'7//70 I ER, BROWN COAT I�16 8"//7/70 STRUCTURAL, FINAL v' / q n�-rJ HEATING, VENT., REFRIG. AND A.C., FINAL —OWNS) /�-G/ EM,.._,, -A4�O .3/2.52/ PLUMBING, FINAL AND GAS TEST 1 1 ELECTRIC, FINAL _ _ ./4Q/rf s'-2-,_2q BUILDING, FINAL 7 • /%A-v q— 7e ,-r 20881PAID 152.25 VW 12-69PASA00 418* *** COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECE,r 9 y DATE RE IV D DATE ISSUED ADDRESSBUILDING 1089 Santa Cruz Circle 2// , 3 �A SEP 2 6 1969 - PERMIT(Na1 OWNER Heltzer Enterprises-Costa Mesa A.P. NO. / c?uon MAILBUILDING /0,9 O �j9 � ADDRESS 740 No. La Brea Ave. j ADDRESS n W U CITY Lo L.A. Cal. N 371' 171 TRACT 6638 LOT 26 BLOCK 1- 2 Z < CONSTRUCTION United California Bank NEW ��AODALTER REPAIR MOVING DFMOI LSH — N a LENDER to Main Office J D BRANCH w 6th and Spring, L.A. OWNER M J ADDRESS VALUE / •/ / J < OR ENGINEER Erank Gonzales TEL• 532-6878 S �� �� ' �, }��, o' za 1336 E. Chapman, Orange, Calif. ZO EE TYPE ✓ GROUP t— o_ ADDRESSt/// w APPROVED W Z CONTRACTOR George J. Heltzer & Assocs. BV DATE —10 cc J et ADDRESS Same as above Zf= ZONE NO.OF USE OF NEWR 1gl0 t. 11 _ CITY NOL Rl PLANS 2 BUILDING 8Ft Gar. STATE CITY YARDS APPROVED YARDS APPROVED y CC LIC. NO. 291998 LIC.NO. 1707 MAIN BUILDING ACCESSORY BUILDING U SIZE NO.OF BLDGS. (FROM C/L��S//T�R STREET/ OF LOT NOW ON LOT RONT LO FT. P I L- FT. USE OF �1 EXISTING BLDG. R..$1DE 111 FT. FT. I— SIZE OF NO.OF if----- Z NEW BLDG. ROOMS STORIES L.SIDE 5 FT. FT. Q EXTERIOR WALL ROOF U COVERING COVERING REAR 0 FT. FT. f —I USE OF BUILDING ANP WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& CL a MAIN BLOCS. ACCESS.BLDGS. Q Residence with attached garage V AR.* .# APPROVED Plan No. `4dr /D7 APPROVED // r �� A - WI.D z mm DATE 10l7 O V/ VI hereby acknowledge that I have read this application and state D that the above Information is correct and agree to comply with CC all laws regulating building construction, and I shell not employ I— any person in violation of the workman's compensation laws of CO the State of California. /!�� to ZI hereby certify that I em properly licensed as a contractor under O SO. FT. 'j o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR //fiA Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: ✓D am exempt from the provisions of the State of California Business V• LU•t IQry -y +/„ / = — and Professions Coda,0 Lion 3,C.apter 9. 3 O PERMIT FEE $ (' 4-ec N C Signature of Permittee • $ _ "ter-� -y / o7/r Authorized Agent . rs7,1 G —