HomeMy WebLinkAbout843 Santiago Rd - Building Permits�I
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Pfl0.1ECT1UDflESB: S43 SANTIAGO RD
OWNE9'�NAME: �OIS R. PEARSON
, �� aonness: 8`4 S SANT,GO
RfltH/FNGINEEH: N/A
�ooxess: �
UNIT:
flE0.N0.: 0
uxrt:
0 CA 90000
PEflMITTEE: LOIS A. PEARSON ( 714 ) 979-0520
eooxcss: g43 SANTIAGO
C.M. CA 92626
110ENSEO fANTMCTOR UELUMTION: 1 hereby aR�rm Iha� I am licens¢0 un0er D�ovlSlons of C�apter 9(commencin0'M�h SCCilon
7UW) ol Uivisian 9 of Ne Busineu anE Profesvons CoOe, an0 rtry license is in lull force anE effect.
ciTr uc.: sr�r� uc.: cuss:
Oate: SiOnatua:
�'^l9NEfl3' fAMPEN3AilON OECUNITION: I hereUy amrm ihat I have a ceriifrate of tonum �o sell-hKura or a ceNlicate oi Workers'
xnution Insuance, nr a cetlifieE copy thereof (Section 3800, La�. C).
.CY NO.: EXP. O�TF:
fAMP11NY:
❑ CertllieC copy is Ae2�y fum¢heA. ❑ Certifie0 coDY a��� �+�� the dry Buildinp Divisian.
Date:
Mo�kzm:
IXEMPfION FflOM WOflKFfl3' COMPENSITION OECUIUTION: na0 no� Ue com e0 il Ue permii i51or one AunErW (5700) a ka�.
I certiry ttut in �� Aorm�ce oi Ne wark for which t�is pe ' issue0, I shatl em oy any person in any manner so az to hecome
suGlep to tlre otkerS CompenSaUon Laws of Califomu.
Date: 7� /y Sipnatu t"`� �• �
NOTICE: II, atler maUnO �ha Aeclaration, you shoulC Cewme su0ject ro t�e Workers' ComOenwtlon pravisbns ol the La6or
COEe, you must fortAwit� comDN �+�h suc� pmNsions or tks permit sAall Ee CeemeA revakeA.
CONSTPUCTION LENOING �GENCY: I hea6y attirm tAat tAere is a canstmction lendinp apency lor tAe pedarmance of tAe waM lor
w�it� �h15 permi�l5 i55ue0 (Section 3097, CiV. C).
IFN�EN:
ROUflE33:
OWNEB BUILOEB OECIAMTION: I hereby aKrm ihat I am eKemD� ��om Na Contracton State License law lor Ne Iallowin0 �eazan
(Seclion 7031.5 9usiness an0 Pmfeuionat Code: My ciry oi counry w�ic� requires a permit to constmct, alter, ImO�ove, UemolisA, ar
rtDair any stmcWm, D�or to its issuanca, also reQuires the aDPlicant lor such permit ta file a sipna0 statemenl that he/she Is IicenSeC
pur5uani to Iha proNsions of tAe Contacmrs' State Licenu Law (C�apter 9(commencinp with SecGon 7000) al OiMsian 3 0l the Busineu
anU Proleuians CoOe) or ihat Ae/sha is exempt t�erefrom anU the Uavs for Ne �Ilepetl exemp(bn. My nolation ol Sectlon 7031.5 Ey
any apPlicanifor a Dermil suhjecls Ihe ap0�icant ro a cNil Danalry af not moa than (ve hunAretl Oollars (5500�.
I, az axner oi the pmOe�Y or rtry employea wit� wapes as t�elr sole wmpenution, will Oo I�e xrork, anC t�e
simcwre a notintenEed orottere0forsale�5ectwn 70d4,Busine55 anE ProfessionalCotle: TAe Contractars'State License Law
Goes not apply to an ovmer of a Dmperry who builtls or improves thereon, and w0o does suc� woB Aimsetl/Aerselt or Ihmuph
his or her own employees, proviAeO iiwt such imD�%'emenis are not intended or ottereE for sale. II, however the Euildin0 or
impmvement a wIE witNn one year of comDletion, Ne owner will have tha burOen ol D�aNnp Mlslie EIE not EuiIE or ImO�e
for ihe purpose af sale�.
I, az owner of tAe D�WeM. am exUusively controctin0 ��h IicenseC wntractors Io construct I�e pmjed �Saction 7044, Business
� aM ProfesWns CoEe: i�e CmtrMors' SGh Liunsa law Oces mt appN ta an wmer ol praperty x1ro OWOs a improves Nereon
aM wlp cmtacts tar wch pmjects xitA a contrattor�s) licenu Dursuant to tAe Contactars' State License Law�. I am aware
Ihdl pf0p� Oi (ACIf WOfklf'S COIIIpE05df100 IIISIIROtE SIIOIIIC E8 D�ONECE [0 8. -
� I am exempt unEer Se[tion: B. 8 P. C.
tar Nis re
Date: % �0�/i'O er. 4't�� "'i '!'f[1„y/��-
I Uo IrereOy ttNN tlut I am aware ot an0 untlerstan0 tne reauirements Cali amu Healin anE Sahry CoAe Secuons 25505, 25533, anC
25594 an0 tAat I or any future EuilEinA �upant wilUwiil nat (tirde one) neeA to campy wit� uiE stata coEes an0 t�e aquirtments lor a
permit for conStruMwn or modifica[ion imm t�e Nr Oualiry Management Ustnct. AeSiAentlal constmction apDlications am exemD� ��am
inesa Vrm6ions.
