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Home My WebLink About942 SERRA WAY - Building PermitsFire Incident # �� ' �� Police Incident # _ RELEASE OF PROPERTY AFTER EMERGENCY INCIDENT , communiry at II ' S�(time) I` T Y'O (�te), CA MESA FIItE DEPARTMENT P.v. BOX 1200 COSTA MESA, CA 92628-1200 (71a) 549-1113 The Cos[a Mesa Fire Department, in Ihe interest of the saf assumed conVol of the property located at �"' �. S'E The necessiry for assuming control of [he property w bec Pursuant to the conditions contained herein, as of �.3 / to, and is to be und�eJ the control and the responsibility of who is the owner (1�), owner's representadve O, tenant ( �� the subject property is released YOU ARE HEREBY PLACED ON NOTICE OF THE FOLLOWING CONDITIONS (Check applicable conditions): OO A rekindle or an additional fire from a hot spot is possible. The Fire Department recommends that a fire watch, with a means [o e#inguish hot spots, should be posted for 24 hours. (�) The following utilities: electricity (SO, gas (�, water O, serving the property have been shut off. It is advisable to contac[ [he appropriate utility company before restoring the service. (X) The struchue may have been weakened by the incident. Until a swcwral survey can be made, it is advisable to keep all unnecessary people out of and away from [he building. O Buildings that canno[ be locked or secured by normal means must be secured by alternative means. Bazricades and/or fencing aze required [o prevent unauthorived entry. I[ may be necessary to provide a sewrity guard. (k) Rebuilding and/or repairing the damage will require permits (e.g., building, electrical, etc.) from the City of Costa Mesa's Development Services Deparimen[, Building Safety Division. They may be contacted Monday through Friday bet«�een �the hours of 8:00 a.m. and 5:00 p.m. by calling (714) 754-5273. T'he Costa Mesa Fire Departmen[ and [he Costa Mesa Police Department retain [he right to re-enter [he property at reasonable hours, should their investigation of this incident require such re-en[ry. ( ) Other precautions/conditions (specify): The condiuons listed above aze not all inclusive. They are intended as guidelines for the City's Fire Department in exercising their discretion in providing emergency assistance advice. Information conceming a copy of the report for this incident can be obtained by cal(ing the Fire DepaRment Business Omce at (714) 754-5106, Monday through Friday, between the hours of 8:00 a.m. and 5:00 p.m. You may be enutled to a reassessment and subsequent reduction of your property tas as a result of this incident. For further information contac[ Ihe Orange Counry Assessor's Office at (713) 834-2727, Monday through Friday, be[ween the hours of 8:00 a.m, and 4:45 p.m. The OWNER, OWNER'S RLPRESENTATIVE, and/or TENAN'I' shall protect, defend, indemnify and hold harmless CI7'Y and its elec[ed and appointed boards, o�cers, and employees from any and all claims, liabilities, expenses, or damages of any nature, including attomey fees, for injury to�or death of any persoq and for injury to any prope�ty, including wnsequential damages of any nature resulting theref�om, ari'singtiou[ of or in any way connected with the negligent pertormance of this Release by act or omissioq by or on tiehalf�( Cf WNER, OWNER'S REPRESENTATIVE, and/or TENANT, or msulting from any violation by OWNER� OWNFiR'S RE SENTATIVE, an .or �ANT of any statute, law, regulation, or other legal requirement. , Signed: I Date �% g' � Time � /� d� Owner ) Owner's Representative ( ) Tenant ( ) ( / � Costa Signed: c� Assignmen[�/ �! ��a►a f Cl� E.: �'. l � N'f0'1'E-FIliEADMIMSIRAT10iY YELIAW--OR'NER/OWNER'SREPRESEI�TATIVF%1'E1YAM' s PINK -- DEVEIAPMEnT SERVICES/BUILDING SAFETY � / � Pfl0.1EtT AUONESS: 9 Q z S ERRA WY OWNEN'S NAME: JACKSON � MARK A aooeess: JACKSON SERENA 942 SER�tA WAY COSTA MESA,CA 9262E 590-8904 RXCN/ENGINEER: flEG.NO.: ROONE55: UNIT: UNIT: PENMITTEE: NUNN CONSTRUCTION ( 714 ) 556-3750 nooness: 2738 FREMONT LN C.M. CA 92626 UCENSEO CONTPRCTON OECIANRTION: I �ereGy atlirm that 1 am licen5ea unAer O�ovisions ol C�apter 9(wmmencin0 �Ih Sepion 7pp� ol Oivigon 3 of I�e Business and PmleRions CaOe. an0 my license is in full farce an0 effect. cin �Ic.: 3 90 4 sTnre uc.:4 817 _ uss: � _ Daie:` Signaiure: �—��, WONNERS' MPENSA71 N DECLABA710N: I hereby alli t� I �a a eni ate ol consen� lo selbinsure or a cehilicate af Workers' Compensaiion Insurance, or a cenifieA cooY ��ereoi ISecti CI. POLILY NO.: E%P. DRTE: COMPANY: —] Cerlifie0 copy is hereDy fumis�etl. ❑ Ceni�ieE copy is �ileG vnth IAe ciry BuildinA �'^sian. Dale: ApD�itanC EXEMPTION FPOM WOBREPS' COMPENSIITION UECIABATION: Qhissection m I cetlity Ihat in ihe pedorma ce o� �he work lor whicA �his Dermii is i55ue0, su�lect to ihe NorkerY Co pensation Laws of Calilarn Oa�e: ignaWr . NOTICE: II. atter making Ais declaralion, you s�o tl be me bi Coee. you musl fanAwith campty witn such o�ovisi o i CONSTNUCTION LEN�ING AGENCY: I herehy aflirm Ihal �here is a tOm. w�ic� Ihis permit is issuea (Section 3097. Civ. C�. LENDEN: p00NESS: I il t�e permil is �or one hwUreU �E700) ar les5�. any per5on in any manner so as to become Workers' CamDensation Drovisions ol lhe Labor e OeemeA revoke0. lenaing agency lor Ihe pedormance ol the work tor OWNEP BUILDEB OECIABRTION: 1 �ereby a�lirm Iha� I am exempl irom t�e Coniractors' Siate License Law lOr Ihe lollowing reason ISection 7031.5 Business and Pmfeuional Cotle: Any ciry oi counry which requires a Dermit to consimc6 alter, imo�ove, Oemolish, or repair any s�mcture, prioi to its issuance. alm requires �Ae aOPlicanl lor such permit �o lile a sipneG Slatemeni I�a� Aelshe i5licensed pursuant io ��e Omvisions of the Coniracbrs' Slate license Law �Chapter 9(commencinA w��h Seclion 7000) of Oivision 3 0l t�e Business antl Pmlessions Code) or Ihal he/s�e is exempl lheretmm an0 Ihe Uasis lor Ihe alleged exemption. Any violation ol Seciion 7031.5 by any a071icant �or a permi� suble«s t�e applicani Io a civil penalry af nol more t�an �ive �un4re0 dollars (E5011). I. as awnei o� me nwoeny or my employees xith wa0es as �neir sole compensaiion, will Go t�e work, and the ❑ SlmtNre is n0i inf¢n0etl Or oneretl for sal¢ (Secbon 70AA, Buvness antl Pmtessional Cotle: ihe CanVaCi0r5' $Iaie LiC¢nse law tloes not aDPly Io an owner oi a pmpeny wip euiles or improves tAereon, anE w110 Oces sutn waM nim5ell/nerull or lnrough nis or ner own employees. provitle0 that sucn ImWovemenis are not inten�eE or oftertd lar Sale. If, however ihe OuilJing ar im0�ovemeni is sold wilhin one year ol wm0letion, t�e owner will have ihe GurGen of OrovinA he/she ditl not bui10 or imOrove � lor ihe Durpose ol sale�. I. as owner ol Ihe pwpetly. am exclu5ively conVacting wi�� licensetl contratlors b constmcl ihe prolan (Section 70a4, Business ❑ antl Profeuiws COGe: The Comraclors' Siate Licenu Law dou not appN �o an owner ol pmperry who bml0.s