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Home My WebLink About839 Santiago Rd - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT �ob nddress: 839 SANTIAGO RD Suite No Viciniry: Parcel Number. 42545216 Applicant: FONZ RODRIGUEZ Address: 7050 LAMPSON AV GARDEN GROVE, CA Owner: ATKINSON, DENNIS PATRICK Address: 117 FLOWER ST COSTA MESA, CA Contracmr EMPIRE PLUMBING Address: 7050 LAMPSON AV GARDEN GROVE, CA FAU CAHMGE OUT SAME PLACE ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <700 k BTU Refrig Sys >700 k 8TU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000c(m AirHandlers> 10000cfm Floor Furnace Floor or Suspend Heater $23.50 $14.80 $0.00 50.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 50.00 50.00 Quantity 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ISSUED BY: Phone: 714-530-7320 Zip: 92841 Phone: Zip: 92627 Phone: 714-530-7320 Zip: 92841 License: 794154 SCOPE OF PERMIT FEE SUMMARY Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unii Ventillation System Evaporative Cooler C ommercial Inci n era to r Domestic Incineraror Compressors /Absorotion Svslems Upto3hp/100kBTU 3 To 75 hp / 500 k BTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Up to 3 hp 3To15hp 15 l0 30 hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: 02/15/2007 Issued: 02/152007 Quantity $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 $0.00 $0.00 E38.30 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21•92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work Is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspectiona and final approvel must be ob�ained. Failure to obtain inspections and final approval will result In Ihe ezpiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 zaauas (s�ao� WORKERS'COMPENSAnON DECLARAnON: I hereby aHlrm untler penelry of perjury one of the following declarations: ❑ ,�eve entl will malntaln e certilicate of cnnsent to sell�lnsure for workers' compensation, as providetl for by sectlon 3700 of the Lebor Code, for the peNortnenca of the work for whlch this permit is issuetl. v end will maintain workers' compensation insurance, az required by secllon 3700 oi the Labor Coda, for poAortnance ot the vrork for which Nis pertnit is issued. _� My w rkg6' campensation Insurence wrrier antl policy numher ere: �- Carti � rti/'��<�c�NG Pol Number: 1�✓f��p�o3�� s section ne�not be compleled i! the permit is veluetl et one hundred dollars ($100) oi less.J �i LICENSED SignaNra: ihe peAormence oi the work �or which this permit is Issued, I shall not employ eny person in any menner so as to become subject to the workers' 5 of Californla, entl egree the� it I should bacome sub�ect to the workers' compensatlon provlslons oi Section 3700 oi tha Lebor Cotle, I shell forthwith ese ipvisions.p �/ 6�<6 -��l' ��J— - - o1a. _ � � 5'J EWRE WORKERS' COlAPENSATION GUVERAGE I5, DIU L'AWFUL AND SHALL SUBJECT PLOVER TO CRI INAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED (5100,000), IN ADDITION TO THE WST OF COMPENSATIQN, OAMNGES A$ PROVIDED FOR IN 5 OB E IABOR CODE.IMEREST, ANO qTTORNEI^5 FEES. RICCTORS DECLARA710N: T licensed untlge� oS� ot Chapter 9(commencing with Section 7000) ot ' n 3 of theBusinas�tl Professions Coda, end my license is in full ture: �� . � a . .Gj�_ Daie: � .