Date: Rpplicant:
�
I �ere0y certity tAai 1 have rea0 this applica0on anG state that tt a� ve iniormation k mrtecL I apree to rnmDM ��� all ciiy and wunry
ardinxnces an0 suta Wws relatlnp to EuilEinq constnntian and e0 � utlrorire reD�nt;Y�n,5yt th6 ary lo emer upon Ihe a0wa�menUonM
pmpeM �or ins0e ' n pur ses. , �' / 1 /
Date: �� � Sipn re�
f'�q Lf^ �r�.--
oriver's License or Saial 5ecunry x:
I 18a1J8 W�ile—BuilEi�; Green—COEe Entorcement: Canery—Npplicant; Plnk—Revenue; �olCenraE—Acsessor
'CITY OF COSTA MESA - bUILDING PERMIT PER,A N0: BE 0400/6�
PERMZT t�0: BE O4a069 PLAN CHECK NO: N GOVT: N SUPP; H
CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE STR PURPOSE: OTH
JUB DESCRIPTION : SKYLT ON PTSO-CVk,RR,& MISC ELECT SQ FT: 3,100
CLAIM VALUE; 3,250.00 CALC-VALUE; 3,100.00 GROUP OCC: R-3 /
COMMENTS: REF G952ti2 AND B45282 S�[,yy�.yy- ��Sa�`,3933
**x�r***�******►..--�*��r**�*�r*�*�r�*x�x..,�xxx+r,�,��r��. �«*�,�����,��*+��+�***�*#***�r�*�***#
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN bUILDING ---------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN
--------- ACCESSORY &UILDING ---------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 14154202 ZNE: REF NO;
PLANNING NOTES>
� � �
*�±�**�*:�*#�r*�r**+�*��tx�*�***�*�rx��*�e�"��*x�**��*��***x�*#*�***�*�*��****��***���*� �
D E V E L O P M E N T S E R-1,' I C E S R E Q U I R E M E N T.S
� . �,
ZONING APPROVED BY . DATE:
f �i F! � ! �� � � I�i:TST:I :TiIY� i �;l'A
APPLICATION ZSSUED BY:�
if if # iEiE iE 3E df k:FiE iE if iEifif 1t if�ltiliEiF ��R'iF'�F'i�'iF
iE if if if K if if iF if iF iE iE iE jf iF iF if iE iE iF iE?E iE �E iP iE 1ElE fE it K af fE iE
LEGALIZATZON:N F E E
1
DATE: �
� ��*�D�**�*��'�4�b
iElE iE ir 1f !f if iE �1F iF jF iE iE iE if iF iE iE iF # iE%9E iE fE-lE ik if jf �f 1f� ji� �6�iE 3F iE i4 if if if if df
S U M M A R Y STRUCTURAL�SEGMENT:Y
HLDG PMT PLUMBING EL£CTRIC MECHANIC FIRE SMIP/RES GRAUING�
PERMIT G3.00 14.00 50
502 SMZP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 77.50 15.00 0.00 92,50 92,50 .00
REVENUE DI�'ISION TOTALS--> COLLECTED: 92.50 OVER/SHOAT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CfiECK
63.00 29,00 .50
if it dE if iE?E iE iE iE?E iE ik iE fE iE it iE!E jF 3f if if dF if iE if iE jE 1k it if iE it if� iE fE iE iE if iF 3F 3F iE iE 3E iE iE iE iE iF iE iE iE iE iE iF iF iE f.1E it it if iE iE'h iE iE iE iE if �1k iE iE if if i6 ik if.
I N D I V I D U A L F E E B R E A K D O W N
TYPE
SFR
SFR
ELE
ELE
QTY
7000
1�0
1
1
D E S C R I P T I O N
REROOF BY VALUE RESIDENIAL NOZONE
STRUCTURAL BY VALUE PER $1.00
RES APPLIANCE NOT OVER 1.0 HP
SUB-PANEL
END OF FEES
ONIT COST TOTAL COST
1.00 3,000.00
1.00 100.00
3.00 3.00
11.00 11,00
O1 00064849-600fi4851 T�'��� ??,�0
Df,TE: 07/!0/s0 TIhIE: I1:�0
\
CONSTRUCTION AND PLANNI OL & SPA
APPROGALS Permit # Date Inspector ,4PpROVAIS Permit # Date Inspector
i•
�1. Temporaiy Electrical Service or Pole � 52. Pool & Equipment Location -
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' ��
3.'Electrical Conduit Utility-Undrgrnd. 54. forms ' '
4. Electrical Conduit•Undr9rnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Gmd. 57. APPROVAL TO COVER�GUNITE �
7. Footings � 58. Electrical Conduit-Undrgrnd.
8. Foundation l 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd..
70. Structural Floor System 61. APPROVAL TO DECK .' �' �,"
11. Property Sewer Line & House Connection , 62. Backwash & Receptor-Final "
12. Sewer Cap 63. Heater & Vent-Final - -�
13. Roof Drains 64. Plumbing System � Finai -
14. Rough Plumbing 65. Electrical-Final - ,
15. Rough Electrical-Conduit 66. Solar SYstem�Final
16. Rough Electric Wiring 67. Fencin9 & Access AnProval a
17. Raugh Wiring Sign 68. APPROVED FOR PLASTERING ,
18. Rough Electrica��T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT .
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing ' 74, Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 7 6 76. Dry Standpipe
� 28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation �� 76. FIRE PREV. PINAL
30. Drywall Nailing � ��i HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coai ,� 79. FINAL INSPECTION
32. Electrical Power Meter�Final � 80. FOOD CERTIFICATE ISSUED
33. Final Eleciric g�3 . NoteS: .
34. Final Heating & Aii Conditioning ',
35. Final Gas Pipe-Test �
36. Hood or Canopy �
37. Final Factory Fir2place � ��
38. Final Plumbing ,
39. Water Service�Fina1 �
40. Gas Service-Final;n
47. Solar pomesticF'�nal ' -
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation SYstem
45. Sound Attenuation
46. Handicap Regulations
i'
47. FINAL STRUCTURE & BUILDING � 6 � �
48. FINAL PLANNING �
49. Electric Release to Edison :
50. Gas Release to Southern California Gas Co -
51. CERTIFICATE OF OCCUPANCY �
No. Date
�pE�� B4:) SANTIAGO RD
A'�N�ME:,I�UIS R. PEAR.S'ON
nooxess:;g43 SAN?'IGO
RHCNIENCINEEB: n] / A .
FDOqESS: U
NEG.NO.: U
UNIT:
UNIT:
q CA 9Q000
PEflMITTEE: LO.LS A. PEARSON ( 79.9 ) 979-057.0
RODflE33: [S43 SANTIAGO �
C.M, CA 92626
110EN5E0 fANIMLTOB DECIAMTION: I �ere0y eHirm tlwt I am Iicense0 under provisbns af Chapter 9(cammencinp wii� Section
7000) ol Oivision 3 af ihe Business an0 Pralessions CoGa, anE my Ikenu ¢ in tull loru antl effect.
cm uc.: sr�h uc.: cuss:
Date: Sipnaiure:
WOPI(ERS'COMPFNSATIONOECUM710N: IMreE allirmttwtlhaveacertiliwteolconxnttoself-insu2oraurtificateaiWoders'
� � ComDenution Insurance, or a certilieA copy I�ereof �Section 3800, La6. C�.
f PoL1CV NO.: EXP. ORTE:
Icornraxr:
0 CenifieE copy is AereOy Iumis�e0. ❑ CertifieA coDY is IileE vnN t�e ciry BuilUinO Oiviuon.
Date: ApDlicant:
IXF7APIION FlIOM WORNFRS' COMPENS1710N OEqAMT10N: (iha sewm not Ce mmpele0 il pm permu ¢ iw a� hwtlaE (S70D) w las�.
