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Home My WebLink About2414 SARATOGA WAY - Building Permits ti r F CITY OF COSTA MESA a i 4 , @@ BUILDING DIVISION F «;, ,I DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER J ' • PERMIT B03-01946 te (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.caus UILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2414 SARATOGA WY Status: ISSUED Suite: Applied: 11/10/2003 Vicinity: MASTER BATHROOM/BEDROOM • Issued: 11/10/2003 Parcel Number: 41916280 Zoning: Applicant TREACY, KIERANISSUED BY: /2/_ Address: P.O. BOX 10714 - Phone: (949)294-0902 - COSTA MESA,CA Zip: 92627 Owner: COCKS,ANDREW Address 2414 SARATOGA WY " ' Phone: COSTA MESA,CA " Zip: 92626 " 1 . . / Contractor: KIEGGO CONSTRUCTION Address: P.O. BOX 10714 - \' Phone:' (949)294-0902 COSTA MESA,CA • Zip: 92627 : License:- 773135 Arch : - Eng: , Address: i .. Address: Phone: Phone: Zip: License: License: - - . - SCOPE OF PERMIT - -, INTERIOR EXPANSION/REMODEL OF AN EXISTING MASTER BATHROOM BY MOVING A NONBEARING WALL.A NEW SHOWER WILL BE ADDED WITH THE CHANGE-OUT OF EXISTING FIXTURES.AN 8 FT WIDE BY 3 FT HIGH BEDROOM WINDOW AT THE FRONT OF THE RESIDENCE WILL BE CHANGED-OUT WITH NEW LIGHTS TO BE ADDED TO THE MASTER BEDROOM. - FEE SUMMARY ' Plan Check: $136.01 Calc Valuation: , $12,000.00 Permit: $209.25 Claim Valuation:; $12,000.00 SMIP Res: ' $1.20 • - SMIP Corn: $0.00 ' Other: $0.00 .. ' Inspection: ' $0.00 _ Total: $346.46 . ' 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 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements 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 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 2446-48(6/00) I 111.1.1 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'comp��}sation surance carrier and policy number are: Carnet Ki S7 51-G.CII, 6 Policy Number: I (O Lc( - 2o03 - (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) 0 I certify that in the perk) .•ce of ,,.(([ 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 Call .mi_ _.•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 " • IS'• __ Applicant Signature:t for�� Date: J (-kr 03 WARNING:FAILURE TO.0) .• PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES 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 ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I em 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.4 A 773135 • - '- Class 8 r B. Contractor's Signature: Date: I I• t a - O?i CONSTRUCTION LENDING AGENCY: Jl— ❑ 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: f..,, Date: Owner ID verified by driver's license. M.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,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 ❑No (Section 25505 of the Califomia 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 end Safety Code been fully complied with? ❑Yes ❑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? IYes ❑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 Califomia Health and Safety Code Section 42303 been made? 0 Yes 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 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 imp: -• es.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 4 ..rOwner(s) Date Auth. [zed Applicant Date _ / COOEL WSPECTION TYPE PATE INTRIALS CODE( INSPECTION TYPE PAIL PANELS 1616 Fixed System Final Fire Prevention • 206 Final Mechanical 1266 Pool Spa Final _ 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical IL Leak.. .u. - 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 7�✓�/1 (f�{ // ' 204 Final Demolition 250 Final Building/Occupancy '- � "fit u, joF &L front ,_— stairs y living- room DIVISION OF BUILDING SAFETY CITY OF COSTA MESA APP% VED BY / Date / 0 /3 ale, any chanties¢arsratior�s on same without r: ;r on' a job at all times an.it i ...whin to hout wrdlen permission from the DMsim of Building and Safety.City 'Vis..VeSa.