o� improve5 ��ereon anC who contracis �ar such pmjects vnih a wntractoqs� license pursuanl �o Ihe Coniractors' S�a(e Litens¢ Law). I am aware Ihai O�oo� al Ihei� Worker's Compensation insurance should De provitletl lo me. � I am eRempl un0er Seciion. B. 8 P. C. tor Ihfs reason: Oate: Owner: I ao here�y cenify thai I am aware of and unAerstantl Ine requiremenis ol Calilomia Healtn anU Salety Coae Sections 25505, 25533, an0 25534 antl I�al I or any luture Guiltling oc[upanl wilVwilt noi (circle one) neeE to comON ��h saitl Slate co0e5 and ��e reQuir¢menis �or a permit br conslmction or moEihcation imm Ihe Air Ouabry Managemenl Ustrict. ResiOential consimction aODlications are e�emp� Irom Inese omvisions. Daie: Ap0licanl: I hereUy certity I�al I Aave reaa lhis application and sta�e Iha� Ihe aUave intormalion is Wrrect. I aAree to compty wilh all ciiy antl couniy ordinance5antls�alelawsrela�inglobudtlingcansimclio antlhe�rizerePres¢n�ative5ollhisci�Y�o¢nleruPon�heabOve�men�ioned Omperly lor in50eciion pi Dases. Oate: � 164t�46 �"/M1�le—Bwltling: Green—Coae Enlorcement', Canary—ApPllcanl', Pink—Revenuo; Goltlonrotl—Assessor CITY OF COSTA MESA — HUILDING PERMIT PERM NO: M 06047 PERMIT NO; M 060470 PLAN CHECK NO: N GOVT; N SUPP; N CONSTRUCTION TYPE: PEAMIT TYPE; MEC PURPOSE: ADD JOB DESCRIPTION ; 265SF FAMILY ROOM EXTENTION SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS; RE:#B60468 �r��*��*�*�***�ex�r**�r***�*��r*****��******x*��**+�+r��*+�**+��***�r�*x*+��*x*�+�**��r�e 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 ---------- --------- ACCESSORY HUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN PARKING REQ• PROV; PARCEL: 19132706 ZNE; REF NO; PLANNING NU1'ES> i ' tik if 1E if iF ik ik if iF ik it ik iF �f �E if 1E iE it if If fE iF 1k ik �F iFlf k 1E k iF 1f 1E iF Ikif iFiFlf iE �kikif ik iE iE iE 1E il1FfF k ik iEiE 3F 1F iF if ik if ik iE i! iF iE lF 1E 1E k!f if 1E�ElE iE iF it 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 T S �ZONING APPROVED BY DATE: ��BUILDING APPROVED BY : DATE; �APPLICATION ISSUED BY; � DATE• \1� � �`(2 iEMffiEiE�f#iElfkiEiElEiF3FiFifiFiFifffiE ififlfi6iFk*jEiFlE ifi! iE iF iElF if iF iE jE ik if M if iF iF ftlF iE iF iF ik if jk iF iE if 1F iE 3! if if dk 3E ik iE il�E �f iF 3k jF iF iflF it �F �F�E 3ElE �E if iF k IE fE iE IE �E If if if if iF iE iE iE iF k if iE IE �F a! iE �E i! �E iE 1k LEGALIZATION:N F E E S U M M A R Y S1'RUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 9'15Y SMIP/NON—RES PLAN ISSQE FEE 15,00 BUILDING—DIV—> PERMIT ZSSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 9,00 15,00 0.00 29.00 29.00 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 29,00 OVER/SHORT; .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 24.00 if if ik i! iE iF 1E iE iE iE if iF if iE if it iE if !f if if ik 1E if k if 1E1F ik if if �t IE 1k iE iE fk * iE ik iF iE if i! iE if iE iE iF iF iF if 1t 1ElE iE iE ik iE 1klk iF �E �E iE i! 1E i! iF if !k iE iE if ik ik iE if iF I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST MEC 1 REPAIR/ALT AEATING UNIT/SYS W/CNTLS 9,00 9,00 END OF FEES CONSTRUCTION AND PLANNWG P��' PA APPROVALS Permit # Date Inspector AppROVAIS Permit # Oate inspector 1. Temporary Electrical Service qr Pole 52. Pool & Equipment Location �. 2. Soil Pipe-Undrgrnd._ - 53. Stee� Reinforcement � 3. Electrical Condnit lJtility-Undrgrnd. 54. Forms � 4. E7ectrical Conduit-Undrgrnd.� � � 55. Electrical Bonding � 5.� Steei Reinforcement 56. Rough Pl�mbing & Pressure Test 6. Electrical UFER Gmd. 57. APPROVAL TO COVER-GUNITE . Z Footings , � 58. Electrical Conduit�Undrgrnd. � 8, Foandation � � � 59. Gas Pipe, � Undrgrnd., Tett 9. Water Pipe-Undrgrnd. ,' 60. Backwash Lines, P�Trap, O Undrgmd. ' ' 70. Structural Floor System ,:� . 61. APPROVALTO DECK 11. Property Sewer Line & House'Connection 62. Backwash & RoceptorFinal � 12. Sewer Cap 63. Heater & Vent•Finat � 13. Root Drains 64. Plumbing SYstem - Final � 14. Rough Plumbing • 65. Electrical-Final � 15. Rough Electricat-Conduit 66. Solar System-Final 16. Rough Electric YJiring - 67. Fencing & Access Anproval 17. Rough Wiring Sign 68. APPflOVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAI � 19. Rough Heating & Air Conditioninq 2/�� LE/� FIRE DEPT. REQUIREMENT 1 20. Ro�gh Facttlry Fireplace • " APPpOVALS ��_Vermit # , 21. DuCts, in $tructur.e- � - 70. Underground Hytlro 22. Ducts, Ve�ti�ating ' ��' 1 77, Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough 8i Zest � ,; . '. 72. Underground Flush 24. Roof Freming "�' � ' •• ' - ` 73, Undergmd,. Storage Tank O Gas ❑ Oil 25. Roof Sheathing '�; • ' �� 74,'Overhead Hydro ' 26. T�Bar Ceiling (Structural) & Monocoat �� 75. Dry Chemical - 27. Frame and Flashing' , 76. Dry Standpipe - , - ` 28. Lathing�& Siding . � '� � _ � � 77, FIXED SY$-TEM FINAL ^ 29. Insulaxion ' ' I I 78. �FIRE PREV. FINAL 30. Drywall Nailing � ' � f HEALTH�DEPT. REQUIREMENT 31. Plaster Brown Coat ', � 79. FINAL INSP�CTION 32. Electrical Power MeteR�Final� S0. FOOD CERTIFICATE ISSUED 33: final Electric ' . I Notes: � 34. Final Heating & Air�Conditioning_ ��L�Z�I (�� ' 35. Final Gas Pipe-Test . � � . � ' � ' 36. Hood or Canopy ' ' j I ;- .� 37. Final Factory Fireplace . � ' 38. Final P�umbing � - 39. Water Service-Final ' � � � ' • 40. Gas Service-Final - 41. Solar pomestic-Final . � 42. Backflow Preventer' " ' ' 43. Backflow Irrigation - ' 44. landscape Irriqation SYsiem �: � - . 45. Sound Attenuation ' 46. Handicap Regulatiops � 47. FINAL STRUCTURE & BUILDING 48. FINALPLANNWCa � , . 49. Electric Release to Edison � - 50. Gas Release to Southern California Gas Co ; � � _ 51. CERTIFICATE OF OCCUPANCY . No. Date � � � VPDJEC7 ADDflE58 9 �} z $E OWNEH'SNAME: JJ;CKSOtN�� ' RDOHESS: ,7ACj(S�N _ _ — � COSTA ' S40-84 AflCHIENGINEEB: R�UXESS: �y UNIi; ERENA WCA 92626 flEG.NO.: UNIT: PEPMITTEE: NUNN CONSTRUCTION ( 7l 4) 556-3750 nooRess: 2738 FREMONT LN C.M. CA 92626 IICENSEO CONTflRCTOB OECLABATION: I �ereUy aflirm lhatl am lic¢n5e0 under prwi9on5 0l C�apie� 9(commencinA wilh Section 70�0� ol Oivision 3 0l Ihe Business and Pmfessions CoOe, antl my lic¢nse is in full lo¢e an0 effect. ciTvuc.:03904 sTnreuc.:48175 uss:� Oa�e: ` SignaWre: _ _ _ WOBREBS'CO PENSni OECIABRT10N: I�¢r¢Gyallir Ina ha a ni1 a ofconsenttoseu-insureoracenilicateafworkers' Com0en5aiion Insurance. or ce�itie0 copY �hereof (Seciion a �. POLICY NO.: E%P. DATE: COMPRNY: U Cerlifi¢A Copy i5 h¢reby �umiSheA. ❑ Certifie0 copY is IileU vnN the ciry Builaing Division. Da�e: � � ApplieanC E%EMPTION FBOM WOflNEHS' COMPENSRTION OECtAMTION: (Ttif sedion nee4 not Ge compleletl i� Ihe permA is Iorone hunEreA (E100� or less�. I certity ��al in the pedormance ol ��e work for whic� ihis permit is issuetl, I shall not employ any person in any manner so as to become subleq lo I�e ofker5' fAm ¢nSalion Laws 01 Cali�ornia� /'1� � ((yy�� / Oate: � �S�gnature: Alw.