I tehity ttNi in IAe peRomWnCe al �he wOrk IOr wNU Ni5 pEflnii 6 iAu I n01lmploy arly De�syu+�y mann¢r w a510 OeCOm!
SuUjetl Io I�e W t¢rs' m0en5aGOn Laws ol CalilIXnia. - ( J
2� � � `��j(
� Date: Siqnature: ��-+� U, � ""�
NO710E: II, ader maldnp tltis Aedantion, you shoulG Gecome suDleC �o Ihe Workers' Compensatian provisions of the La�or
CoOe, you must tonAwit� comDN ��� suc� proWsions or tNs Dermit shall Oe EeemeG revoke0.
CONSTHUCTION 1EN01NG FGENCY: I hereEy affirm that t�em is a wnstmction IentlinA aAe�' �or t�e pedormance oi the work tor
whic� lhis permii is i55ueC (Sec�ion 31197, Civ. C).
lFNOEP:
�DOBESS: " �
OWNEq BUILOEB OECIAMTION: 1 AereGy aflirm tAat I am exemD� ��om t�e Coniractors' Stam License Law far Ihe follwnnp reason
(Section 7031.5 Business an0 Prolessional COUe: My city al counry which repuires a Dermil to constmct, atter, imprwe, aemolis�, ar
rzpair any stmcwm, pnor to ils issuanre, also repuims the applicant lor suc� permil to file a siAneO statemen[ that Ae/sAe is IlcenSeE
pursuant la t�e pmvisians of Ihe Comractori State License Law (ChaD�er 9(commencin0 wit� Section 7000) of �ivivon 3 af ihe Bus�ness
anE Pmfessions COEe) ar t�at tie/she is exempt t�erelmm anU ihe Casis br Ihe allepeE exemption. My violation of Section 7037.5 Oy
any appliwnt br a permit suDiects tM aDPlicant ta a civil penalry of nat more tnan INe AunEreO Oallars (5500). �
I, as owner ol Iha property or my employeas wiN wages as Iheir sole compensation, vnll Oo ihe work, and IAe
, '❑ slmcture is not intended or ollereA lar sale (Section 7044, Business anA Pmtessianal Cada: TAe Cantractors' State License Law
does not apDry ro an awner al a pmperty who 6uilds orimproves tAereon, znd wha tloes such work himSeltlAersell orthmuph
. his or Aer own em0loyees, proNaeA that such imDrovemenis are nat intenOeA or otlered for sale. If, however tAe UuilOinp or
Impmvement is so10 within one year ol completlan, Iha ownecwlll have the bur0en of Orovin0 he/she tlIE not huilU ar impmve
tor ine ouryose oi sale). � '
I, as owner of tha pmperry, am exclusively coniractlnp wi�A Iicense0 contractors m consVuc� �he pmle�� (Seciion 7044, Busine5s
� antl Pmfessions COGe: The Contrxtors' Stata License Law Oou not appy ro an owner of proDeM `�'� buA0.s or improves Nereon
and wt�u wniracis for such Drojects witA a coniractor(5) licenu Oursuant Io t�e Conmctors' State License Law). I am awara
tlut D��� o� t�eir Worker'S Compenution in5urante SAOuIE Ue pra�tle0 to,me.
� I am exemp� untler $ectlon: B. d P. C. �^�T�_
lor �his re s/on: ///��� i �
� Date: /�/ U /�� . ner: �J
I Oa �ereGy certiry that I am aware of and unAerslanE t�e apuirement Calit ia Meallh antl Safery Catle Sectians 25505, 25533, an0
25534 an0lhai I or any lutute OuilOinq ottupant vnlUwill noi (circle one) nee0 io comply witA saiE slale cotles anU the requi2men6 for a
permit for canslructwn ar moEilication tmm t�e Air ualiry ManaOement Distnct. ResiAential constmctian aDPlications are exempt Irom
tAese vrovisions.
�ate: �1pDlicant:
I �ereby ceriity Ihat I �ave reaE this aD0licalion anA state tlut the a�ov ormatiw a tonect I apr � compty wftA all dry an0 counry
oNifu(rcesarqsUtelawSreWtiriproDWGinpmnsWctionanOhere erepresenutiva ro terupontheahove�mentione0
D�oce�Y �a� inspec (on pur -ses. � � '
Oate: SiOnamm'
Omxr's License ar Social S¢curiry N:
16n28 WMto—BuiMiiw; Green—COEe Enbrcemenl: Canarv—MOlicanC Pink—Revenue: Gabanrotl—Assegsor
CITY OF COSTA'MESA -� BUILLING PERMI.T PERM Nb; B 045289
PERMIT NO: B�'045284 PLAN CHECK NO: N GOVT: N SUPP: N'
CONSTRUCTION',TYPE: V—N • PERMIT TY.PE: STR PURPQS�: NEW
JOA DESCRIPTION .: 16fi SQ FT PATIO COVER S� FT: 16A'
CI�ATM VALUE: 900.00 CALC—VALUE: 2,274.72 GROUP OCC: N-3 /
COMMENTS: PATIO CO��ER PART OF G45282
***�***�r*+t+t*x�***�**��r�**�t�t*�-**x�**�**�r*�x******+�*�r�x�***�**�r*�t�*x���*�***�r�c*��*�.��t
Z O N S N G R E Q U I R E: M E N T S
S E T FT A C K S
------------ MAIN BUILDING ---------- ---------/.i+l11CCESSORY BL7ILDING ---------
FRrIT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN I�EFT: FT IN RGHT: ET IN
PARKING REQ: PROV; PARCEL: 14154202 ZNE:.R1 RFF NO:
PL�At�lNINC NOTES> FUR A168 SQ. FT. PA'PIO COVER AllDITION, UNLY ADDED TO PERMIT
- > # G45282.