(�{�� _ q 711e damps g of iris cis: an:so C€Akkatio s SHAUNQT be � of the violation of any prows!ons of any City of Costa Mesa Ordinance anWo Sate a ed pt g ,tan These plans and permit shall expire by limitation and become null.r,. „', .. , Stag% �� per s:r ,3p3id)wd1Ar1180days dastregoe. Li i . l r / 0 MI 4 r icer rig AI c CPN e v-- . . Er( 185' a }/I3 master bedroom friliiiiplitiligliMM 230' u i CITY OF COSTA MESA vX3 -33R PLANNING DIVISION 24I t Sari SUBJECT TO BLDG. DEPT. REG. II V NOTE: ADDITIONS, DELETIONS, CoS t t25� OR CORRECTIONS SHALL BE APPROVED BY THE PLANNING DIV. R. B • L , .i' ATE: C /- ' iir DDDR D / 9-' V67 A 14. S �3 . b�'7( . , ,- F CITY OF COSTA MESA 4 BUILDING DIVISION > • -r ,1 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4. a - PERMIT / 4 a ,.A - / P03-00741 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2414 SARATOGA WY Status: ISSUED Suite No • Applied: 11/10/2003 • . Issued: 11/10/2003 Vicinity: MASTER BATHROOM/BEDROOM ere Parcel Nunmber: 41916280 ISSUED BY: lk /SYS_ r • Applicant: KIEGGO CONSTRUCTION Address: P.O. BOX 10714 - , - Phone: (949)294-0902 , COSTA MESA,CA Zip: 92627 �� Owner: COCKS, ANDREW ' Address 2414 SARATOGA WY . - , Phone: , COSTA MESA,CA Zip: 92626 Contractor: KIEGGO CONSTRUCTION _ , Address: ' P.O. BOX 10714 Phone: (949)294-0902 COSTA MESA,CA Zip: 92627 License: 773135 Arch / Eng Address: - . Phone: Zip: . - - • License: . SCOPE OF PERMIT INTERIOR EXPANSION/REMODEL OF AN EXISTING BATHROOM BY MOVING A NONBEARING WALL.NEW SHOWER WILL BE ADDED WITH THE CHANGE-OUT OF EXISTING FIXTURES.NEW LIGHTS WILL BE ADDED ADJOINING MASTER BEDROOM. - ' - 1 BATHTUB,1 SHOWER, 1 WASH BASIN, 1 WATER CLOSET .� , , - REF:803-01946 - - FEE SUMMARY - • AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Inigation $0.00 0 Swimming Pool, $0.00 0 Backflow Preventer ' $0.00 0 P-Trap $0.00 '0 . Trap Primer $0.00 0 Bathtub `$9.80 1 ' Pressure Regulator , $0.00 0 Urinal," " $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ) $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 $9.80 1 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) $9.80 1 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements 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 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 2446-46(6/00) DECLARATIONS t 1 WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: . O 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 rk for which this permit is issued. SI 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'comppenLs�ation/JIQS;�surance carrier and policy number are: [[ /'/ - 2 Carrier: Sht iC kft vD • Policy Number: I O S7 O'TI o03 (This sect/on need not be completed it the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performsl e 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 la -• ali•mind agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with the-e pro I '�/n _. Applicant Signature: i t Date: I.(' 10 -03 • WARNING:FAILURE 0 t. 5'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND Wt I - 100,000),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: 1 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 77 3 3S— Class a_t 'B - Contractors Signature: Date: . II- (O 'o3 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 subjects the applicant to a civil penalty of not more than five hundred dollars($500).): O 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 properly 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.). O 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 drivers license. 