� � N ICE: I al�er making �is e ara�ian. yau shoul b e b� t �'Ihe Workers' Compensaiion D�ovisions ot �Ae Lahor C04¢. y0u mus� �otl�wil� tomply wilA Sutli Omvitio r.- i� S II be GeemeO revokeA. CONSTflULTION LENDING AGENCY: I �ereCy allirm that there is a construtlion IenGing agency fot Ihe petlormance oi Ihe work for wAicA I�is Dermil is IssueO (Sectian 3W7. Civ. C�. LENOEfl: ' aooxess: OwNEB BUILOEP DECUNA7lON: Ihere�y aflirmtAatl am eKempifrom ine Cantactar5' State Lkense Law lor the I011owinA �eason ISection 7031.5 Business ana Pmlessional Cotle: Any ciry ol couniy which repuires a Dermit Io consimct, alter, imomve, Oemolish, or ieDai� any S�mtWre. prior l0 iI5 is5uan[e. al5o re0uire5 1�¢ applicani �Or Su[� p¢rmit Io �ile a SiBned Slatemen� �hai �rJShe i5licensetl pursuaN m Ihe pmvisions ol l�e Convacbrs' Stale License Law �CtuD�er 91�mmencing wi�h Seclion 7000) oi �ivision 3 0� Ihe Business an0 Professians Coee) or inal he/sne is exempt therelrom ana ine Eavs for rtie alleped exemplion. Fny violation ol Section 7031.5 by any applicanl �or a permil sublects IAe aD0licanl �o a civil penalry ai nol more �han live hunGreG dollars �E500). 1, as owner ol tAe pmperty or my employees with waAes as �heir sole com0an5a1ion, will Eo Ihe work, antl Ihe ❑ slmcWre is nol in�enCeG or oflereE tor saie (Sectbn 70a4. 9usine55 an0 Pmleuional Cotle: The Coniractors' State license Law ' Uoes nol apply Io an owner ol a propeny wAo 6uiltls or imo�oves lnereon, and who tloes sucn work nimseltlnersell or inmugn �is or her own employees, pmviGea Ilui suc� imDmv¢menls arE nol inlenae0 or offere0 lor 5aie. Ii, however ihe EuilOing or improvemen� is soltl withm one year oi campletion, Ihe owner vnll hav0 t�¢ DurAen ol Drovinp �e/she Oid nol Guild or improve for Ihe purpose of sale). I, as owner ol �Ae pmpeMy. am exclu5ively contraciinp with IicenSeE conlratlors �o [onstmtl �Ae pmjec� (Sec�ion 7004, 8usiness ❑ anE Pmlessions CoOe: ihe CanUactors' Siate Licrnse Law Uoes rwt appty io an wmer ol procertf' who bwlds or improves Nereon antl who caniraCtS lor SUCh Dmle��s wiih a tonlratlOr(5) liCense purivanl lo I�e Con�ratlors' S�a�e License Law�. I am aware that D�ool ol t�eir Worker's Compensaiion insurance shoul0 �e provi0etl to me. � I am e�empi unGer Seclion: B. 8 P. C. for IAis reason: �ale: OwneC I oo hereby cenily Ihat I am aware oi ana unaerstane tne reQuimments ol Calilomia Healtn anA Safery CaOe Sections 25505, 25533, an0 2553d anE I�at I or anyluiure huiltlmg occupanlvnlVvnllnot�circle one�neetllo comply with SaiU slaie totles antl the requiremen�s�or a permil lor consbuc�ion or modi�icalion Imm Ihe Air Oualiiy Management Us�ricl. Pe9deniial con9mctian aDD��ations are exempt from Iheu pmvisions. Oate: pODlicanl: I here6y certity Ihai I have reatl ihis application and Slale IAaI l�e a�ove inlormalion is rorrect. I agree to comply with all ciry and counry artlinances an0 51a�elavrs�eialingio building cons�mctionana �ereby au�IpnzereDreseniatives ott�i5ciryto enlerupon��eabove�menlione0 omDer�v br inspeciion �r0oses. (� � � � �, Oare: — Signature IDriver'S license or SOti I Seturiry i64La6 W�ite—Builaina: Green—COtle EnlorcemenC Canarv—Noolicanl: Pink—Revenue: Goltlenr0a—Assessor 1 � CITY OF COST MESA — BUILDING PERMI'C PERMIT NO: B 060468 PL N CHECK NO: 04980-92 S CONSTRUCTION TYPE: PERMIT TYPE; STR JOB DESCRIPTION ; 265SF FAMILY ROOM EXTENTION CLAIM VALUE: '15,000.00 CALC—VALUE; 19,610,00 I, PERM NO; B 06046 �� PORPOSE: ADD SQ FT; GROUP OCC; R-3 / 265 COMMENTS: X �r*��r�r�r*�r�r****�r�r+r*�rx�r**�r�r��*�rx��t�r****��r�r*****�**�r*�*�t�r**�+t**x*��+t*�r�r�***x ***�r*� 2 O N I N GS EATEH�AUCIRRSE M E N T S -----==----- MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; 20 FT IN REAR: 15 FT IN FRNT; FT IN REAR; FT IN LEFT: 57 FT IN RGHT: 12 FT IN LEFT: FT IN RGHT; FT IN PARKING REQ • PROV; PARCEL: 19132706 ZNE: R1 REF NO: PLANNING Ni3TES> 265 SQ, FT, TI TO ADD A NEW FAMILY ROOM � iE 1E 1E 1E if !f if �)f!f iF �F if !E �lik 3f iF iE iF ff ik �E ff if iE k!E If !f iE iFlE 1F i! k it jf iE if i! iE iE 1f iE i!!E if iE iF 1tiF k if if !! �f 1f 1F lE if !k if !E if �k iE iE ik �f iF �F 1E iElElE 1E iE iF iE D E V'E'-L O P M' E�N T S E R V I C E S A E Q U I R E M E N'T S ZONING APPROVED HY . � ` � . _ � DATE; 12 3`� � �� BUILDING APPROVED BY. : `� DATE; APPLICATION ISSUED HY: DATE; \' L`I�� ifififiFiFiF�EiFlfif�Flfiti!ltiFftltltkiEiF IEiFiEiEjfiFiElElkiE iElf �E �f iE if if if if if itlk �t 1f 1E 1E �F iE it �E iElf If k iF i! iE if ik ik if iE 1F 1E iE IE!! k�F iE 1! k iE 1E IE IE ik 1! if if ik iF iE if iF iE I! iF if 1f iF if ik 1E k iF iF ik iE iF iF �E ik iE iE ff iF iE ik 1f it LEGALIZATION:N �� F' E E S(J M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 207.00 a 1.96 � ' ,, — , SMIP/NON—RES PLAN 134.55� . ISSUE FEE HUILDING—DIV—> PERMI'� ISS[iE PLAN—CHECK TOTAL PAID DUE TOTALS----> 208.96 0.00 •' '134,55 343,51 343,51 ,00 REVENUE DIVISION TOTALS-->� COLLECTED; 343,51 OVER/SHORT: .00 BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN=CH£CR 207,00 1.96 134;5-5 ik iF if !F iF 14 �k iF i! iF it-1f if if !f!! ik ik i4 if if ik iE if iE if ff iFlF 1Fit 1f if iElf 1k if if iE i/� 1f iF 1k it i!!! �kiF �f IEif iF 1F 1F iflF �kif i61k iF 1! k!E iE ilik ik it it it ik ik iFiE iE iE iF ih\ I N D I V I D U A L F E E B R E A IC D O W N TYPE QTY D E S C R'I P T I O N� UNST COST TOTAL COST SFR 265 DWE—TYPE V—WOOD FRAME —GOOD •74,00 END OF FEES - � 19,610,00 CONSTRUCTION AND PLANNWG P00� .PA 1PPRUVALS Permit #�_ Date Inspector p�ppROVALS Permit # Date Inspector 1. Tert»ora�y Electrical Service or Pole 52. Pool & Equipment Location i 2. Soil Pipe•Undrgrnd. 53. Steel ReinforCement !3� Electriwl Cond�it Utility�Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd., � 55. Elect�ital Bonding 5. Steel Reinforcerrient �Z� ��' 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER•GUNITE �7. Fobtin s I 56. Electrlcai Conduit�Undr rnd. 9 J 9 . '8. Foundation - 59. Gas Pipe, � Undrgmd., Test � 9. Water Pipe-Undrgrnd. .- 60. Backwash Lines, P�Trap, O Undrgrnd. 10. Structural Floor System �Z�lY'3 jj�-- 61. APPROVA� TO DECK ! 71. Property Sewer Line & H�useConnection � 62. Backwash & Receptor�Final 12. Sewer Cap i 63. Heater & Vent-Final 13. Foof Drains 64. Plumbing System � Final 14. Fou9h Plumbing 65. E�ectrical�Final 15. Rough Electrical-Condu�t � 66. Soiar System•Final 16. Rough Electric Wiring 67. Fencing & Access Approval 1�. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Aough Heating & Air Conditionin9 FtRE DEPT. REQUIREMENT 20.� Rough Facto'ry Fireplace � '- APPROVAL$, ��Permit # ' 21. Ducts, in Structure �-�� - 70. Undergro�nd Hydro 22. Ducts, Venti�ating �- '' 71. Product. Piping O Gas O�OiI 23...Gas Pipe•Rough & 7est , � . � 72, Underground Flush � • • 24. Roof framing • ' � ' i�, `73. Undergrri�.Stor�geTank�Gas ❑Oil 25. Ro'of Sheathing : . ' , �./� & ��.0 '^ 74„ Overhead Hydro , !- 26. T-Bar Ceiling (Structurall & Monocoat d - . 