**�**r�**x*�exrtx*��****�*��r*�******�r*�x�������**���*n**�r��*****�+�**�*+�*�r*�r�r����**�
D E�� E I� O P M E N T S E R V I C E S R E Q U I R E M E N� T S
ZONING APPROVED AY
DUZI�DTNG APPROVED BY :
APPLICATION IS.SOED BY.: � �
iE�f�EiFiEiFiEiEifiEifikifiEiEiEklEiP#3(-itiF 3FiFTFiF�F3fiFiFiF �
�****�r**+��***�tr�*����*�r��t�*�*******
LEGALI2ATION;N . F F. E
BLDG Pt4T PLUMHING EI.E
FERMLT " 59.U0
PLAN
zssaF r•Fe
BUIL�DING—DIV—>
TOTALi---->
_ _. DATE: __
DATE:
w�i�'�"�'SFiF'i�* * * �c *+p't * * �li-itl Z'�'it #
�iF iE�EiFdEiE�1E�%iEiFiEiE#ififiEifiEififiEiEifiEiF9t3fiE�lt�%1Ei(�#ikiE�lfiE�lEiEiE#
U M M A R Y STRUCTURAL SL;GMENT:.Y
IC �MECHANIC FIRE SMIP/RES GRAI�ING
.. .50
SMIP/NC�N—RES
PERMIT ISSUE' PLAN—CIiECK �TOTAL PAID DUIi
54.50 � 0.00 0.00 54.50 54.50 .00
REVENUE pIVIS1:ON TOTAL�S--> COLL�ECTL'1): 54.50 OVF.R/SHORT: .00
BLDG PMT PLUMAING E'LE:CTRI.C; MECFiANIC FIRE SMIP/TOT GRADING.PLAN—CHECK
SA.QO � .50
iF �1E it-�lE fE K� if� k k if iE k iE if iE if IE-!f �1E iE i�� iE 1f if iF iF iE iE 3E if iE jE �E iE iE �1E �E it iE x� it �K- iF 3E iE � iE 1E iE iE iE #�1f it iF �Jf k�1F it it �lE �)E iE it iE iE iF iE iE �lE iE 7E 1E iE iE �E if if ±E
I N D I V I D U A L F E E B R E A K D O W N
TY.PE �TY D E S C R I P'C I O N �. UN.LT COST TOTAL COST
SFR� 160 RES—PATIO COVER—POST & SOLID ROOF 13.59 2,274.72
END OF FEES
•t:
. '
O1 00049077-00049078 T O T 54.50
DATE: 12/Ob/39 TINE: 04:36
;
�,• � ,
..,
�ONSTRUCTION AND PLANNING POOL & SPA .
APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector�
��1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ! � .
� '2:'Soil�Pipe-Undrgrnd. � 53. Steel Reinforcement . .
3. Electrical Conduit Utility-Undrgrnd. - 54. Forms � �
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding .
5.•Steel Reinforcement � 56. Rough Plumbing & Pressure Test
6. ,Electrical UFER Grnd. �� 57. APPROVAL TO COVER-GUNITE
� 7. Footings � � 58. Electrical Conduit-Undrgrnd.
8. Foundation � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P�Trap, O Undrgrnd..�'
10. Structural Floor System ~ 67. APPROVAL TO DECK _
17. Property Sewer Line & House Connection 62. Backwash & Receptor-Final �
12. Sewer Cap 63. Heater & Vent�Final
13. Roof Drains 64. Plumbing System - Final .
14. Rough Plumbing Y 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final -
16. Rough Electric Wiring 67. Fencirig & Access ApProval
1�. Rough Wiring Sign , 68. APPROVED FOR PLASTERING
18. Rough Electriwl�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace . APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test � ' 7Z, Underground Flush
24. Roof Framing � � .73. Undergmd. Smrage Tank O Gas ❑ Oil
25. Roof Sheathing • ' 74, Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat � 75. Dry Chemical .
27. Freme and Flashing � 76. Dry Standpipe
28. Lathing & Siding - �- ' " 77. FIXED SYSTEM FINAL �
. 29. Insulation - ' � 78. FIRE PREV. FINAL
30. Drywall Nailing � �, HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ' 79. FINAL INSPECTION
32. Electrical Power Meter-Final �' '�80. �FOOD CERTIFICATE ISSUED
. 33. Final Electric • � i�i1 Notes: " �
34. Final Heatirig & Air Conditioning .- {�rp- / . �
:: :
35. Final Gas Pipe�Test • ' % � . �
` i! e
36. Hood or Canopy , �,� w I� Z g/
37. Final Factory Fireplace � . � - �
38. Final Plumbing � .
39. Water Service�Final. - _ - GZI( �
40. Gas Service-Final � ' - � � •
41. $olar pomestic-Final . •
42. Backflow Preventer � �
43. Backflow Irrigation � ' �
44. Landscape Irripation System
45. Sound Attenuation � .
46. Handicap Regulations � ' �
47.� FINAL STRUCTURE & BUILDING ��-ij� ��' "
48. •FINAL PLANNING ' � . '
i'
49. Electric Release to Edison � �. . '
50. Gas Release to Southern California Gas Co . .
51. CERTIFICATE OF OCCUPANCY '-"
No. Date
rAaec�.;ooeess: aq9 gANTIACO RD
izWxea�s�NAME: I�O.I'.S R. PEARSON
eooness: g 4 3 SAN'i I GO
f �
�3 a
oxiT:
. . �
11flCHlENGINEEP: �.j /A ' NEO.NO.: �
�UOflESS: � Q ' , UNIT:
� CA 90000
� PEXMRTEE: LOIS A. PEARSUN ( 77.4 ) 979-0520
- RODflESS: $Q� SANTI:4G0 ' '
C.M. C:A 92626
❑CENSEO CONTMCTON OECIAMTIUN: I hereby al/irm Ihat I am IicenseA under provision5 of ChaD�er 9(commencing with Section
?000) af Uivision 3 al tAe Business an0 Pmfessions CoOe; antl my license is in tull forie anG elfect. .
Cltt LIC.: STRTE LIC.: ClAS3:
Oate: � SiAnaNre:'
WOHNEBS' COMPENSRTION UECIARATION: I hereby affirm that I have a certi(icate of consen� to self-Insure or a certilicale al Workers'
vnpensation Insuranca, or a cehified copy ihereai (Section 3800, Lah. C). . .
.ICY NO.: E%P. UATE: '
COMP�NY:
❑ CetlifieC copy is here�y lumishea. ❑ Certilied copy is filed wit� ihe ciry Building Division.
Date: ApDlicam: '
F%EMPTION FIiOM WOBNEflS' COMPENS�710N OECUIUTION: ,(This secnon need not Ge completeG il Ihe permA is lor ane �undred (f700) or leu�.