� - � 7 '-O % LENDING AGENCV: - �_ ndhallhere is e consiruction lending agency for Ihe pedormance of �he work for which Ihis permit is Issued. (Sec. 3097, Civil Code). Lendels Atltlress: Date: OWNER-BUILDER DECLARATONS: I hereby eHirm t�et untler penalry of perjury ihat I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW fo� Ihe lollowing reason (Sec. 7031.5, Business end Professions Cotle: Any city or counry which requires e permit to constmct, alter, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for such pertni� to file e signetl stetement that he or she Is licensed pursuent to ihe pravislons ot Ihe Cantractors License Lew (Chepter 9(commencing wlih Section 7000) af Division 3 of ihe Business and Professions Code) or thec he or she Is exempt ihereirom and tho basis for Ihe alleged exemption. Any Woletlon of Section 7031.5 by any eppllcant for a pertnit sublects the applicant to a civil penelry M not more than live huntlre0 tlollars ($500)J: ❑ I, as owner ot t�e Omperty, or my employees wilh wages as iheir sole compensetion, WILL DO THE WORK, and the sirucWre Is not intentlatl or oHered tor sale (Sec. 7044, Business and Professions Code: The Contractors License Law tloes no� apply to an owner of properiy who builds or improves thereon, and who does such work himself or herself or Ihrough his or har own employees, pmvitletl that such Improvemen�s are not Intentletl or oHered tor sale. If, however, the builtling or improvement is soltl within one year ot completion, Ihe owner-builder will have ihe hurdan ol proving ihat he or she did not builtl or improve for purposo ot sele.). - ❑ I, es owner of ihe Oroperty, em E%CWSIVELY CONTRACTING WITH LICENSED CONTRACTORS to con5truct tha project (Sec. 704d, Busine5s and Profes5ions Cotle: 7Te comractors License Lew tloes not apply to an owner ot pmpeny who builds or Improves thereon, entl w�o contracts for such prqea with e contractor(s) license pursuam to ihe Contraclors License Laws.). ❑ 1 em exempt under sec. Business end Prolessions Code for Ihis reeson: SlgnaNre: Date: Owner ID veniied by drivers licensa. ❑ Ves ❑ No Driver's License No. Expires: Vediication ot Ownership by (type of Document, i.e. - pmperty tax bill o� deetl): __ DIVISION OF INDUSTRIAL SAFETY VERMIT CERTIFICATION: ❑ I hereby certify that no excave0on live (5) or mora feet in depth imo wNch e person is required to descen4 will be made in conneclion with work euthonzed by this permit, antl that no building slrucNre, scaHoltling, talsework, or demolition or dismantling thereof, will 6e more than Ihirty-six (36) teet high. (Chap. 32, Grp 2, An 2, Sec. 341, Tule B, Califomie Adminisiretive Code). ❑ As owner-builder, I will not employ enyone to do work which woultl requlre a pertnit trom t�e Division ot Indusirial Safery, as noted ebove, unless such person has e permit to do such work iram the divisian. Signature: oate: Division of Indusinal Safety Permit Number: CER7IFICA7E OF COMPLIANCE ANO AU7}10RVA710N OF ENfAY: I certity under penalry of perjury that I have read this application end state Ihat the Information given is wrrect. I egrae to comply with ell state laws end ciry ordinances relating to bullding wnstruction, en0 euthonze representatives oi the Ciry of Cosia Mesa ro enter upon the ebovadescnbed property tor inspection purposes. I egree not to occupy or ellow occupancy of eny building authonzed by Ihis pertnit until tinel inspection. cooe �, iNsreenoxnve 761fi Fi:ed System Final Fire Prevention 1266 Pool Spe Finel 200 Final Re-Root 201 FIneI BIocWReteining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Damolition P� ItffII1SLi cooe� ixsvecnoxrrve 206 Final Mec�anical 208 Final Plumbing 210 Final Elecirical 212 Flnel Fire Prevention 220 Finel Planning Approval 222 Final Site 250 FinalBuiltling/Occupancy P� i� -�Y -CJ% pplicant to fill in al� spaces wilnin heavy bortler lines antl sign all aDC�opri�te tlecL'f, tians. PERMIT NO. TRACT NO. LOT NO. BLDG. NO. •� PERMIT I�, ��LO �o MI noo�ev C ,//i /fDU�-F-/Ld_ �� Arch/Eng. License No. � Address � Contractor � � .