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,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 end 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 Califomia 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? ❑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? a Yes U 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? ❑Yes ❑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? ❑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 slate 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 Le.. r(s) Date And/Or Authori = ':S Date /j. ( O' of CODE! INSPECTION TWE ' I INTTTALS van I INSPECTION TYPE j1A¢• 101161$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical ^�1 L 1266 Pool Spa Final 208 Final Plumbing I -p(7- I,r A J IY 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 �Y V 9 CITY OF COSTA MESA 04/a.) BUILDING DIVISION F • ,r,' DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER oPERMIT 03-01056 st (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT • • Job Address: 2414 SARATOGA WY Status: ISSUED Suite No Applied: 11/10/2003 Vicinity: MASTER BATHROOM/BEDROOM - Issued: 11/10/2003 Parcel Nunmber: 41916280 Applicant: TREACY, KIERAN ISSUED BY: �' _ // r Address: P.O.BOX 10714 , Phone: (949)294-0902 COSTA MESA,CA Zip: 92627 , • Owner: . COCKS,ANDREW ,' Address' ",2414 SARATOGA WY Phone: - - - - COSTA MESA,CA Zip: 92626 - ' Contractor: KIEGGO CONSTRUCTION Address: P.O.BOX 10714 Phone: (949)294-0902 COSTA MESA,CA Zip: 92627 " .. License: 773135 - . - SCOPE OF PERMIT INTERIOR EXPANSION/REMODEL OF AN EXISTING BATHROOM BY MOVING A NONBEARING WALL.NEW SHOWER WILL BE ADDED WITH THE CHANGE-OUTOF EXISTING FIXTURES.NEW LIGHTS WILL BE ADDED ADJOINING MASTER BEDROOM. 12 LIGHT FIXTURES,9 OUTLETS,6 SWITCHES REF:803-01946 - - . FEE SUMMARY Quantity . - . Quantity , ISSUE FEE $23.50 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(31-units) $0.00 - 0 Transformers up'to`t.kva/kw- - $0.00" ' 0 , Pool/Spa , $0.00 . ' ' 0 up to 10 kva/kw $0.00 0 Lighting Fixts . $13.20 12 up to 50 kva/kw $0.00, , 0 Recept Outlets $9.90 9 up to 100 kva/kw $0.00' 0 ' Switches $6.60 6 over 100 kva/kw $0.00 0 Non Res Appi $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 1hp $0.00 0 Circus(mech ride or 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 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements 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 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 3446-46(6/00) • , 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 • in w>•ers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My worker' ,- sa'• Insurance carrier d policn(y��n�u,m,�b�re-�r are: [ �1 -Carrera it#,' 54--ta. RtWY Policy Number: I6C 7041- 2o03 - (This section Arm• •- d i/the pe•- 7 s valued at one hundred dollars($100)or less.) ❑ I certify that in the performan rk 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 '.,1 •'. =.ree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these• ovi t Applicant Signature: .../ Date: � WARNING:FAILURE TO SE'S " 0- ''S'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100.000).IN ADD ION 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 lull force and effect.tic.#• '3/ 3 S Class# 3 - Contractor's Signature:' Date: II' (0. 03 . CONSTRUCTION LENDI 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: 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 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,end 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. Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of Mc Invent,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 e permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I 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 tile a registration form for acutely hazardous materials? 0 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 Rand 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 end 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 ere required to register acutely hazardous materials with the Fire Department. 