I cetliTy tAat in the parfarmance al Iha work for whicA ihis permrt i iss , I shall no� employ a rwn in any manner so as ta became ,
subject m tAe WOMers'�C mpensation laws oi Califomia' . /�%
Oatef;/��G �_ Signature: �� ��-•+ C` ' �
NOTICE: It, atleomakinp this declaration, you s�oultl'uBaome sbGle�� io �he Warkeis' Compensation provisions of the Lahor
CaAe, you must lotlhwit� comply witA such pmWsionsor t�is permit shall be tleemed revoke0.
CONSTNUCTION IFNDING �GENCY: I hereCy affirm that t�ere is a canstructian lending a9ency for the petlarmance ol t�e work for
which �his permi� ¢ i5Sue0 (Seciion 3097, Civ. C�. ,. . �
LEHOEH: ' . ,
nooxcss: .
OWNEP BUIIDEH OECIAMTION: I hereby allirm t�at I am exempt fmm tAe Cont2ctors' State License Law for Ihe tollovnnp 2asan
(Section 7031.5 Busineu and Professional CoOe: My ciry oi counry whic� requires a permit to consimct, alter, improve, Uemolish, or
repair any stmcture, D�or ro its issuance, also repuires Ihe applicant for such permit ro tile a sipne0 statement that he/she is licensetl
pursuanl to t�e pmvislons oi t�e Contractors' SWIe License Law (C�aO�e� 9(�ommencing with Seclion I000) o� Division 3 of lhe Busina5s
an0 Professions Cotle)�or that Ae/she is exempt Ihereirom and the bazis for the alleqed exemD�ion. Any violaiion of Section 7031.5 by
any apDlicant far a Dermit suble�s Ihe applicant to a ciWl penalry of not more ihan five hunAreA dollars (E5001.
I, as owner of ihe proDerty or my employees with waAes as their sole comDensation, will do the wark, antl Ihe -
stmcture is not inten0e0 or otteretl lor sale (Section 7044, Business anA Professional Code: The ConVactors' State License Law
tloes nut a07ry to an owner of a D�operty wAo builUs or improves thereon, anU who tloes such waM himself/harsell or thmuAh
his or her owmamployees, Dmvitled t�at such impmvements are not intenOeA or offeretl for sale. Ii, however the builtlinA or
'improvement is sald witAin one year of completion, the owner will have the hur0en ot proving he/she Ai0 not 6ui10 or impmve
� .for tAe Durpose ol sale�. - • '
I, as owner of the pmperry, am axclusively contracting with IicenseA contractors to constmct ihe pmlect (Section 7044, Business
� and Pro�essi0n5 COde: The CanlfaCiOrs' Sta�¢ LiCense Law tloes n0� apply to an Own¢r o� pmperry wAo hwltls or imprOv05 tAef¢On .
anA�who conVaclsfor such prolec�s wi�h a contractoqs)license pursuantto Ihe Cantractors' Sta�e License Law),I am aware
that pmoi of iheir Worker'S Compensation insurance shoul0 Oe provitlea ro me. ' .
� I am exem0� unUer Sectlon: 8. 8 P. C. /�\
for tAis reasan: (/ ,�. . !} / )��_,
� � /�+ /O , Lu..✓ LC \7�
Oate: ��_� Owner'
I Oo hereby certiry ttwt I am awaa al an0 untlerstanA tAe requiremenis of Califomu Mealih anU Satety CaOe Sections 25505, 25533, antl
25534 anA that 1 or any fuWre OvilGinp occuDant wiNwill not (circle one) neetl to comply wit� saiE state co0es anG the requirements for a
permn br wnstmction ar moUification Imm the Nir Oualiry ManaAement 04s[nct. Fesitlential wnstmction apDlications are exempt from
�hese D�ovisions.
Date: � RpPlicant: . .
I hereby cerliry that I have reaOlAis aDDlication anU state ttwt the above{nforma�ion is correct. I aA�ee �o compty wii� all ciry anC counry
orEinances anE sute Wxs relatinp to builEinp wnsimction an0 hereby adih6rize repreunta[ives ol t�o emer upon t�e ahove�menuonetl
properry forinsce lion D'�. , /
x/` C/ //
� Oate: � � J ^ SiOnat ..� �=��� N�
Duver's License or Social Securiry x: .
Wpita-BuilEinO; Green-Cotle En�orcemenC Cana�v-Applican�: Pink-Ravenue; GOIEemotl-Assessor
CITY OF COSTA MESA - BUILDSNG PERMIT�.. PF.RM NOc G 0452(32
PERMIT NO: G 045202 PI�AN CHECK D10: 01052-89 S GO�rT; N SUPP: Dl
CONSTRUCTION TYPE; V-N PERMIT TYPF.: F.LE MEC PLU S'PR PURPOSF,: AUU
JUA DESCRIPTION : 520 S� FT BEDROOM & BATH S� FT: . 520
CLATM VALUE: 35,000.00 CALC-VALUF.: 3S,2Q9.00 GROUP OCC: R-3 /
COMMENTS: MAS'T DED 6 HATH I:nD: F�PATIO COVER����y�, �'("� �jg-$'Zgg-�
iE3E�JEiF?Eif'/.-iF#ififififitiEiEifitiEiFibiEiFiP�lEiEiEiEiEjEiE iEitif�ElF�I(-�iEifiEik iFiFitifi6�lffffE�fiFiEiE�IE#iEyf�lt3f+E##dE# ifi(-iEiEiEjE�E1E1E
Z O N I N C, R E Q 0 I R E M E N T S
� S E T B A C K S
E
------ - -- MAIN AUI:LDSNG ---- ----- --------- ACCESSC1kY BU2LDING ----�----.