��/ �� 01 � Address � [7 � o %1 LICENSED CONTRACTOR ECLARATION \1 hereby at(Irm th:.t I am IlcenseC untler provl51on5 Of C mencin9 wltn section 7000) af Division 3 ot the Pmteszlons Cotlg, antl my Iicense is In full force 9 WORKERS'COMPENSATION DECLARATION I h¢reby attirm that I have a certiflcate of consent to self-insuro or a ro-Hti�re o( Workers' Comoensatlon Insurance. o/ a certlfietl copy � N � a�-�> >—.,r�mPan i i:� i r. r��L�-i � V Cerilfietl copy iz heraby IurNzhetl. - d�ertitietl copy is filatl with the dty BUlltling DiviSion. EXEMPTION�FROM WORKERS' COMPENSATION DECLNRATION (This section neetl not be completeC If tne permit i5 for one huntl�ed SEloo) or leu). - CCrtify that in the perfO�mance o( lhe wo�k tor wP�Ch thi5 pe�mit IS issuetl, I shall nOt emplOy any person in any manne� so as to betOme subject to tne Workers' Compen5ation Laws ot Ulifm��a. � Date Si9nature � NOTICE: If after making this tleclaration, you shoultl bemme subjecl to [he Workers' Comp¢nsdtion provisiOns of the l.ab0� Cotla, you must tOrthwith comply with such provislons o� [his petmi� shall b¢ tlecm¢tl f¢voked. CONSTRUCTION �ENDING AGENCV t hereby ai(irm that there is a constructlon lending a9ency tor the per- formance of the work ror which this permit is izsued (Section 3097 Civ. 0.�. LenCer's Name Lentler's Atltlress OWNER BUIIDER DECLARATION I nereby aftirm tnat I am exempt hom [ne Gontracror's License Law for the following reason (Section 7031.5 Business antl P�otessions Cotle: Any city or county which requires a permit to constrvct, alt¢r, improve, tlemolish ourepair any strut[ure, prior to it5 izsuante; al5o re- quites the ap, lit'ant fo� such pe�mit to file a slgnetl Siatement [hat he i5 IlcenSetl pursuant to lhe provl5ion5 ot the Contractor's License L.aw (�^apter 9(wmmencing with Setlion ]000) of Oivision 3 0l �the iess antl Professions Cotle) or that ne is exempt theretrom antl the for the allegetl exemOtion. Any violation of $eciion 7031.5 by applicant for a p¢rmit. subjeGts [h2 applltant to a civll penalty of not more than five huntlretl tlollars (E500). ❑ I, a5 ownet o( the property, o� my employees w�th waq¢5 a5 Ih¢ir sole compenution. will tlo the work. antl Ihe s[ructUre is not intentletl COM�actoYs LicCnse Law tloes not appry to an owner oi a prop¢r[y who bulld5 or improves lhereon, antl who tloes SUCP work hlmself or through his own em0�oyecs, provitletl [hat such implOvement5 a�e not Intentletl or oftered far sale. It, however, the builtlin9 or improvement Is soltl within one year of completion, Ihe owner will have the burtlen of proving he tlid nol builtl or improve to� the Purpose of sale). ❑ I, as owner of the propmty, am exclusively contractinq wi[h licensetl contractors to wnstruct tne project (Sectlon 7044, Buslness antl Pro(¢ssions Cotle: The Cont�aclor'S LlcenSe Law tloes nof dppty [o an owner of proDerty who builtls or Improves thereon, antl who con- tracls f�om such projeCtS wilh a conlractor(s) Ilcesn¢tl pursuanl to the Con[ractor's License Law). � ❑ I am exempt untler Section 8. & P. C. to� thii reason Dale Owner I �ereby cer[ifythat I have r¢atl this application antl stat0lhal the above info�mation is correcL I-aq�ee [O Comply with all�city antl COunty o�dinances and state laws relating to construttiOn, and nereDy authorize repre5entative5 of this Cty to ¢nler upon Ihe 9bove menlionetl property fo � spe<llo u� s. �_ Signature A Date�/ � � Drivers' License or 55 �-� CMF 0865�46 White-Bulltling; Canary-Applicant; TVPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT ' ❑ GRADING ❑'FOUNDATION ❑ STRUCTURAL ❑ TENANT.� ELECTRICAL ❑PLUMBING ❑MECHAI ❑ OTHER .PROJECT�SCl./Rlv OION 54. FT. - � � _ OCCVPANCV_CONSTRUCTIONTYPE VALUATION � � ZONE GRADING CV: YDS. ACRES PLUMBING PLAN CHECK TOILETS URINALS �AVATORIES DOUBLE LAVS KIT.SINKS DISHWASHERS SERVICESINKS SVMPS FLOOR SINKS � FLOOR DRAINS ORINKING FOUNTAINS INTERCEPTORS CLARIFIERS SWIMMINGPOOL PTRAP WATER SERVICE ALTERATION GASSERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS � SOLARTANK COL'CECTORS SOLAR PIPING SYS. ISSUE FEE MECHANICAL , vLAN CHECK HEATING SVSTEM 0-100,000 BTV _ ANDDUCTING 100,000+BTU_ REFRIGE(3ATION 0-100,000 BTU_ SYSTEM 300,000 + BTV _ BOILERS BTV $VSTEM REPAIR,ALTERATION EXHAUSTSVSTEM . MULTIPLE ISSUE FEE k-Accounting: Goltlenrotl-Assessor u 9`�/I . I I /�i i /„" - ZONING REGULA710AS A.P. if �.