4 If en 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 aaPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes L.I 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? ❑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.1 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• r••ses.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. S'.nature"•al Owner(s) Date OFP(horizzt •Applicant Date SODS 6 INSPECTION TYPE ' Bag INTITIALS CODE t INSPECTION TYPE PEI RIM& 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbingf ' 200 Final Re-Roof 210 Final Electrical /IAA 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 44. PROJECTADDRESS: 2414 SARATOGA WY UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 069629 OWNER'S NAME: DOEBLER KATHLEEN H TR k ADDRESS: 2414 SARATOGA WY PERMIT NO; B 069629 PLAN CHECK NO; N GOVT; N SUPP : N 714 COSTA MESA,CA 92626 CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE; ALT ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/O RESTH & REROOF W/CS9Pt1 & HOT MOP SQ FT: 2, 508 ADDRESS: UNIT: �� CLAIM VALUE: 2, 508 . 00 CALC—VALUE:dp&9pp• 2, 508 . 00 GROUP OCC: R-1 / PERMITTEE: STOUT ROOFING INC ( 310 ) 923-6775 ADDRESS: P 0 BOX 4309 COMMENTS; REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE, REQUIRED DOWNEY CA 90241 ******s *4******+r�r+r�r�r�r********sr*+r+E�rx�6**********err****+r******x�E*** a6*Tr***gr*akk6***yk LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON INC REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACK S. CITY LIC.: 59377 STATE 402536 cuss: C 39 EXP ; 10/95 Date:ID a Q signature: J MAIN BUILDING ACCESSORY BUILDING WORKERS' OMPE SA71oN DECLARATION: (hereby affirm that lhave acertificate of consentto self-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT IN LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN Compensation lgcuTarlge2opa,gerldied copy thereof(Section 3800.Lab.ckS/19/95 PCOIMPANY: .AIG EXP.DATEPARKING REQ; PROV; PARCEL : 41916280 ZNE; REF NO: .7 Certified copy is ereby furnished. 11 Cendled copy is filed with the city Building Division. PLANNING NOTES> // > Date: Ili ....-40 ` Applicant:.-0404------1--- ******************************************************************************* EXEMPTION 'OM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES R EQUIR EME N;T S 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. ZONING APPROVED BY DATE: Date: signature: BUILDING APPROVED BY NOTICE:If,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor DATE; ' Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. r, CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y ; �4 • DATE; . which this permit is issued(Section 3097.Civ.CI. **************************** ************************************** ** LENDER: *************************** ******************************************** *** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT;Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING • (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 54 . 00 , 50 repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensedSMIP/NON—RES pursuant to the provisions of the Contractors'Stale License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/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). ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I. as owner of the property or my employees with wages as their sole compensation, win do the work, and the TOTALS----> 54 . 50 0 . 00 0 ,00 54 . 50 54 . 50 • 00 ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 54 . 50 OVER/SHORT: orimprovemento is of sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI P/TOT GRADING PLAN—CHECKH 0 for the purpose of sale). 