PRN'I': F.'T 7 IN REAR• 9.]. F'T IN FRNT: FT IN RfiAii: FT • IN
LEFT: • 40 FT 6 TN RGHTe,• 5 FT IN LEF'C: FT IN RGHT; FT IN
PP.RKING REQ; 2 I?ROV:I 2 PARCEL: 14154202 7.NE: R1 REF NO:
PLANNTNG 1JdZ'ES> ONf, STOAY, 570 SQ, rT. MASTER•AD/BATH. ADnITION ATTCHL:D TO
> REAR OF EXISTING SF RES.iDE:NCE -
x.***�*x *��t�e*�t�*�t*�**x**�t�r��r�tt�*�r**�t�t**�.�t x�***�t�t**���*�x�*�r��r*�**�*#*�t�����c�t�t-*��t**
D E V E L O P M E, N T � S E R_ V' I C E S R E Q U I R E M E N' �,�, S
1f,ONING APPROVEU BY __^ _ DATE; __
�F?UI.LUING_APPROVED BY : . _ _ DATE: ----
'AFPLIC?�TION :LSSOEll BY:�..yr�r - � ' DATE: �� D6'�•�'1
itiEiE**itiE��t�tititifltit3E.*iE�Eit�EiE'iFFititi �F�"�'iFiFiE � �rt. jF'��TF�FRTFiFiFiFiF'�FiF'iF'iFiEiEit#��-�-*iEiE;€�tiE�it��iF1i��3F�.,iE �
iEif�lEiFiEiF3Eit#ifiFiFit3EiEiEiEiFiEiEiE�1(-iE1E�Eif3EiEiE.iElEiEiFiEiEiEiEiEiEiFiE +E-�iEifiE�f�EiE�Fif�lfi(-iEiEiEiE3EiEiE3h�1F�lE�E#if�)E•K�'.�EiEiE%3FiEjEifiE3f
L�GALIZA'TION:N F F. E S U M A R Y ST.RUCTURAli SEGMENT:Y
BLDG PMT PI�UMBING ELECTRIC IMECHANIC F.IRE SMIP/RES GRAli2NG
PERMI'1` 323.50 10.00 23:25 11'.00 - 2.46
� � 253 S0� 258 SM7P/NON-RP.S
PI�AhI . � 210.28 " .
ISSUE I'EE :3.00 ' 1:5,00 15.00
f3L1ILllIIdG-DI..V-> PERMIT SSSUF T?LAN=CHECK TOTAL PAID DUF
TOTALS----> 970.21 33.00 210':20 f,7.3.99 � 613.49 .' .00
REVENOE UTVTSSON '1'OTAI�S--> COLLfiCTED�: 403.21 QVER/SHOR'T� � .00
ALL'G PMT PLOMAING EL�rC'PRIC. MECHANtE: F.IRF ;MI1�/TqT ,GRADING PLAN-CHECK
323,.50 7.:).00 38.25 26.00 � ;l_.4G
. �
jF 9E df 3f 9F �k iF 3f �E it iE iF iE if X 1E if� 36 if k�k fE ik iE iF iE iE iF iE iF it � iF iE iE iE iE�iE iE �.3E 3E iE # Y.-iE if ih i� iF 1E iE if fE !F 1E �k iF iE iE jE 3E iE dE iE iE jE iE iE 1h iE 3E iE #' iE iE iF iE iE
I N D I V 7 D U A L F E E A R E A�K D O W N
7.
7'1PE QTY U S S C'R I P T I O N' � ON7T COST TOTAL COST
SFR 520 AWE-TY.PE V-WOOD FRAM1,�' -GOOD 67.70 3,5,204.00.
EI�H 6 FIXTORE5. I;ZGHTSNG i. ST 20 EA. � .75 4.50
ELE ' 1J RECEPT/OUTI�ET 1 ST 20 EA, �,: .75 9,75
ELE 8 RECEPT/SWITCii � 1 S'T 20 �A. .%" .75 6.00
ELE 1 MOTOR/POWR APPARATL35 .'0.0 - 1.0 HP ,�.04 9.00
MEC 1 EP.CH APPI� A]OT IN OTHER CAT DNDER b'EE ' .6,50 6.50
MEC 1 ?�EAITII�ATION FAN CONN TO SINGLE DUCT ,-i. ,' 4.50 9.50
PLL 1 BATHTUB , ^2.00 2.00
�+'LU 1 WASFI BASIN r " 2.60 i.00
PLO 1 SINECS. BAR -;CC7MMERCIAL ' 22..0Q0 2.00
PI�U 1 WATER CLOSET ( TOILF.T ) O1 00D4'9U99-00049QE3 TQT �' �Q03.21
DATE: 12/06I89 TIflE: 09:37
{ � � 1
• �J• a'' �:%
� �„�CONS,TRUCTION AND PLANNIN� � �L & SPA .
' APPROVALS � Permit# Date Inspector qppROVALS Permit# � Date Inspector
t
� i.� Temporary Electrical Service or Pole . � 52. Pool & Equipment Location � -
2. Soi1 Pipe-Undrgrnd. � (.� 53. Steel Reinforcement
3. EYectrical Conduit Utility-Undrgmd. 54. Forms "
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding �
� 5: S`teel Reinforcement - � 56. Rough Plumbing & Pressure Test
. 6. Electrical UFER Gmd. � � 57. APP�ROVAL TO COVER-GUNITE .
7. Footings �,��'�> J�a�� .(P d. 58. Electrical Conduit-Undrgrnd.
8. Foundation , 59. Gas Pipe, O Undrgrnd., Test ". •
9. Water Pipe-Undrgrnd. _ 60. Backwash Lines, P-Trap, � Undrgmd. �
10. Structural Floor System - i 61. APPROVAL TO DECK �
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final '
� 72. Sewer Cap 63. Heater & Vent-Final •
.� 73. Roof Drains � 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final �
15. Rough Electrical-Conduit ,- 66. Solar SYstem-Final
- 16. Rough EleCtric Wiring . 67. Fencing & Access ApProval .
17. Rough Wiring Sign . 68. APPROVED FOR PLASTERING
18. Rough Electrica6T Bai Ceiling . 69. POOL/SPA SYSTEMS FINAL . �
19. Rough Heating & Air Conditioning � �� ��/, FIRE DEPT. REQUIREMENT ��� �
��
20. Rough Factory Fireplace - � APPROVALS Permit # �.
21. Ducts, in Structure� 70. Underground Hydro
22. Ducts, Ventilating . . � 71. Product Piping O Gas O Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24: Roof Fram�ng 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing . _ 74, Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat � 75: Dry Chemical - �
27: Frame and Flashing �� 76. Dry Standpipe �
" 28. Lathing & Siding � i 77. FIXED SYSTEM FINAL
29. Insulation �-e p �,e p'�0 �p,Ltib:- 78. FIRE PREV. FINAL � �
30. Drywall Na�ling . � � � '� HEALTH DEPT. REQUIREMENT .
37. Plaster Brown Coat L � 79. FINAL INSPECTION
32. Electrical PowerMeterFinal � 80. FOOD CERTIFICATE ISSUED �,
33.'Final Electfic ' ' ' � Notes: :�-Q��� 9(L ]�q ��/ -�j`s'
34. Final Heatin & Air Conditionin ' �p9�� ' // ��+�
9 9 �. D 31 9D L7r? �-�' r"°C' � d!" E47-'!-. D
35. Final Gas Pipe�Test • � r
f�,. , �..�.6 .� �, -Gw�
36. Hood or Canopy ' , - : � � � . ' , .
-37. Final Factory Fi�eplace �
�� �
38. Final Plumping �:1 'DI+,�� c� �, � � 1
t
39. Water Service-Final , _ � .
40. Gas Service-Final'� � ' � '_ ' � � -
41. Solar pomesticFinal � . ,,.,2�_�� %' ._�
42. Backflow Preve�titer -�;=i
i
43. Backflow Irrigation � . . - "
44. Landscape Irriga;ion System ' � � � .. � _ � ^ ' � � -
45. Sound Attenuation ,
46. Handicap Regulaiions � � `�
47. FINAL STRUCTURE & BUILDING ! 2� q� �, . �
48. FINAL PLANNING ' ,'7
49. Electric Release to Edison ' t' �
50. Gas Release to Southern California Gas Co � ' ' ' .
51. CERTIFICATE OF OCCUPANCY •
No. Date . .�
reaecn�ooeess:
. _ GWNEfl'S'NIIME: �
` �ooeEss: '
� , • a
pptNIE11GINEEfl:
ROUflESS:
�� .
uxir:
flEG.NO.:
uxrt:
PEPMRiEF: . -
�OONFSS:
LICENSEO CONTMCTOB DECUMTION: I hereby attirm that I am licensetl under provisions of C�apter 9(cammencinp with Section
70W) oi Didsion 9 0l the Buvness an0 Pmlessions CoEe, and my Ilcense is in lull force antl etlect.
CITY LIt.: 37RTE LIC.: CUSS: '
Oaie: SipnaNre:
WOPI(EHS' LOMPFNS�TION OECIAMTION: I herehy atfirm Nat I have a ceNliwte of conseni to self-insum or a certilicata aI Wo�kers'
"vn0ensatiw Insurance, or a cenifieA wpY �hereol (Seciion 3800, Lah. q.
LICY NO.: E%P. D►TE:
COMPIINY:
❑ CeNiieC coOY �s �ere0y tumisheU. ❑ Ceni/ieE coDY a GieO wit� ��e ciry BuilEing ONivon.
Wte: APOlicant: ...
E%EMFfION FNOM WOBIIEBS' COMPENS�710X OECIAMTIOX: (iTis section nee0 not Ca completed ii Ne pemit is la one �untlre0151001 a less�.
I cetliry Itwt in [Ae peAarmance of the work for which tAis permit is issue4 I s�all not emDlay any Derwn m any manner w as to 6ecoma
suGleti Io �Ae Worker; Compert5aiion Laws af Calibmu. �,. . ' 1
�dIO: $IU113IYf0:
NOTICE: I�, atler makinp tAis Oeclaration, you should 6ecome su6lect ta Ihe Workers' ComDensationprovisions al Ihe Labor
CoOe, you must foFthwith camDly with wcA provisions or this Dermit s�all be tleemeA ravokeA. •* '
CONSTPIICTION LFNOIN011GFNCY: I here6y attirm ihat thera is a constmctlon lentling a0ency lor Ihe�pedormance oi the woM for
wNc� this Dermit is issue0 (Section 3097, Civ. C�. '
lENOEN: ,
ROUBE38: ' . . ..
OWNEB BUILOER OFCLAMTION: I Aere�y affum tlwt I am aempt trom the Contractors State License Law lor t�e idlowinp reason
(Sectbn 7031.5 Business anE Professlonal Cotle: Arry ciry of munry wliiU repuires a Dermit ro construn, alrer, impmve, demol¢�, or
repair any stmcture, D�or ro its iuuance, also requires the apDlicant lor such permit to file a si0ne0 sta[emen� Ilut �Ns�e is IicenseA
pursuant to IAe D�oWvons ol t�e Contactors' State Licenu Law (ChaO�er 9(commenpnp vn�� Section 7000) ol Divivon 3 a11M Business
anC Pralessions CWl) Ot tlwl lie/sh¢ is ¢eempt ih¢relmm an0 Ne Eua lar I�0 allepeA ¢xemptlOn. My �iolatlOn Of Setlion 7031.5 �y
any app6unt lar a permit suDl� Ne apptiwnt to a ciril penalry af nat rtwm tlun frve hunEreA tlallars (5500�.
' I, as owner ol tAe OroDeM a��mY emplayeu with wapes as t�eir sole compensation,� will Eo the work, an0 the
simdure is not imenAetl or ottered tor sate (Section 7041, Business anE Pmfessional Cotle: The Contractors' State License Law
tices nol appN �o an axner of a properry wAo huiltls or improves Ihereon, anE wM Oaes suc� woM himsetf/hersell or tAmuph
Ais ar Aer wm employees, proviOeE tlw[ such imD�ovements are not inten0ed or ollere0 lar ule. II, however I�e Duildinp ar
imDmvemeni is SotA wiNin ane year. of completion, tAe owner will �ave t�e EurCen ol D�'�nB he/she OiA not bui10 or impmve
lor t�e Ourpose ol sale�.
I, as owner oi t�e D�oOerry, am exclusively coniractinA with Ilcansed contractors to constmcCthe Dmject (Section 704d, Business
❑ an0 Pmfessions Catle: The Contractors' SGte License Law Oces not a07ry to an ovmer al property who hml0s or Improves Ihereon
antl wM contraas tor sucA projects vriin a comractoqs) license pursuant b the Contracmrs' State licenx Law). I am awam
Ihat 0��� ol their Worker'S Compensation insurance shoNE Ue D�ovi0e0 Io me.
� I am exemD� unAer Section: 8.�8 P. C.
lor this reason:
Oate: O+mer.
1 Co nere0y ceniy Ilwt I am aware ol ana unEerstan� tAe requirements of Califomia Mealt� an0 Satery Code Sections 25505, 25533. an0
25534 anU ltwl I af any Iuiure builEinp atupant wiltlwill not (tifCl¢ one) neetl ro cOmpty vnt� ui0 Slate cod¢5 antl t�e reQuirem¢nt5 fof a
permit for conSWctpn or mo0ifwtion fmm ihe Nr �ualiry ManaO�ment 06tnct. NesiEential wnstmction applications are exempt fmm
tAese Provisions.