�. ZONE PLNTGp. gRUEFL.p:p SEpTBACK C/L ST. PROPE�RTVNL NL L�EFTVARD SI�E VAH6 . ' RIGHT REAR VARD (TO P/L) PKG.SPACERE�. PROVIDED .STREETVJIDTH PARKFEES ZONINGAPPROVEDBV ' . I DATE SPECIAL CONDITIONS: ELECTRICAL' — PLAN CMECK GENERATOR p.1 KW_ ]-lO KW _ TRANSFORMER •APPLIANCE 30-50 KW_50 + KW _ .MOTORS � 0-1 HP �,_1-30 HP _ - • (ING SOLAR) 30-50 HP 50 +�HP _ 'FI%TVRES � OUTLETS SWITCH[5 ' GAS TVBE SIGNS � � POLE LIGHTS . ; 4o5D. ?' POLES v� v METERED SUB PANELS - MAIN � .SUB SERVICE - . . . ,AMP ' ISSUE FEE � ' - APPLICATION APPROVED BY - ' '�ATE � SUMMP.RV OF.FEES 'BVILDING �� ' � PERMIT E SMIP � §�__ PLAN CHECK S .PERMIT " ' ' ' ISSUANCE S PIVMBING E - � � GRADING S_ .PLAN CHECK S . � ELECTRICAL y S ' P�AN CHECK E MICROFILM E MECHANICHL E � TOTAL FEE E LE55 A�- P�AN CHECK E VANCE PC E____ FINALFEE S_�� F CONSTRUCTION AND PLANNI APPROVALS Permit # _ 1. Temoorarv Elearical Service or Pol 11. Property Sewer Line & House 12. Street Sewer Conneaion 13. Rough Plumbing 74. Rough Electric-Conduit 15. Rough Electric-Wiring 16. Rough Heating & Air Conditii 17. Duc[s, in Structure 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test � 20. Roof Framing 21. Roof Sheathing 22. Frame and Flashing 23. Insulation 24. Lathinq & Sidinq 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar pomestic-Final 35. Landscape Sprinkling SVstem 36. Sound Attenuation 37. Handiwp Regulations 38. FINALSTRUCTURE�&BUILDIN 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California 42. CERTIFICATE OF OCCUPANCY No Date , POOL & SPA Date Inspeetor APPROVALS Permit#_ 43. Pool & Equipment Location � 4 . Steel Reinforcement 45. Forms -� 46. Elec[rical Bondin 47. Rbu h Plumbin & Pressure Test 48. APPROVALTOCOVERGUNITE 49. Electrical Conduit-Undr rn 50. Gas Pipe,� ❑�Undr rn, Test 51. Backwash Lines P-Tra ❑ ndr - II �56. Electrical-Final 60. POOL/SPA SYSTEMS FINAL NOTES: AI� � I - Date _ � � i � � P.00��ant to /ill in all spaees except t�osa wit�in �eavy borGer lines an0 sl9n all aDVraOriate Eeclantlons. RUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NG. r� _ l .,.n n.? /rl ,'" Project AdcYe:�. -� Appliwn�'S Maili Addreu � Owner's N�am.e-��.C�a �'eJ'L� KP Phone��F�('�,`ap U..,�� Address �-.�-1—J�_� �� Arch/Eng. License No. Address /'� Contrector's Name.yL�_ Phone Address (mailingl ' I City License No. u( LICENSED CONTRACTOR DECLARATION I her¢by at��m that I am Ilcensetl untler provi5ions of Charfer 9(commencin9 wltM1 section 7000) of Dlvlsion 3 of tM1e Business antl Protessions Cotle, antl my license is in full force antl eftect. License CIaSs License No. �ate Si9nature ORKERS' COMPENSATION DECLARATION iereby aR�rm tnat 1 have a certificate of mnsent t0 selt-insuie or a tertificate uf Workeri Compensatlon Insurance, or a certitietl copy thoreot (Sectlon 3800, Lab. C.) � Policy No. COmpany BC¢rtiti¢d �opy is hereby lurnishea. Certified �oDY is tile0 witb [he City Builtlin9 DiviSion. Date APPliwnt EXEMPTION FROM WORKERS' COMPENSATION DECIARATION (Thiss¢ction �eetl not be completetl ii the permit is �or one huntlratl ($100) or less). I certity thaf in the perlormance of the work for which this perm�t is izsued, I Sha11 noi eR�P�oy any person in any mannet so as to bewma wbjett to the . Worker5' COmpensation Laws of CalifOmia. Dace Signature 'NOTICE: If, aiter �making this declaration, you shoultl become subject to the Wo�ke�s' COmpenSatiOn provisions of the Labor Cotle, you muSt forthwitb comply wllM1 such D/ovislOnS or Ihis Oermit