54 , 00 • 50 I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business ❑ and Professions Code: The Contractors'State LicenseLaw does not apply towner trproperly ah bc0nserimprovesthereon and who contracts fr such projects with a contraterLaidoese pursuant to the Contractors'State LicenseLaw). I am aware *************************************************************************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: SFR 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 508 , 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said stale codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from (hese provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspecb n purposes. n Date:10 k signawre. 4L 01 00170642-00170643 TOT Driver's License or Social Security n: DATE: 10/28/94 TIME: 13:17 5{ 50 1641.46 White—Building:Green—Code Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor 4. ,.- CONSTRUCTION AND PLANNING - POs s 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 :6.'Steel Reinforce'/nent 56. Rough Plumbing & Pressure Test 6._Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE - 7. Footings 58. Electrical Conduit-Undrgrnd. 1 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9.-Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System - _ , 61. APPROVAL TO DECK - 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap63. Heater & Vent-Final 13. Roof Drains r 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 i 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 1 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20.:Rough Factory Fireplace - APPROVALS Permit # 21. Ducts, in Siruct uieit ; - -70. Underground Hydro '' 22. Ducts, Ventilating- 71. Product,Piping ❑Gas ❑Oil 23.-.Gas Pipe Rough &'Test . - 72. Undergrountl Flush. • . 24.•RoofFraming , - - - 73.' Undergrnd.StorageTank0Gas 0Oil 25. Roof Sheathing `tse•lilt &�'� , -.74.c Overhead Hydro .' ' a I 26. T-Bar Ceiling (Structural) &Monocoat - -„ + 75.-'Dry Chemical . + 27. Frame and Flashing' , r - ; 76. 'Dry Standpipe ' • 28.•Lathing-St Siding.;; ', . • 77. FIXED SYSTEM FINAL' '29. Insulation '. - ' ' 78. FIRE PREV. FINAL I. - ` :30. DrywallsNailing s-• HEALTH:DEPT: REQUIREMENT 31. Plaster Brown Coat' i • _ - ._79. FINAL INSPECTION ; '" - 2, 32.- Electrical;Power Meter-Final ..`.L - -80.•FOOD CERTIFICATE ISSUED 33. Find) EI'&rid - " " . ''Notes: ' , 11 •34. -Final Heating•& Air,Conditioning •r t• 35.-Final Gas'Pipe-Test' I. _ - ' 36. Hood orCanopy , - , .,. 37. Final Fatioiy Fireplace,_ - " t . 1- i 38. Final Plumbing - '39. Water Service-Final•. . _ - - - 40. Gas Service-Final ' ' . , . " ' . '' :41. Solar Domestic•Final • , ' 42. Backflow Preventer , _ 43. Backflow Irrigation - ,44. Landscape Irrigation System, ;- r . , ') _ 45.•Sound Attenuation I ' 46.'Handicap.Regulations 47. FINAL STRUCTURE & BUILDING 6-'b--1j ..• - 48. FINAL PLANNING ' ,- , . .•, • •.. A9. Electric Release to Edison - -. .. 50. Gas Release to Southern California Gas Co „ _ , Si. CERTIFICATE OF OCCUPANCY No. Date OWNER SAN VISTA Building Co. DATE 7-21-67 JOB ADDRESS 2414 Saratoga Way BUILDING PERMIT NO. 27326 GENERAL CONTRACTOR San Vista Bldg. Co. DESCRIPTION OF WORK Res.w/att.gar. _ AP No. 930-03-256 LOT 256 TRACT 5160 FIRE ZONE VALUE $ 18,114.00• _ INSPECTIONS ,St�igtnature Date GROUP I & J TYPE V ZONE R-3 Soil "` 7 Z PERMITS ISSUED /�� SUBCONTRACTORI Gas ac /-/ -� Date I Number Signature RoughWate ! ep -/-{$7 P imbing pB ( of S•L �4% 7-?/-7I'' umbingJ7 Prop. Swr. Line 0 House Con. V /14,15- q-27- � Sprinkling System Miscellaneous Rough Heating and Air Conditioning ^/C/7o7 Temporary Service or Pole Underground 0 „Power ❑ Rough Wir / _�. Tzar ,Heating d V nt. Trenches Forms�l Steel Reint : cgs i- jALy-//d,./-07/0, Floor System • 2. r Y 67 / Bond Beam 0. Steel Reinforce 0 Sheathing 0 e- 7 / i Frame and Flashing / t g'/' - Lathing— In mAsti/ Out [y i Q- r. a ' Plaster, Brown Coat e fr. 7 _ Structural, Final a--- (/� 7 Elec 'c Heating, Vent., Refrig. and AA., Flnal (( ` f - _ Ariti Plumbing, Final and Gas Test Pr K_-f 4 ' Electric, Final /-d -� Building, Final I _-i}] Q-_//G/') __--- • car PAP ,I 29325 JUL 2567csan00 1682a yr **9 i f0 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92616 - For Applicant to Fill In Completely . . APPLICATION FOR PERMIT TYPE OR PRINT BUILDING l� /� ) • For Office Use Only BUILDING ' Ict / 1�(AQ01� i Lauf R ADDRESS alt,-(T 1�.1`�f ip(t(fq'Rr W C 'RECEIPT NO. PERMIT NO. //�C�OpS�TA MESA. CALIF I//JN IIIA �J 11 0 1 OWNER (V o ti 0(/ [6 N/ (,E / (- BUILDING OA j[IVED DATE 19au D MAIL I. I�t �� ADDRES O / 6 0� (o =aims 3�- W �„(•µ�), ADDRESS Q�A/-� L{y3 FIRE Vi/GROUP // {/ CITY 0 �� V NO./}c/a,...IS�t ZONE - TYPE GROUP��`% ARCHITECT /y� /� �/� TEL APPROVED / 1�/ ilii YXi,. 7923-4221 BY DATE OR ENGINEER 1 Y l4 L. NO. of ' ZONING ADDRESS (a .--,‘7•✓L-• 'tel l:/1/1O/IDe NA /fdMl � ZONE R� NNO.OF uSEOFNEW //�� {� Pura 2 I BUILDING sins Res; CONTRACTOR 0 c^^"-c( F / /y ADDRHSS p — DESK I,4- SL Y44A0- .c' v n ' , „ n DESCRIPTION ` A.P.NO. 930-03-256 CITY l' GLI I I r 9---- ' l NOTE: NO SAVE OVERHANG SHALL BE LESS THAN STATE • TEL. 301 TO SIDE a REAR P.L. LIC.NO. NO. EAVES SIZE A -1e I HOow gmLOTS�b - ALLOWED (U.B.C.REOUIRHMENT). OF LOT ! ]� YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. .. (FROM C/L STREET) SETBACK LINE FROM FRONT .0 FT. PT. CENTER OF STREET - REAR YARD RIGH R.SIDE0 PT. - PT. SIDE YARD f LEFT DESCRIPTIONIOF WORK 1..LIDS 0 PT. FT. NEW II ALTERATION _ ADDITION REAR RI'' FT. IILII DISTANCE BET. BET.MAIN& REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS. BUILDINGS ^ NO.OF �7 VAR.# DATE SIZE y/(�J X i o ROOMS STORIES C.U.P.# ��jj .y� APPROVED CCOVERIOR ING: I 4� I COVERING C(p 'APPROVEDF / np{/ DATE 7-7-67 USE OF BUI IN D WORK TO BE RF C. �/'�' P. ALP& 13.tlIrPlitriq 99 ri. i/34/eSG.FT. ! / o a ' x. oD. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT {NGWN UNDER A PERMIT IF FOR TME AND STATE THAT THE ABOVE IS AND STATE LAWS AGREE TO COM. PURPOSE OP.ESTABLISHING A PERMIT FEE ONLY. Z.31 PLY WITH ALL C TY ORDINANCES AND STATE LAWS REGULATING VALUATION 1 DD BUILDING CON-Ali ON. PERMIT FEE $ (/ O SIGNATURE OF / �� q PERMITTHF [,L�L(rL if^ - _ $ 57 J/7 PLAN CHECK S 9 b --- A", AUTHORIZED GE / �... , . _. .._.,:. r...;.:.,.. .,;,,....�.., r..,. TOTAL FEE $ ?el i ;--\\ • • '? 'a COSTA MESA BUILDING—SAFETY DEPARTMENT •PAIL1d,,,w,, ,. 3 P. 0. BOX 1200 :=f 19-MEE77;k)U 499 d +_•-3.;,0 Costa Mesa, California ELECTRICAL PERMIT APPLICATIONLI� TRACT NO. REC'D BY P g°33 4-",ELECTRICIAN � — All' LOT NO. - . DATE ISSUED ADDRESS BUILDING USE CITYn /9I7� CITY TEL. NO. c2 STATE LICENSE NO. CLASS. �� / BUILDING r/ CITY LICENSE NO. ADDRESS - NO. ITEM EACH FEET COSTA MESA, CALIFORN e Dwelling, Sq. Ft. f NEAREST ` CROSS ST. F IL Garage, Sq. Ft. OWNER wAiC d -S ` /� O I— !!! O First 20 Outlets, each MAIL ADDRESS t E �� C Cay, )k J Outlets, Additional \\�l r Q CITY a- AY TEL. NO. > First 20 Fixtures, each I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI. > CATION AND -STATE THAT THE ABOVE IS CORRECT AND AGREE • J Fixtures, Additional • TOFCOMPLYyWITH ALL CITY ORDINANCES AND STATE LAWS REG. CC ULATING-ELECTRICAL WIRING. 1 Dryer � iN CERTIFY THAT I POSSESS THE ABOVE VALID STATE OF Y 1t.. VCALIFORNIA CLASSIFICATION OR I AM THE LEGAL OWNER OF 'y THE SINGLE FAMILY RESIDENTIAL PROPERTY DESCRIBED ABOVE. CC Fan � '� �' _ ----v. F V' Signature of W / / La Heater d PERMITTEE 1 ' S � Oven, Domestic �y IN—'L NO. ITEM EACH FEES — Pole, Construction ,01 1/4.--jk Sign& 1 Trans. 2.00 " �, CC Range, Domesrtt�_ Y' Transformers KW W Ci L1 misc.( ,C'.�� 7 i+'" Generators KW is CU- 0 - >- co / Motors ISee Schedule, �l' "L(}��-rte 2--2L-75— I-rn //n� / / Nv '1� ' - tete - HP Sub-Total Fees HP APPROVALS Meters, ea. I INSPECTOR 1 DATE TEMP. POLE , I UNDERGROUND CONDUIT I Parma Fee 2 00 ROUGH Sub-Total Fees FIXTURES POWER Total Fees e '^T/ UTILITY CO. NOTIFIED xFINAL BLDG. PERMIT A/I��I� IaRM BU-33 ®—m AAIT �O• For items not listed refer to Fee Schedule I