75, Dry Chemical 27, Freme and Flashing . �� ` D 76. Dry Standpipe 28. Lathing & Siding ` � n- 77. FIXED SYSTENFFINAL 29. Insulation , ( � 78. FIRE PREV. FINAL . 30. Drywall'Naiiing �d HEALTH DEPT. REQUIREMENT -31. Plaster 8rown Coat � 3 l�Q3 � . 79. FINAL INSPECTIQN 32�. Electriwl Power Meter�Final 80. FOOD CERTIFICATE ISSUED 33. Final Elect ic Nqtes: 0�__e?V� 34. Final Hea ing & Air Conditioning .. �I�� `�� lSG,(.. 7'O� r''W 35. Final Gas Pipe-Test ' '- - ' 36. Hopd oi CanopY • 37. Final Factory Fireplace. , " 38. Final Plumbing � � "39: Water Service-Fina1 - ' 40. Gas Service-Final .. _ 41. Solar pomeSticFinal ///�� " 42. Backflow Preventer � - � 3�� /� J� �K U� 43. Backflow Irrlgation � 44. Landscape Irripation System _ ' . 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTUflE & BUILDING 30 '. %% � 48. FINALPLANNING - 49. Electric Release to Edison 50. Gas Release to SouFh¢r� California Gas Co � I � 51. CEfiTIFICATEO OCCUPANCY , . , No. Date City of Costa Mesa California 92628•7200 P.O.Box 1200 Insulation Certificate Permit Number �I.p'„T— . �-�Z �-�,4 -�� (�C�� - Number and S�ree� City Counry Subdivision Lot Number ROOF Material Thickness (inches) Description of Installation Brand Name Thermal Resistance (R-Value) EXTERIOR W L ' Material �� Brand Name ��v �( Thickness (inches) %� \ /..._ � Thermal Resistance (R-Value) — 1_� CEILING ��(,�� Batt or Blanket Type�� Brand Name �` =V–`1`�'�_�� Thickness (inches) _ � Z Thermal Resistance (R-Value) �— Loose Fill Type Brand Name Contractor's minimum installed weight/ft2_ Ib. Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) RAISED FLOOR Material Thickness (inches) SLAB FLOOR Material Thickness (inches) Width (inches) _ FOUNDATION WALL Material Thickness (inches) Brand Name Thermal Resistance (R-Value) Brand Name Thermal Resistance (R-Value) Brand Name Thermal Resistance (R-Value) Declaration I hereby certify that the above insulation was installed in the building at [he above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the Califor ia Adminstrative Code. ��C� � >>�u�� __�j�� 1�1 �a 1 General Contractor (Builder) License Number ' _��r .�-- ��.�� Z-z �t °� SignaWre and Title � � Date Sub-Contract�ula�nstaller) . License Number � Signature and TiUe 1sOl-a6 Date : PflQIECi ADOflESS: 9 Q Q SERRA WY ., ; '�NEfl'S NpME: H(�K JACKSON ^•�� = noexess: 942 SERRA WY COSTA MESA CA 92626 (719)662-3656 APCN/ENGINEEN: flEG.NO.: uxiT: ADONESS: UNIT: PEHMIiiEE: MARIC JACKSON ( 714 ) 662-3656 noonEss: 942 SERRA WY COSTA MESA CA 92626 LICENSED CONTBACTOP �ECUIMTION: I �ereby allirm �hat 1 am licensea under piovisions o� Chapter 9(commencing wilh Seclion 7000) af Division 3 0� ihe Business ana Pm�essions Cotle, and my license is in full force antl enec�. CITY LIC.: STATE LIC.: CIASS: �a1e: SignaNre: WOPNEBS' COMPENSIITION DECNNATION: I �ereby aifirm thal I have a cenificate of consent to selLinsure or a cenificate oi Workers' Compensalion Insurance. or a certified copV �hereof (Sec�ion 3800. LaO. C�. POLICY NO.: E%P. OATE: COMPFNV: � �] Ceni�ietl copy is �ereby �umished. ❑ Certilietl copy is IileJ with Ue ciry Buiitling �ivision. �ale: ApDlican�: E%EMPTIONFBOMWOflNEflS'COMFEN511TION�ECIABATION: Qhi55edionneeana�becomplete�iithepermi�i5foroneAuntlretl(E11p�orle55�. I certity ��a� in ��e pedormance of the work for whicA Ihis Oe�mit is issuetl, I shall no� employ an rson in any manner so as to become subject lo �h orkers' Com ensation Laws ol Califomia. Dale: �� Signaiure' � NOTICE: I�. afler making ihis declara�ion, you should become sublecl �0 1 arkers' Compensa�io vision5 0� �he Labo� Coae, yau musl forihwilh comply with such pmvisions or t�is permii s0 e deeme0 revoketl. CONSTNUCTION LENUING RCENCY: I here�y a��irm t�ai there is a constmtlian lending aAency �or �Ae petlormance oi the work tor w�lch �his permll Is issue0 (Sec�ion 3097. Civ. C). LENOEX: noosEss: OWNEB BUILUEH OECLFBATION: I hereby aifirm thai I am exempt iwm t�e Contracmrs' State License Law for �he tollowing reason (Section 7031.5 Business antl Pm�essional CoOe: Nny ciry oi counly which reQuires a Oermi[ m constmct, alter, improve, tlemolish, or repair any sVuclure, prior �o ils issuance, also re0uire5 IAe aDP�icant �or such permit to �ile a 5igne0 5�a�emeni �hai �elshe is Iicen5e0 pursuanl io Ihe provisions o� ��e Contracmrt Slaie License Law (Chapier 9(commencing wiih Section 7000) oi �ivision 3 of the Business anA Pm�essions Coee) or I�a� he/she is exempt thereimm anU Ihe basis �or ihe allege0 eKemption. Any violation o� Sec�ion 703L5 by any applican� lor a permi� sublects the applicanl Io a civil penalry o� noi more �han five huntlred dollars (5500). I, as owner oi Ihe pmperty or my employees wilh wages as Iheir sole [ompensa�ion, will do Ihe work, an0 �he ❑ simmure is not intentlee ar oiferetl lor sale (Sec�ion 7a44, Business ana Professional Coae: 7he Coniracmrs' State License Law does no� apply lo an owner of a pmperty who builtls or impmves �hereon, and who Ooes such work �imselflhersel� or �hmugh his or her own employEes. pmvideA �hai such improv¢menis are noi in�ended or oifere0 for sale. Ii, however the building or impmvemenl is 5010 within one year oi comDlelion, �he owner vnll have Ihe �urden ot Dmving Ae/she tlid noi build or impmve , lor ihe purpose ol sale). I, as owner o� the pmper�y, am eKclusively coniracting wilh Iicen5e0 contracbrs to conS�mcUhe pmjec� (Sec�ion 7044, Business I� and Pm�essions Catle: The ConVac�ors' Stale Ucense Law tloes noi aOPly �o an owner o� pro0erty who builOs or impmves Iherean and who coniracis for such prolecis with a contracbr(s) license pursuant to Ihe CAntraclors' State Litense Law). I am aware that pmol oi Iheir Worker's Compen5ation insurance ShoWa be pmvided ro me. � I am eKempl under Section: B. 8 P. C. �or i/nis �`reason: Q Da�e'. 7S �/� % � Owner. I Oo here�y ceniry �ha� I am aware ol and unders�antl �he requirements of Cali�amia Heal � d Safely Code Secti 550.5, 25533, and 255� antl Iha� I or any fu�ure buil0ing occuDani will/vnll no� �circie ane) neeU lo compty with said s�a�e codes an e requiremen�s fo� a permit lur can5imction or modi�ica�ion �mm t�e Air Oualily Managemen� DiSiricl. Fesitlential conSVuction ap0�icaiions are exempi tmm �hese provisions. �ale: AOPlicanL I hereby ceritlytnal I have reatlthis applicalion an0 statetnatine aboveinformation is correcl.l agree lo comply wilh allcily an0 county ortlinances antl sia�e laws relating Io bwltlmg consimclion and �ere�y auihorize represen�a�ives a� �his ciry to en�er upon Ihe abave-men�ione0 pmperlY �o/r yin50.eclian purpo/5es. � � i2�},��'_ Daie: �/ �[ L / � Signaiure: �� 1I onver's License ar socia� securiry 16<La6 Whi�e—Builtlinq; G�een—CoOe En�arcemenf. Canary—Aoolicant: Pink—Revenue: Goldenrotl—Axnswr CITY OF COSTA MESA — BUILDING PERMIT PER O; IB PERMIT NO; IB 058642 PLAN CHECK NO; N �VT�—$IIFP�— CONSTRUCTION TYPE: S—N PERMIT TYPE: OTH STR PURPOSE: ALT JOB DESCRIPTION ; REMODEL EXISTING SWIM. POOL d DECR SQ FT: CLAIM VALUE; CALC—VALUE; GROUP OCC; R-3 / COMMENTS; REINSTATE EXPIRED PERMIT #BEP48421, �r****x�r**�r**********�r**�r�******�**�r�r*�r**�r**�*�e*�r�r�r*****�+��r*�r�*�r**�r�r**xx*x�****�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 BUZLDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN PARRING REp • PROV; PARCEL; 14132706 ZNE: REF NO; PLANNING NiSTES> i �t�*�t�r�r�t�r�r�t*�t�r*�t+t****�r,e�r*x*�rx*��r�r�r*�*�x��r*�r,rx*x�rx��x�r�r�r�e*�r�r�t�r�t�r�t�t*�r,r*�e*�e�t�t*�t�t�r�t**�t D E V E L O P M E N T S E R V I C E S A E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY ; DATE; APPLICATION ISSUED BY; DATE• �� I�`1'� �tifkiFiFikiFlkltif�klklE�Flkltk�ElflFlkiF �Fifit�F�Fki!!flEif Ifif �Fit ik iFlf iFit iF IE �k�k k�t 1E 1k �E k 1f iE �E if if k iE dk iFlF iE iF 3f iF if 1FlFif if if if fF if if !t it iF if k it kifltlFiF�k 1F itlEiflk iF f! IE IF iF kiF iE if �F If it ItiF it 1E �Flf k k 1t LEGALI2ATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 30,00 SMIP/NON—RES PLAN ISSUE FEE HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 30,00 , 0.00 0.00 30.00 30,00 ,00 REVENUE DIVZSION TOTALS--> COLLECTED: 30,00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADSNG PLAN—CHECK 30,00 �F Ik MiE k it 1t 1k if if iE k ik if k if iE �E k 3f lf it iE �! Mik 1E iF if �F 1E 1E k if iF iF 1F iE iE * iF M 1F ik �k if ik if iF 1liE k iF If 1E 1E �E iEiE iE iFiFiF if iF iF if iE iE iE k iE iE ik iE ik iE iFiF I N D I V I D U A L F E E; B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST �INS 1 BUILDING RE—IN�PECTION FEE 30,00 30,00 { fiND OF FEES �� : EXPIRED I pl e InsPectwns t7ete ' .. gig �"""' �' r+rj' ?;-'' �; ii�' --� CrNSTRUCTiON AND PLANNWG POC SPA P�'ROVALS Permit # Date Inspector qpPROVALS Permit # Date Inspector� i.f�i'emporary Electrical Service or Pole 52. Pool & Equipment Location ' � 2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement . - �� .�,�. E1'ec`�PicalCond$Uit,I7iility-Undrgrnd. 54. Forms -� 4,.Elgctricai CondUit�l:Yndrgrnd. 55. Electrical Bonding i '' 1��5.L�'p� Reinforce`tnerti 56. Rough Piumbing & Pressure Test � � � 6. E�ectricai UFEE�Grfld. 57. APPROVAI TO COVER-GUNITE ;•i:-Footiqys ��; 58. ElectricalConduit-Undrgmd. "� r 8. Foundation ' 59. Gas Pipe, O Undrgrnd., Test '" �. Water Pipe-Undrgrnd. 60. Backwash Lines, P-7rap, O Undrgrnd. ' 70. Structural Floo� System 67. APPROVAL TO DECK 11. Property Sewer Line & House Connection � ' 62. Backwash & Receptor-Final � 72. Sewer Cap _ 63. Heaier & Vent•Final � 73. Roof Drains ' ' 64. Piumbing System - Final � 14. Rough Plumbing " 65. Electrical-Final - ' 15. Rough Electrical-Conduit 66. Solar System•Final � �, 16. Rough Electri��Niring 67. Fencing & Access Approval � 77. Rough Wirin9,$j9^ 68. APPROVED FOfl PLASTERING '.' 18. Rough Electricpl-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ' 19. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' � ' - ' - cr,_,.ef- � < - 20:±7Ro'u'yh E�ct¢y �replace � � �i r � CS� ^ c� � "APPROVA�L•S-�CPe� it # � �' ,L � � '• . _i 1 . " :w . " G... " _' 21 _;Ducis, in StructGie;; - � - -.a , � ; )0. Undergcozin Hytiro .s ' 22: Ducts. Ventitratingi . : � '� -2� x ^77. Produq�(�Ping [3�as �Oil , 23 �Gas Pipe_Rough & * est � - '�` „ - I � �' ` g ' ' �:•.t, �, r .)x % -72. Under round Flu i 24-Roo'f Ftaming :Tx ' � r 'A > > � *' Y'. 73?Undergrnci.Storag�T�nk OGas ❑Qtl �. " i 25• Rop3 Sheathing ": ' " ` ' = � '''' ^ - � v -•�'•' ' . T .- 1: ,,, Z; •' ,� � JQ� Overhead Hydro: � a �1 1 26yT�Bar Ceiling (Sfructural) &-N}onocoat �' - _ �C'r � 75rDtY Chemical Y - � '1 ^` 27.�Frame a�d Flashin� 't � ^ ° ^ ° y„ �`. 76. �ry Stanc�'pipe � a � �' ' �- � ' -28�Latbing&Siding K^ -. L,L - ' x 7T4' FIXEDSY � E(i�;fINAL�` 7�- .. . `29. Insulation ,;�;: " �- � :, y 78c� FIRE PREV. FINAL - �' !'� .'30.DrywallNailing�::�.K�` V R'� - HEALTFY'pEPF.R�EQUIREMENT .31. Plaster Browq Cqa{`. y '_ ;, ;� � 79:'�FINAL INSPECTI�N n' ' � ��32., ElectriFal Pomer.Meter�Fina6 � >:, c? -80 rF00D CERTIFl�C,4,7E ISSUED - .- r ' ,33_:Fin�i Ef�ctri� �'„ � `' � a � No�es: _ �i�r � .. J �'' „ � i r . .. - ' ; . � ._ .��34; Final Heating &.�i; onditioning, - , . � z �-�t �K _ ,.,:, . �- `35.TFinal Ga3 Pipe�'I�esY '� " T �� y�? ` r� i. :c > i' . ., �, . -36.�Hoador�CanoPy: - ' � . � y� > - : ,r�,� - r '37-Finai Factory Fire(ilace�. ' x� I �' � K ' �,; '� 38. Fiqal Plumbing � .� � � �I ~ ; � * ��. .39. Water Service-Finak y - r x � , � „r �; .c KY- � I iK� � ,40. Ga95er,vice-Final � ,r , , _ , � � ;� "� _ R ' 541. Solar pomestirFinal-. ^ � * .�s � : ¢c �, � 4 Y T �:� ' L i' - '42r'Backflow Prevente�. � _ �� ` ' �� - '_', s: S 43. Backflow Irwgation � i > � " ' � S � x = � = +Y X { / +� ' 44. Landscage Irripation System�'� '-' - _ - ,y :%,�, _� ' `: ,., �_45.=Sound Attenuetiorv - � ^ = � - �-" � �-� . -' �-'Q x (� T 'T'ty' � ' Z` - �46.'Handicap R'e,gulations - �- ' �� '� ,;',= � Y _„ � � , y47.-FIf�tAL STRUCTURE & BVCLDING F � I K• .�' � . { �48`_''FIFFAL PLANNING ' � � � �� - ` ,, i i Y . �49.: Eleetric Release to•Edison � � � ��. r � z � � - �1, v. �' i i r ; _ r :. :.50. _Gas Release to Southern Califomia Gas Co .: � � ��; '" -. r Y � ,:5L CER7IFICATE OF OCCUPAN'CY , x _ - _ -� . r No. Date � � � Pfl0.1ECT ROOPESS: J t} z S ERRA WY OWNEx'S NnME: MAAK SACKSON nouness: 9q2 SERRA WY «��`� COSTA MESA CA 92626 (719)662-3656 AXCN/ENGINEEH: RODNESS: aec.xo.: uxir: UNIT: PEHMITTEE: MARK JACKSON ( 714 ) 662-3656 aooeess: 942 SERRA WY COSTA MESA CA 92626 LICENSED CONTBACTOB DECIAPATION: I �ereby a��irm �hat I am licensetl unaer provision5 0� Chapter 9(commencing wi�� Section �000� ol Divisian 3 0l t�e Business and Prolessions Cotle. anE my license is in full force and ellecl. CITY LIC.: STATE UC.: CIASS: Daie: Signature� WOBREBS' COMPENSRTION UECLRPATION: I �ereby a�firm thal I have a ceni�ica�e ot conseni b sel4insure or a certificale of Workers' Compensabon Insurance, or a ceni�ied coDY �hereol (Sec�ion 3800. Lab. C�. POLICY NO.: EXP. DATE: COMPRNY: ❑ C¢rtifietl copY i5 h¢re�y �umishetl. ❑ Certtlie0 copy is tileA with the ciry BuilOing Division. Date: Ppplicant: E%EMPTION FflUM WOflHENS' COMPENSpTION OECIABRTIDN: Qhis sec�ion neeA no� be completetl i� the permi� is for ane huntlre0 (5100) ar less�. I cetlity �hai in �he pedormance ol �he work �or which �his permi� is i55ueU. I shall not employ any Derson in any manner so as to become su�le�� o Ihe orkers' Compensation Laws oi Calilomia. � ./' /f � ♦� /L -fY Y. 8�. /b Oaie: — — Signature: 7el¢.C.u� 7�A�-Pi✓�h,fG�LCd NOTICE: I�. afler making IAis declara�ion, you s�oultl become subi Io Ihe WOAers' Compe �ion provision5 0� Ihe La6or CoOe. yau must lonhwith comply wit� such provisions or t�is per t shall Ue OeemeO revoke . CONSTflUCTION LENOING RGENCY: I here�y a��irm Iha� Ihere is a conSlNction lentling agency �or IAe Oe�ormance ol I�e work for which �his permi� is issuea (Sec�ian 3W7. Civ. q. LENOEfl: aooxess: OWNEfl BUILOER DECLABATIDN: I �ereby aflirm Ihal I am exemp� Imm �he ConVacmrs' Slate License Law lor [�e following reason �SecOon 7Q31.5 Business and Pmfessional Cotle: Fny ciry o� counly wllictl reQuires a permi� to conslmct, alter, impmve, Oemolish, or repair any s�mc�ure. pfior lo it5 issuance. alio repuireSlAe aOPlitan� for SUch permit to �il¢ a Signed 5ta[emen� �ha� helshe is lic¢nsea pursuanl �o the pmvisions a� the Conlrac�ors' Slate license Law (Chapier 9(commencing wi�h Sec�ion 7000) af �ivision 3 0� the Business antl Pm�essions Code) or Iha� he/she is exempt Ihere�mm an0 Ihe �asis br the alleged eKempiion. Nny viola�ion of Sec�ion 7031.5 by any applicani for a Dermil Sublecis �he apDlicant Io a civil penalry of no� more �han �ive hunOred Uolla�s ($500). I. as ownei ol ine Woperty or my employees with wages as their sole compensation, wlll Oa Ihe work, antl ihe ❑ simcWre is not intenaetl ar otterea lor sale (5ecnon 7044. Business and Protessional Cotle: The ConiractorY State License Law DOes not appty �o an ownef 01 a property who builtls or imD�oveS thereon, antl who doe5 SUth work himsell/Aersel� Or �hmugh his or her own employee5. D�Ovid¢tl ��al Such impmvemenls are no� in�entle0 ar ofl¢re0 Ior 5ale. I�, how¢ver f�e �uilAing of impwvemenl is soltl within one year of comple�ion, ��e owner will have Ihe bur0en of Oroving �e/she tlitl noi �wld or imD�ove for Ihe purpose ol sale). ,K I.as owner o�lhe propeny,am exclusively can�mc�ing wilhlicensetl conVacbrs�o conslmctthe D�olec�(Sec�ion 7044, Business � C9 antl Pmfessions Code: The Contracmrs' Staie License Law tloes noi apply to an owner of Omperty who �uilds or impmves ihereon �. antl who conlracis lor such pmlec�s wit� a conVac�or(s�license pursuant �o the Conlraciors' S�a�e License Law),I am aware Ihat pmof ol I�eir Worker'S Compensalion insurance 5�ou10 be pwvitled ro me. I Q I am exemp� untler Section.- B. 8 P. G. for t�is reason: /f �ate'. �/ / �7 Ownec �� I tlo herebY certify Ihal I am aware o� antl understantl �he requirements ol Califomia Heal�h a�ety Cotle Section 505, 25533, and 2553a anA lhat I or any luture huil0ing ocapanl willlwill noi (cirde one) neetl �o comply with saiA sia�e codes an0 ih requirements �or a permil �or con9mclion or moadicaiion Imm Ihe Air Oualiry Managemenl �isVict. FeSiAen�ial cons�mction applications a�e exem0� «om Inese provisions. oa�e: noorcam: I hereby cetlity Iha� I have read this applicaiion and s�a�e Iha� �he above inlorma�ion is ortlinanc¢5 ana sialelawsrelatingto butlding conslmction antl hereby aui�orizerepresen� propetlY �arins ection purDaSes. Oa�e: � � Signature: Oriver's License or Social Searity »: _ �o comply wiih allciry and coun�y �o enter upon the above-mentionea 16At�46 Whi�e—Builtling: Green—Cotle Enlorcemenl: Canary—Applicanf, Pmk—qevanue: Goltlenrotl—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO; IE PERMIT'NO: IE 058643 PLAN CHECK NO: N GOVT; , CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE OTH PURPOSE: ALT JOB DESCRZPTION : ADDING ELE FIXTURES SQ FT; CLAIM VALUE; CALC—VALUE; GROUP OCC; R-3 / COMMENTS; REINSTATE EXPIRED PERMST #E51921. +��r**�r�r*�e�r�r+�x��r*x*�r�rx*�r**��r��r�e�r*******�r�r**��r+��r*�*��r******�***+e+�*****�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 ---------- --------- ACCESSORY HUILDING --------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN PLANKNINGRN6'iE5> PROV; PARCEL; 14132706 ZNE; REF NO: % k k 1k iE iF iF iE iF �f 1k iE k�f iE ik iF iflElf iE iE iE 1f iE iE ff 1E iflf ikff !E if �F k iF if 3f if iEif fFlt ik if iF ik if k ik if if ik k If iEiElF�F if iE if iF iF iF iE 1f �f iE if 3t iFik iE k i! 1F iF ik 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 T S ZONING APPROVED BY DATE; BUILDING APPROVED BY : DATE; APPLICATION ISSUED BY• � DATE; � l7 L iFiflfifikiFiF�FkiEkifitiEiFiFlf1lifiFiFiFiFiFiFifiFiF7f'iF�FiFiFif7f'if7FiF��fiF �{FiF{f�FiFiF�l(�iflf�lif�EiFi6iFiFif7 lPif if �k �f iE iE iE iF it if if 3f if iF if iE�f ik if iF ik k it Ik iF ik 1f �F�f IF IkiF iF 1klFik iF �F�E �F iF iF itlt iF �k k k k�k iF if it IF 1f �F fE 3E �E �k if ik iE1f if �E �E 1E iF iE i! �f if if itif iE iF iF it LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N PERMIT BLDG PMT PLUMBING ELE30R00 MECHANIC FIRE SMIP/RES GRADING �OY SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DDE TOTALS----> 30,00 0.00 0.00 30,00 30,00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 30.00 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 30.00 ik kif iE k iE iF1F �F k iF if 1FiF�f iF If �FiEif 1E iE iFiE iE 1FlE 1FiEiF�E if iE if if if iE iF iE iE iE 1E if iF 1E 1k ik iFiF iE if iE iF ik 1f if if �f if if 1FiFiE if 3f ik ikiFlf 1k iE 1E iE iF if iF iE iF i! I N D I V I D U A L F E E H R E A K D O W N TYPE QTY D E S C R I P T I O UNIT COST TOTAL COST ELE 1�' ELECTAICAL RE—INSPEC��ON FEE 30,00 30,00 r`� END?"OF FEES � EXPIRED � P} te Inspect ri� � � � 5ig :� C67!STRUCTION AND PLANNING � POOI .PA P.PPROVALS Permii # Date Inspector AppROVALS Permit # Date Inspector 1. �emporary Electrical Service or Pole .52. Pool & Equipment Location , 2. Soil Pipe-Undr md. 53. Steel Reinforcement .-" �• _ By`'Etecif�cal Cond�ii Fhility-Undrgrnd. " 54. Forms " • �^�4_�E�testrieal Condui¢fldndrgrnd. i 55. Electrical Bonding :�'-�Stee`�F�einforce�i�n� 56. Rough Plumbing & Pressure Test ! - ��,�'. �fitectiicai U�ER Grysd. 57. APPROVAL TO C6VER-GUNITE _ !?i'footir�s � r 58. ElectricalCqnduibUndrgrnd. � 8. Foundation 59. Gas Pipe, O Undrgrnd., Test � 9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd. 10. Structural Floor Sys.em 61. APPROVAL TO DECK 11. Property Sewer LincT& House Connection 62. Backwash & Receptor�Final � �- 72. Sewer Cap � 63. Heater & Vent-Final _ � 13. Roof Drains 64. Plumbing System - Final � � 14. Rough Plumbi� ` 65. Electricai�Final � ' 15. ftough Hectrical-Canduic 66. Solar System-Final 16. Rough ElectricWi�ing 67. Fencing & Access Approvai - � • 77. Rough Wirin9 �9� 68. APPROVED FOR PLASTERING � , i 18. Rough Electric�i�T Bar Ceiling 69. POOU5PA SYSTEMS FINAL ' j 19, Rough Heating & Air Conditi0nin9 FIRE DEPT. REQUIREMENT � � - - ' s•.a.- .x 20?flou�qh Eactocy Fir�place = "* i : : _ �� -* u . ppROVACS-C��Permit# - �" ' >'x •C^ ��K .t rx'a .0 �l- > r 21?�u�{5, iUr SV.uctuE�� •. .. ,_ ; < 's ' � < x `70. dergrnu'nd HyAro -. 22. Duc��s, Venti2ting�# ^S <_ � �< i� _� �77, ProductTPe�ipg G��as O'Oii 23CGas:,Pipe?Rough $�''�esc � ; S ;; r�+ y v s�72. UndergrouPd Flus� _ - � . .. - 24.-Roo'3 Ft�amirg .nY i C-'- •� Y'� ` � **• 73'Undergmd'.Stora��Tank C]Gasy0011 25. Roo-f Sheathin � ' '�� '� " - ' � - - _ 9 '� ��, � �� ., +c "� � 'Z r . '74.^Overhead 7-IydrQ^ � ., _ 26.�T-Bsr Ceiling (StcOMural) &-Menacoat � ' .�`- ' 75;sDry Chemical � � ^ = - , 27:i-Frame ar�d FlashiFiq'. 2 _ � � _ �"„ � ` .' 76. Dry Standp�pe ' -� � f � ` r , ��28.�Latying='&Siding<�-z -: t.c r. < % •�i •;� * 77"FIXEDSYS�EIu(RINAL" � _ '� �� '"29. Insulatian C�� " S�� l � r � �x �� 78ssPIRE PREV, FINAi �. t r� 30. Drywall�Nailing _ � � '� � � �� HEALTH�DEPT<REQIiIREMENT - r ,. � -, c - .31. Plaster Brown Cci�c;� r. ; r,,, . � ,-79:'FINAL INSP�CT16t�T. , ` �" " _1 +-32� Electriral Po�er.