Shall be tleemetl �evoketl. CONSTRV4TION LENDING AGENCV I hereby altlrm tnat there is a construction lentling a9ency for the performance Of the work for whicn thi5 Permlt iz issuetl (Section 309] Civ. CJ LenCer's Name LendeYs Adtlress OWNER BUILOER DECLARATION I hereby at��/m that I am exert�Ol from the Con[rattor's LI<en5a l.aw for the lollowing reason (Section 7031.5 Buslness and Professional Cotle: Any city or county whlCh requires a plrmit [o ConStruct, alteq im0�ove, tlemolish or �epai� any structure, priot to Ils IssuancC, a150 require5 th¢ appliGant for such permit t0 file a siq��etl statement tnat he/she is licensetl pursuant to th¢ provisions ot ie ContraGtoYs LicenSe Law (Chapter 9(commencing with Section 7000) of ,ivision 3 0� the Busines5 antl Professions Cotle) or that be/she is exemp[ .berefrom 3ntl the ba5i5 for th¢ alleqetl exemptlOn. Any violation of Section 7031.5 by any applicant for a permit subjects tne applicant [o a civil ,[��e alty of r�ot more than five huntlretl tlollars (E500). l)4J, as oWne� ot Ihe properb or my employE¢5 wilh'wage5 as lheir Sole compensation, wili tlo the work, antl the sVucturo Is not Intentletl or otferetl � for sale (Section ]044, Business and Professional Cotle: Tne Contractor's" '� License Law tloes not appty to an owner of a property who builtls or improves ' thereon, arYtl who Eoes such work himself/nersel( or tnrou9h his or her own ', employccs, P�ovitletl [hat such �mD�ovemeniz are not in[entletl or ofteretl for � sale. 1/, hoWlver, the bulltling or ImprOv¢ment is solU wi[hin on0 year o� com- pletioq tne owner will have Ibe burtlen ot proving he/she tlltl not builtl or im- prOve for (ne purpase ol Tale). � ❑ I, a5 owner ofithe property, am ezclusively cont�ac[ing with IicenSetl Con- Vactorsto Gonstruct tne oroject (Section ]044, Business antl Professions Cotle: Tha Contractor's License Law tlues not apply to an owner pt prppertY wno builtls or hnproves th¢reon, antl.who contracts tor Such prOjCcls with a con- tractor(sl license purouant�to the ConVactor's License Law). 1 am aware [nat proo( ol tpeir Worker'S Compensatlon insurance shoultl be provitletl to me. ❑ I am exempt untler Section B. & P. C. for this reason Date Owner _ I nereby csrtity that I have reaa this informatiOn 15 correcL I agree [o compl antl state IDN's relating lo builaing con5 sentatives 0/ this city to en[er upon inspectlan pu os Signature Drivers' �ken5e or 55 � �epte- Y 10� TVPE OF CONSTRUCTION LI NEW I�SVADD LJ ALTERATION LI�REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p# _ DESCRIPTION OF WOFK/USE OF BLDG. - S Main Buildi TVPE OF PERMIT ❑ GRA�IrvG FOUNOATION 57RVCTURAL T Front ❑ TENANT ❑ ELECTRICA� ❑ PLVMBING ❑ MECHANICAL B R¢ar ❑ �OTHER C Right PROJECT DESCRIP710N 5c2. FT. oCCUPANCv K CONSTRUCTION TVPE VALUATION $ g Left ZONE GRA�ING CU. VDS. ACRES ping. Ref. # RemarMs: Planning Notes: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishvrasher Drinking Fountains Floor Drains Floor Sinks GasService Outlets Interoeptors ' Kitchen Sink Lavatories P-Trep Roof Drains - Reinspection Fee � $15 Boiler Duct- UnderGround Duct - Structural Duct - Ventilating Exhaust System � Multiple FirepVFacL Blt. ICBO # Heating System & Ducting ❑6100,000 BTU �700,000 Reinspection Fee � $15 CMF 0865-46, rev. 10/B6 W�ite - Builtling; Canary - APPlicanh Pink - Accountinq; Goltlenrotl - Assessor PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping $olar Tank Swimming Pool wlSpa Urinal Water Closet Water Heater � Water Service Auto-Wash Laundry Trays laue Fee Hood or Typel ❑ Canopy Typyll ❑ Refrigeration System DO-100,000 BTU ��1 W,000 SVstem Repair/Alteration Pire Dampers Registers � Issue Fee Automatic Washer Construction Pole Sub. Caoking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage �isposal Generator O0.5 KW �5-' 5574 5/20/f#u Zone Accessory Building: Z O N I N G R Parking Req./Provided � E Q M T S ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel Motors 00.1 HP � 7 h�$ Inc.Solar �9-15 HP �16-1$+ Microwave Pole Light I I, Standing Settions 5 KW I Trash Compactor $ 3 I —�— Reinspection Fee $15 Issue Fee FEES �DEVELOPMENTSERVICESREQUIREMENTS; Zoning Approved 6y Building Approved 9y $ 3 FEES $ 3 SUMMARY OF FEES BUILDINGPERMIT $ SMIP $ �-C3�" PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE ' $ PLAN CHECK 25% S ENERGY P.C. $ ELECTRICAL g GRADING S PLANCHECK 50% 5 MICROFILM S MECHANICAL $ h�� 70TALFEE $ �j O� PLAN CHECK 25% $ � ONSTRUCTION AND PLANNING PPROVALS Permit # 1. Temporary Electrical Service or Pole .�� 2. Soil Pipe-Undrgrnd. 3�vElecVical Conduit Utility-Undrgrnd. 4. Electrical Conduit-Undrgrnd. 5. Steel Reinforcement 6. Electrical UFER Grnd. 7. Footings . 8. Foundation 9. Water Pipe-Undrgrnd. 10. Structural Floor System 11. Property Sewer Line &'House Connection 12. Sewer Cap 13. Roof Drains 14. Rough Plumbing 15. Rough Electrical-Conduit 16. Rough Electric Wiring 17. Rough Wiring Sign 18. Rough Electrical-T Bar Ceiling 19. Rough Heating & Air Conditioning 20. Rough Factory Fireplace 21. Ducts, in Structure 22. Ducts, Ventilating 23. Gas Pipe-Rough & Test 24. Roof Framing 25. Roof Sheathing 26. T-Bar Ceiling (Structural) & Monocoat 27. Frame and Flashing 28. Lathing & Siding 29. Insulation 30. Drywall Nailing 31. Plaster Brown Coat 32. Electrical Power Meter-Final 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer . 43."Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed 49. Elec�tric Release to Edison 50. Gas Release to Southern California Gas Co Date Date PG 3� SPA Inspector AppROVALS Permit# 52. Pool & Equipment Location 53. Steel Reinforcement 54. Forms 55. Electrical Bonding 56. Rough Plumbing & Pressure Test 57. APPROVALTOCOVER-GUNITE 58. Electrical Conduit-Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test 60. Backwash Lines, P-Trap, 0 Undrgrnd. 61. APPROVAL TO DECK 62. Backwash & Receptor-Final 63. Heater & Vent-Final ' 64. Plumbing System - Final � 65. Electrical-Final 66. Solar System-Final 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. Undergraund Hydro 71. Product Piping OGas ❑Oil 72. Underground Flush � 73. Undergrnd. Storage Tank O Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED Notes: Date � Inspector 0 Applicanl to fill in all spaces exccot those witnin neavy Dortler lines ana sign all appropriate tleclatations. , CITY OF COSTA MESA CONSTRUCTION PERMIT/,,, .. � P�MIT NO. ,^, � TRACT NO. LOT NO. UNII' NU. ProjectAddress �3� ��^��•�_^��`<+�'l C /' Applicant's Mailirig Nddren �'i't!t—nv Ch q.� (s.'Z I Owner'sName �4 3 Photn�e�`%�/'�`�42) Address g�9—.�c--�Ta-.ia � o �-/7 S.&'l'- �y2E: Arch/Eng. —�— License No. Address Contractor's Name Phone Address Imailing) City License No. LICENSED CONTRA�TOR DECL I I h¢reby aHirm tha�-I am li<ensetl untl¢r provisions ot Chart¢r 9(commencin9 witM1 section 7000) of Division 3 oi the Business antl ProfeSsions Cotle, antl my license is In tull �orce antl etfecl. Llcense Class. License No. Date Signature � 'ORKEqS' COMPENSATION DECLARATION iereDy aifirm tnat I have a certititate ol consent to selt-insure or a certiflcate �� Workers' Comp¢n5ation Insurance, o� a certifietl Copy the�eot ($ecHon 3800, Lab. C.) Poli<y No. Company Certitietl cooY �4 hereby furnishetl. 