Date: ppDlicant
I herehy certity that I �ave aad this aD7�ication an0 state t�at t�e above inlormatian is correct. I apree to comDly with all ciry anA caunry
w0i`unces anE state laws reWtinq to Ouildnq construction an0 here0y authons represenutWes oi ttns ary to enter upon Ue a6ovo-mentioneE
proDeM for inspecibn purposes.
Date: SiAnature:
Driver'S License ar Social Secunry N: '
184t�ae W�ile—BuilCing; Green—Cotla Enlorcamenl; Cenery—Applicnnl: Plnk—Revenua; GolCenroC—Assessor
PERMIT NO; G 045282 PLAN CHECK NQ; 01052—F39 S PAGF: 'l
�*+�**���**�**�**��**�r**�r�*�*�rr***�rx�*x�r*�*�r�r*�����r��r+��*�r�r*+�*��r*�*�+r+�#**��*x�****
TYPE QTY. D E S C R I P T I O N UNI'P COST TOTAL COST
PLU 1 BACKFI,UW PREVENTER � 2.00 2,00
END OE FEE.S
n
0
.
�
.. � CONS.TRUCTION AND PLANNINb �L & SPA ,
� APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
�; .
1. Temporary Electrical Service or Pole 52. Pool & Equipment Locatiori
2: So:l Pipe-Undrgmd. {�{ Qp L,� 53. Steel Reinforcemen[ -
3. H�c[rical Conduit Utili[y-Undrgrnd. 54. Forms .
4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding
5: Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit�Undrgrnd.
8. Foundation -� 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O,Undrgrnd.
70. Structural Floor System 61. APPROVAL TO DECK
17. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System � Final
14. Rough Plumbin9 ' d � 65. Electrical-Final _
75. Rough Electrical�Conduit 66. Solar System-Final
16. flough Electric Wiring 67. Fencing & Access ApProval '
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electricai-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22.: Ducts, Ventilating 71. Product Piping O Gas � Oil
23.�Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33:=Final Electric � �p Notes:
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 Irriqation System
45. Sound Attenuation
46. Handicap Regulations .
47. FINAL STRUCTURE & BUILDING
46. FINAL PLANNING
49. Electric iielease to Edison
50: Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. pate
CITY OF CUSTA 11�ESA
CALffORN1A 92628-f200 P.O. BOX 1200
Insulation Certificate
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Description of Installation AN ���0 2�026'
x ?s �' q �/
Material LLI�Ss �/'i�jE/L6.t.iKS �-3qBrandName G[.K' �P255�qa � G uS�R �G'�k, �tA 3� Q�
'Ihiclrness (inches) DGC'�c j/.E "�Or GYwe..� 'Itiernial Resistance (R-Value)
F�r Lp�EB�aJ-nye2 Oc.cn.; dRRk'wooD
EXTERIOR WALL � �rte�D �a�'�
.% Ma�erial FiSE2�LASS Rpe�. RR poo2 �randNamellQR�Vt�eG /!e. f3c� 5iv3 DE^�'�E2.�i.CSc��T
77vckness (inches) ' " 'Ihermal Resistance (R-Value) R -//
CEII.ING `
n�SE/tGGA�s �1�0. 3ox � j�� ?01 t 7
, Bau or Blanke� T �co�� �.•� KaAr-T FR��c � �"'
ype oe� daaR,a�randName �%�/�V/�� DENvf2.
. 'Ihickness (inches) � �4 � 'It�ermal Resistance (R-Value) rQ -/ Q
Loose Fill T Bran�ame i � i
Contrac muum nstalled�hUft ��mum chic � ��inc� /
Man cturer's i�ed weig per square f o acheiv ermal R tance (R' )
7hickness �hes) / 'Ihermal FFesistance (R-Value)
SLAB FLOOR
c, Material �
Thickness (inches)
Width (inches)
FOUNDA7'/ION WALL
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(inches)
Brand Name
'fiermal Resistance
Name
�al Resistance {R-Value)
Declaration
;
I hereby certify that the above insulation was installed in the building at the above locaaon in confomiance with
the current Building Energy Efficiency Standards for new tesidendal buildings contained in Tide 24 of the
Califomia Administrative/Code.
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a! acwr(BuiJder) — - LicenseNumber .
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1 SignatvreerdTitle Date
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Sub-Contrac tuionlnstall . LicroseNumber
Signattve ard Title
F184 -
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COSTA MESA BUILDING-SAFEN DEPARTMENT
r. o. sox sn COSTA S7ESA. CALIRORNIA
For Applicant fo Fill In Complefely
TYPE OR PRINT
COSTA MESA. GALIFORNIA
3800 E. Cosat H
Corona del Mat
ER �CCO COIp.
3800 E. Coast H
3600 E. Coast
TEI.
uc.No. 7aaua sn-
B�ZE..r 6500 SF
uae or NoII@
EXISTING BL�G.
68TBACK YN6 PRON
�rmx or erneer 45
SIDE YARD I LEFT S
DESCRIPTION
urw I% II e� rewer�nP
� USE OP
No'OR
NO. OP
WORK
B2 PERPORMED
FE��REC1EI�VED
FINANCE DEPT.
navuC�i4Ti�►QF�RS��rt�A
BUILDING
For Office Use Only
necarvee er I o�re rtecerveo
APPROVED
ZON6
_J
L60AL
COSTA MESA. CALIFORNIA
�
IYPE v - GROU�
�
DATE
ZONING
I NO. OF �I UBC OR NBW,
PLAN9 BUILDIN6 � (
(C6M[M YNL BT.) �
vaenrt
J1 t 1C �a - u y1V1R H('CH - 1J01 JC
w/attached ara e Gara e Area - 410 SF
ch 99 SF
1 XEHBBY ACNNOWL�O6 TNAT 1 NAVE qeAD i3119 MPIJGTION Trye AMOUNT BXOWN UNOBR VALUATIOH 19 pOR re�e
AND eTATH THAT TH6 ABOV¢ �8 CAWIi6CT AND AGR6E TO LOM• pUf1P096 OP 69TAGLI6HIN0 A P¢RMIT P88 ONLY.
PLY WITH ALL CITY ORDINANCEB AND HTATB UWB Ii86ULATNO
BuiLDiNa GONBTRUt11oN. VALUATION �� �
61GNATUR F MESA MAR DEVEIAPMENT CO PERMIT PEE
PERMITTE
� L�F,339.�0 PLAN CHECK $ �
BY� ,�. .1/�,_...�DO