�Jotet-Final, �� . � x.t. =SO.;FOOD CERTIFVCA''i'E ISSUED� '> � . r- _33:`YPinal ElectriC, '� . � w T �; ,� � Nofes: = � ,', _ ri, � � :�34,�Finyl Heating& AjECondition*9� n • is • 5 M 5 -C ' , . 35.�irial Gas Pid'e-TAst" ,'J � _` `� ' ' " i1:�~' ` . � S . � -'�: �l.�i� _:n .,G ' S:r' , 36.��Hood or CanoPY�,x � � •- . - i ' _ E ':� . . . � r .37.-Final Pactory Fireplace,� "� `, �` � � . �; � ` i .` ��, �:38. Final Plum6ing - � i: � .- •. � + ., � � � . �._ v � > - _ - :39. Warer Service-FinalY '� � ; - ', �' r �' I �v ^ �+ -40. Ga�'$ervice-Final �y � n , S . r, j � :�c �.,1 <�' �41. Solar pomestic-FinalS ' • ` �=s � �� ° ' °� % ' � n ,; r i = + .'v - 'r '^42.'Backflow Preventer'� ;� " � � ., ,� �' �_ . ' 43. Backflow Irr�qatiorr =- - , :` � '�..' ' • - y i - ,: � } _ � , '.44. landscaQe laigation System�_ ..; �. - r r v i, = .-45 Sound AtteoLatiort ' ` T � ' � _' �� • t � �46..Handicap R�gulations ' - � � � � � � ,� � ; � ; - -- 47.-FINAL STRUCTURE & BUttDING ^ � ! � �� x '- ti .� � � � - S � �48::FINALPLANNING �_ r' t i �� . r r � �= :49 =Electric Release to�Edison • ' � jy � � '-� ` � � ;:50rGas�Release to Southern Califo[nia Gas Co .' � � � j. .' � �"� _ -',- � . �51. CERTIFICATE OF OCCUPAN Y : S, ;..� , .� No. Date - •• r C I T Y 0 F C 0 S T A M E S A CAI.IFORNIA� P.O. BOX 317 From the Office of the Planning Department Regarding Building Permit No. 17�9 Location: 9`� �='x'A H3y Dear Pool Qwner: Date: 9-11-63 The COsta Mesa Planning Department called at your property to inspect the Swi�ing Pool. Our interest in pools is for the purpose of safety and to be sure all provisions of Section 9298•9 of the Municipal Code have been met. Section 929$•9� l. No swimming pool shall be constructed closer than five (5) feet to any property line, measured from water line of pool. No swi�ing pool shall be constructed under any electric power lines or on any electric power easement. 3• nro swimming pool shall be constructed unless the yard surrounding Such pool is completely enclosed by a six (6) foot fence or the pool itself is enclosed with a£ence six (6) feet in height and hav- i.ng a self-locking type gate or gates. Note: (Gate should close and latch on a free swing). Your pool will not receive final approval until the requirements of the aforementioned Section of the Municipal Code have been completed. The following disposition is noted in reference to your pool: ❑ No one was at home. �� No springs on gate. ❑ Improper latch or defective hardware. U idall surrounding pool not 6' high. � Other. [� Telephone 646-2411 and ask for the Planning Department so that an appointment may be arranged. Since you have incurred certain liabilities through the installation of a pool, it is requested that these matters be taken care of as soon as possible so that your poql will be a safe one. � J ` � �`" � Sincerely yours, � � � Planning Technician '� � ..PBOJEbT pODNESS 9 q z S ERRA WY owxensxame: JACKSON, MARK A aooeess: JACKSON SER$NA 942 SER{ZA WAY COSTA MESA,CA 540-8409 RPCH/ENGINEEN: p00HESS: uNir: 92626 XEG.NO.: I1NIT: VEXMITTEE: NUNN CONSTRUCTION ( 714 ) 556-3750 aooness: y738 FREMONT LN C.M. CA 92626 LICENSEU CONTRACTOB OECIAPATION: I hereby aflirm that I am licensed untler O�ovisions of Chapter 9(cammencing with Section 7000) oi �imsian 3 oi �he Business and Pwiessions Coqe, antl my license is in full force and e��ect. cirr uc.:0 9040 srnTe uc.:48179�P�Rtuss: � Oate: SignaWre'. // �� WOBREBS'CO ENSA71 N ECLAflATIDN: Iherebya�(�� ¢hi � teo�consent�o5e14in5ureoracerti�ica�eofWorkers' Compensatmn Insurance. or cenitied coDY Ihereot (Sec�io U�C�- .POLICY NO.: E%P. OPTE: COMPRNY: � ❑ Certifietl coDY is hereby �umi5he0. ❑ Certifietl CODY is �iled with �he ciry Builtling Division. �I �ate: Applicam'. E%EMPTION FROM WOPNEHS' fAMPENSNT10N OEQABATION: Rhis section nee0 noI be completed if lhe permit is forone hundretl ($100) or less�. I certity Iha� in ihe petlormance oi �he wark tor which �hii p rmit is issued, I shall n � employ anq y person in any mannerso a5 �o become subject lo �he Workers' ompensation Laws oi Califomia. I 1A i� � �a�e: Sgna�ure: V NOTICE �. afler m�ing �his tleclaro�ion, you shoultl � e �e t 6 �he Workers' Compensaiion pmvisions of the Labor Cotle. you mus� foh�with compty wi�h such pmvisions or � is per n� s all 6e tleemetl revoked. CONSTBUCTION LENDINC AGENCY: I hereby affirm �ha� ihere is a constmction lending agency for �he De�ormance of the work �or which I�is permii is issued (Section 3097. Civ. C�. LENUEfl: / � aoonEss: OWNEB BUILOEB OECLNBPTION: Ihereby aHirm �hatl am exemp�from �he Contrac�ors' State License Law �arthe following reason (Section 7031.5 Business antl Pmtessional Code: Any ci�y of counry which requires a permi� �o cans�mc�, atler, impmve, tlemalish, or repair any struc(ure. prior ta its $saance, also req�7re5 [he applicant !or euch permit to fAe a slgned s�etement that he15hB I5 t7censetl pursuam m �he pmvisions ol �he ConVac[ors' S�a�e License Law (Chapter 9(commencing with Sec�ion 7000) of Oivision 3 0� the Business antl Pmiessions Cotle) or Ihal he/she is eKemO� �herefmm antl �he basis lor �he allegetl exemp�ion. Nny viola�ion o� Seclion 7031.5 by any apDlicantfor a permi� sublects ihe applicant to a ci�il penalry ot nol mare than five hunOretl tlollars ($500). I. as owner of �he pwperty or my employees wi�h wages as �heir sole compensation, will Ao �he work, antl �he � siructureis notintenAed orofferetlforsale�5ection 1044, Business antl PmfessionalCotle: The Contractor5' State License Law does no� apply �o an owner ot a pmperty who builds or impmves the�eon, antl wha does such work himsel�/hersel( or lhmugh his or her own emDloyees, pmvided [ha� such impmuemems are not intendetl or ofleretl �or sale. It, however �he building or _ improvemen� is sold wiihin one year o� complelion, Ihe owner will have �he burden o� pmving he/she Oi0 not buila or impmve �or �he purpose o� sale) , I, as owner of �he proDerty, am exclusively con�rac�ing with licensetl comracmrs �o consimct �he projec� (Section 7044, Business ❑ an0 Pm�essions CoOe. The ConVacmrs' S�ate Li�ynse Law does no� appry m an owner oi Ompehy who bui105 or impmves lhereon and who conVac�s for such projecis wi�h a con�rac�oqs)license pursuan�to �he ConVactors' S�a�e License Law�. I am aware ' tha� pmof ol �heu Worker's Compensa�ion insufance shoultl be pmvi0ed �o me. � I am e�em0� untler Semion'. B. & P. C. for this reason: �ale- Owner: I tlo hereby certify Iha� I am aware of antl underSlantl tha, requiremen�s o� Calitornia Heal�h ana Safety Cotle Sectians 25505, 25533, antl 25534 and �ha� I or any fuWre builtling occupan� willlwill not (circle one) need Io comply wi�h said sta�e co0e5 an0 �he requiremen�s for a permi� for consimc�ion or modi�ication fmm �he Air �ualiry