'Certifietl copy I4 /iletl with che city BuilCin9 Divisian. �ate APPlitant E%EMPTION FqOM WORKERS' COMPENSATION DECLARATION (Tbissection neetl not be comDletetl II the perm�t is tor one huntlrutl (EI00) or less). I certi(y tnat in lh6 pertormance o1 tne work tor which tnis perm�t is issued, I shall not employ any person in any manner so az to become subject [o [he Workers' Compensa��an Laws ot Cali(ornia. ' Dale Sl9nature �NOTICE: If, after rPakinq this tleclaration, you shoul0 become subject to the Workers' Compensillon pwvisions of lhe Labor Cotle, you mus[ forthwith Comply wi[h such provisions or this pe�mit sM1all be tleemetl revoketl. CONSTRUCTION LENDING AGENCV I hereby attirm [hat IhCre is a construCtlon lentling agency tor th! pEr/ormance o/ the work tor which Ihis permit i5 i55u¢tl ($ection 3097 Civ. CJ Lentler's Namo Lender's AOaress . � OWNER BUILOEH dECLARATION I hereby aiflrm tb�� I am exempt irom Ihe COntractor's License Law fo� the tollowina reason f5e�tion ]031.5 Buslness antl Professlonal Cotle: Any city or rom antl the basis for tne alle� 5 by any apP�ieant for a pe y ot not more than tive huntlre� a5 own¢r o( [he prope�ty o� :nsatiOn, will tlo tbe work, antl �.le (Section ��44, Business ar e Law tl0¢S Pot apO�Y to an ow m, an0 wbo tloes zuch work h yees, provitl6tl lhat sucM1 imprc f, however, (he builtling or Imp n, the Owner w'��I have the bu�[ for the OurpOse of sale). esjowner of Cne o�operty, am e .c �n rnn<�.ur.l the oroiett ISect 'mIt subjects [he applicant to a i tlollars ($500). - ny employee5 with wage5 a5 [heir (hC SLNCIllf2 IS OOL �O[EOlJCd Of Oi(f A Profess�onal Cotle: The Contract �er of a property who builEs or impn mzelf/nerself or tnrou9h his or her � ✓ementz ar¢ not inlentletl or ofter¢tl �ovement is soltl within one y¢ar Of c en of provin9 he/she tlitl not builtl or, Kclusively contracting with licensetl � on �044, Business antl Protesslons C< not apply to an owne� of property � TYPE OF CONSTflUCT10N LJ NEW LJ ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TVPE OF PERMI7 GRADING FOUNDATION STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL . ❑ OTHER PROJECT DESCRIVTION SQ. FT. pCCVPANCI' CONSTRUCTION TYPE VALUATION S ZONE GRADINGCU.YDS. qCRES Remarki: Bar Sink Backflow Preventer Backtlow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Dralns ' Floor Sinks Sink pair P—T�2P mit ' °� Root Dr " s ot npt ion ivil ;o�e Reinspection Fae buiids ar �improves thereon,�ana who contracts for sucn proje<ts wltn a com Vactor(s) lic<nse Oursuant�to the Cant�acto�'S License Law). I am aware that proo( oi tneir WorkeYs Compensation insurance shoultl be provitletl to me. ❑ 1 am exempt unticr Section B. & P. C. (or this reason Da[e Owner I here0y certily tnat I have�reatl this applicatlon antl state tnat lhe above information is corrCct. � agree to como�v wiih all tlry antl counry ortlinances antl state laws relating to buiidin9 �onstruction, antl�hereby authorize repre- senlatives of' tnis city to enter upoh tne above-menUonetl property for inspection p ses. � Signa[ure � _ Date,j-�_�� Orivers' l_icensc or 55 � ' �% ��..— FEES Showers Servite Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swim Mg Pool w/Spa' . nal OuUets Water Closet - Water Heater ' - • Water Service � � - Auto�Wash � W undry Trays. , , $15 Issue Fee � $ 3 �uct- Under Ground - 7uct - Structural Duct � Ventilating Exhaust System ❑ Multiple ❑ FirepVFact Blt. IC80 # Heating System & Ducting ❑ ai oo,000 aTu O i oa,000 eT (ieinspection Fee � $75 CMF 0865-46, �ev. 30/84 White - Builtling; Canary - Applitant; Pink - Accou��ing; Goltlanrotl - Assesso� Hoodor Typel ❑ Canopy Type II ❑ Refrigeration System ❑0-100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Issue Fee A.P. # S Main Buildi E T 'Front B Rear A C Right K S Left Ping. Ref. # Planning Notes: �653 5/07l3: _ ?. 2one Accessory Building: Z O N I N G R Parking Req./Provided . E � M T $ ELECTRICAL Auromatic Washer Trans(ormer ❑ 15-50 KW Conscruction Pole Sub. � 50 + KW Cooking Unit Dishwasher � Dryers �Gas ❑Elecvic Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Dispoul Generator �0-5 KW �5-15 KW ReinSpection Fee � $15 Merer �up to 100 amps Meter ❑overi00amps Sub Panel Motors 061 HP � 1 K� B Inc.Solar 09-15 HP �16-15+ Microwave Pole Light Range Sign ; Standing Sections Trash Compactor Issue Fee FEES DEVELOPMENTSERVICESHEQUIREMENTS: _ 2aning Approvad By 8uilding Approved By Aaoliration luued Bv � $ 3 BUILDING�PERMIT S PLAN CHECK S PLUMBING 5 PLAN CHECK 25% 5 ELECTRICAL S PLAN CHECK 50%, $ MECHANICAL g PfAN CHECK 25%' $ OF FEES — SMIP $ _ PERMIT ISSUANCE $ ENERGV P.C. $ GRADING S ��f— MICROFILM S ! TOTAL FEE $ � FEES $ 3 CONSTRUCTION AND PLANNING APPROVALS Permit # 1. Temporary Electrical Service or Pole 2. Soil Pipe-Undrgrnd. , 3. Electrical Conduit Utility-Undrgrnd. 4. Electrical Conduit-Undrgrnd. 5. Steel Reinforcement 6. �Electrical UFER Grnd. � . 7. Footings 8. Foundation 9. Wa[er Pipe-Undrgrnd. 10. Structural Floor System 11. PropertY Sewer Line & House Connection 12. Sewer Cap 13. Roof Drains 14. Rough Plumbing 15. Rough Electriral-Conduit i6. RoughElectricWiring 77. Rough Wiring Sign 18. Rough Electrical-T Bar Ceiling 19. Rough Heating & Air Conditioning 20. Rough Factory Fireplace 21. Ducts, in Structure 22. Ducts, Ventilating 23. Gas Pipe-Rough & Test 24. Roof Framing 25. Roof Sheathing 26. T-Bar Ceiling (Structural) & Monocoat 27. Frame and Flashing 28. Lathing & Siding ' 29. Insulation 30. Drywall Nailing 31. Plaster Brown Coat 32. Electrical Power Meter-Final 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irripation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY Date Date PG k SPA . Inspector AppROVALS Permit# �"Date Inspector 52. Pool & Equipment Location 53. Steel Reinforcement 54. Forms 55. Electrical Bonding s� � 56. Rough Plumbing & Pressure Test 57. APPROVAL TO COVER-GUNITE 58. Electrical Conduit-Undrgrnd. 59. Gas Pipe, � Undrgrnd., Test � i 60. Backwash Lines, P-Trep, � Undrgrnd. 61. APPROVAL TO DECK 62. Backwash & Receptor-Final , 63. Heater & Vent-Final ' 64. Plumbing System - Final . - 65. Electrical-Final 66. Solar System-Final - 67. Fencing & Access Approval � 68. APPROVED FOR PLASTERING � 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit# 70. Underground Hydro � 71. Product Piping O Gas ❑ Oil 72. Underground Flush 73. Undergrnd. Storage Tank O Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical � 76. Dry Standpipe 77. FIXED SYSTEM FINAL " 78. FIRE PREV. FINAL � HEALTH DEPT. REQUIREMENT � 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED � Notes: '4184y� ~ �� COSTA MESA BUILDING-SAFETY DEPARTMENT � P. O. BOX 9f7 C09TA MEBA. CALIPORNIA � For Applicant io Fill In Complefely TYPE OR PRINT ADDRESS 839 Santia o Road COSTA MESA. CALIFORNIA ADDRESS 380�"E. Coast Highway c�Tv Corona del Mar No:OR ARCHITEGT �CCO COTD. niEo OR OR FNCINFFR ��. Corona del Mar, G STATE _ _ _ _ _ __ . TEL. 6500 SF No. OP EXI6TING BLOG. NOne 86T9ACK LIN6 FROM CeMER OP STREET �F8 �- $�� REAR YARD3 SIOE YARD ILEFT S � IRIGHT S DESCRIPTION OF WORK .,�,., � x �) ., _�o.r,..., � �� ....,,_.,.:, F�E RECEIVED fy' JUL 121�0"9 FINANCE DEPT. CITY OF COStA MESA APPLICATION FOR PERMIT euau�N� For Office Use Only ae��veo er � owre rsece�veo COSTA MESA CALIFORNIA FIRE ZONE APPROVED ZONING ZONE ✓/ I NO.OP '% I U8E OP NEW ruNe `" BUILD�NG � LEWL . / /1 � /I�i � icee+re.n uNe EVES �sY§gt %�l EXTERIOR WALL IROOF � COVERING COVERING U6E OF BUILDING AND WORK TO BE PERFOR ED i Living Area - 1245 SF w/attached garage Gara e Area - 390 SF Cav. Porches- 123 SF 1 HEPEBY ACKNOWLEDG¢ THAT 1 XAVE READ TX18 APPLIGTION THE AMOUNT 6HOWN UNOER VALUATION IB FOR TXE ANO 9TATE THAT TXE ABOV¢ IS CORREGT AND AGHEC TO COM- pURP08E OF EeTABLIBHING A.PERMIT FEE ONLY. PLY WITl1 ALl CITY ORDINANCE9 AND BTAiE L�W6 Pl6ULATING BuitolNa coxeTauciloN. . VALUATION q � SIGNATURE PERMIT FEE S ��S PERMI7TE By : ,�j � 13 , 225 .00 PLAN CNECK S�G� � AUTHORI2ED AG C'�f ��¢d TOTAL FEE