Managemen� Dis�ricL Fesiden�ial canstmc�ian apDlicaiions are Cxempt fmm �hese pmvisians. �ale ApplicanC I hereby certity �hat I have reae this apPlication and statN IhaUhe above in�armalion is correcL I agree �o comply wi�h all ciry antl counry ordinances ana siatelawsrela�inglo builtling con5imc�ion antl hereby auihorizere sen�aUves oi�his ciryto en�eruponthe abov¢-men�ionetl pmpetly lorinspection rposes. \ /��/� pa�e. � Signa�ure( �LT�1 onver�s �icense or Sacmi Seariry a: 1641-a6 Whiie-8uiltling�. Green—Gotle Enbrceme��, Canary—AppLcan�; Plnk—Revenue: Goltlenrod—Hssessor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO; E 060469 PLAN CHECR NO; N CONSTRUCTION TYPE; PERMIT TYPE: ELE JOB DESCRIPTION : 265SF FAMILY ROOM EXTENTION CLAIM VALUE: CALC—VALUE; PERM NO: E 060469 GOVT; N SUPP; N PURPOSE: ADD SQ FT; GROUP OCC; R-3 / COMMENTS: RE:#B60468 x�*�*��***�r***��r�*�r�**x��*x��x******�*�r**�r�r*��r�**�x��***x x�**�*��**�*****��*� 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 ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT; FT IN RGHT: FT IN LEFT: PT IN RGFIT; FT IN PARKING REQ• PROV: PARCEL: 19132706 ZNE; REF NO; PLANNING NbT'ES> i �**«***�***�,�*�*�*****��****��*�,��**�**,«*,�*�,�**�,«��**�*�r«��*�*****��*��**��r D E V E L O P M E N T S E R V I C E S R E Q U Z R E M E N'T S ZONING APPROVED BY DATE; BUILDING APPROVED BY : DATE: APPLICATION ISSUED HY• DATE• 1ti��, ******�rx�r****�r***+��*** �r********�r �** iE �E iE 3F �f iF dF-lf if iE iE �lE 3E iE jE 3E fF1E �E 1f iE iEif iF if iE 3F iF iF i! iE 3E iE iE if 3E iE iFiE iE iE!! iFi!!E Ik iE iEiFiF dF aE iE iF iF 3kiE 3E iE if �E iE i! iE �E iE iF iE iE IE iE ik iE 1F 1EiE iE jF �E LEGALI2ATION;N F E E S U M M-A R Y STRUCTTIRAL SEGMENT;N HLDG PMT PLUMBING ELECTRIC MECFIANIC FIRE SMIP/RES GRADING PERMIT 9548 SMIP/NON—RES PLAN ISSUE FEE 15,00 HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS----> 9.75 15,00 0.00 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRZC MECHANIC 29.75 �: TOTAL PAID DUE 24.75 24.75 .00 24.75 OVER/SHORT; ,00 FIRE SMIP/TOT GRADING PLAN—CHECK 1 if iE iEiE iF iE iE iF iE �E �E 1E �E ik 1E 3F if iF if jE 3F 1E iE 1E iF �E iF iE iE if 3E if jF iE iF 3E ik iF if iE 1F �E iF iE 3E 1E iF iFiE 1E iE iFif iE if !E 1E �F�E �E 1E iFiF 3E 3E �f iF 1E iF iF-1FiF �E iF iEiE jE iE �E I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 4 FIXTURES LIGHTSNG 1 ST 20 EA. .75 3,00 ELE 5 RECEPT/OCTTLET 1 ST 20 EA. ,75 3,75 ELE 4 RECEPTISWITCH 1 ST 20 EA. ,75 3.00 END OF FEES �� CONSTRUCTION AND PLANNING P�� & SPA � "1 ' Date Inspector Date Inspector '�,; APPROVALS Permit �€� � . APPROVALS Permit # . _ � i. Teinporary Electrital Service'or Pole �- 52. Pool & Equipment Location - 2. $oi� Pipe�Undrgrnd._` -' �; 53. Steel ReinforcemenT �. ,3.� Electrical Conduit UtilitY-Undr.yrnd. 54. Forms . _ � � 4. Electricai Gonduit-Undrgrnd.�. . � � 55. Efectrical Bo[iding � ��i 5. Steei Reinforcement 56. Rough Plumbing & Pressure Test � �� Electrical UFER Grnd. = 57. APPROVA� TO�COVER-GUNITE . . 7. Focftings . 58. Electrical Conduit-Undrgrnd. `'� ��8. Eoundation �- ;;1 59. Gas Pipe, O Undrgrnd.; Test r ` 9. Water Pipe-Undrqrnd. � - ; w'S 60. &ackwash Lines, RTrap, O Undrgrnd. -� 10. Str�ctural Floar System - - 67. APPROVAL TO �ECK - 1 i. Property Sewer �in2 &�HouseEonnection 62. Backwash & ReceptorFinal � 72. Sewer Cap - 63. Heater & Vent-Final i ' 13. Roof Drains - � � 64. Plumbing System � Flnab 14. Rough Piumbing ` 65. Electricai�Finai 75. Rough Electrical-Conduit , � /J J/ 66. Solar System-Finai � tE. Ro�9h E(ectric Wiring � "L��f--C)� b! ,�,��C 67. Fencing & Access ApProvat � t f L� 71. Rou9h Wiring Sign 68. APPROVED FOR PLA5TERING � 18. Rough Electrical�T Bar Ceiling 69. POOLISPA SVSTEMS PINAL 19. Rough Heaiing & Air Condi:ioning FiRE DEPT. REQUIREMENT � �� i � 20 �Rough Facto�y Fireplace ' - �Y � r� - '� -` ' rAppROVALS:-'- Permit # �' 21:'Duc4s, inStructure., i �.. • .-� r�70. Underground Hyd�o 22. Ducts, VentNating, - ! ��".• � ''' ' 77. ProducYPiping �7 Gas O'O�I 23:.Gas PiPe�Rough & Test ; ' � i: ;., � �� t t. a72, Under9round Flush +' ' 24i•Roof Freming ' �"� '� � � _ ' =73�"Undergmd'.Storay�'Tank OGas�00i1�- '' �- . 25. Roo,f SFieathing ;� ,; �� .,; .. 74:.Overhead Nydro;� 26. �T�Bar Ceiling (5tructuraq & R9onowat �� 75. .Dry Chemical � 2T.'Frame and Flashing� . - � ��,� ; 764 Dry Standpipe �- .� � 28. Lathing & Siding •� - �- '� 77;• FIXED SY$TEM FINAL' � �29. Ins�latio❑ ' � � . .' 78,�.�FIRE PREV. FINAL - � 30. Drywall�Nailing " � � HEALTH DEPT. AEQUIREI41ENT i ' 37. PIa>ter BroYvn Coat` , � - tI ;79� FINAL WSPECTION. ,' - 32: �Electrical Power MeterFinat r.; 1 �•$0.. FOGD CERTIFICATE 155UED 33.'Final Electric, ' _ � � Notes: �+ 3 �� _ /�� . . _�= �_ _ �� 34, Final Heating & Air Conditioning .� � • • r�... . � 35. �inai Gas Pipe-Tesi ' � ' � ' ' , 36. Hood or Canopy - j I I > 37.-Final_FactoryFireplace , - ' � i • .- 38. Final Piumbing � . � �' - - � .. ; ` -- ------ �39. WaTer Service�Final' - � ` ' . _ � 40. Gas Service-Final �. - • . . I _ _ � �- �41. SolarpomesticFinai . � i - '- ' ' 42. Backflow Preventer'' , '� � . . � , . . 43. Backflow Irrigation � - ' . , 44. Landscape Irrigation System � � . , - . � - . 45. So�nd Attenuatipn � � � • ' � i'46. Nar�dicap Regulations �� , . 47. FINALSTRUCTURE&BUILDING r� � � !° � � ' J jy r3 i 48. FINA�PLANNING � � I I -I � �49. Electric Release to Edison � , i � ; � 50. Gas Release to Southem California Gas Co ; I , �� - - ' ,57', CERTIFICA7EOFACCUPANCY i , � � . No._..� Date PflOJECTA00flE5S: 94Z SERRA WY OWNEF'S NAME: MARK �TACKSON aoonEss: 942 SERRA WY COSTA MESA CA 92626 (714)662-3656 APCN/ENGINEER: flEG.NO.: UNIT: q00flE55: UNIT: PEPMITTEE: MARK JACKSON ( 714 ) 662-3656 ADDHESS: 942 SERRA WY COSTA MESA CA 92626 LICENSEO CONTBACTOfl DELLABATION: I here�y alfirm Iha� I am licensed unUer pmvisions ol Chapter 9(commencing wil� Seciion 7000) af Division 3 0� I�e Business and Roiessions Cotle. anG my license i5 in lull force antl e�letl. CITY uC.: STqTE UC.: CU55: Oate: Signalure: WONKEHS' LOMPENSRTION �ELNPATION: I here0y allirm t�at I �ave a cenifica�e ol conseni to selFinsum or a cerlificate of WOBers' CamOensation insurance, or a cenilietl copy i�ereol (Section 3800. La�. q. POLICY NO.: E%P. DFTE: LOMPFNY: ] CenifieA coOY is �ereby WmisAea. ❑ CenilieC copy is filetl vnih I�e ciry Builaing Oivision. Dale: ApPliwnt: E%EMPTIONiHOMWOPKEflS'COMPENSATION�ECIAflATION: (i�isseclionneeOiwlbecomDleteAillhepermilisl0roneAunOreU�St00�orless�. I ceriity Ihal in I�e pedOrman[e oI ��e work for w�ich IhiS Oermil is issued, I Shall nol employ any person in any manner 5o as �o b¢tome su01ec1 to I�e N/orkeri ComOensalion Laws of CaLlornia. Oa�e: Signalure: NOTICE:If. atler making inis aeclaration, yau shoultl eecome subject to tne Workers Comoensation D�odsions ai the La�or Cade. you musl fonhvnin camDN ��n sucn provisions ot INs permit shall oe EeemeO revoketl. WNSTBOCTION 1EN01NG AGENCY: I hereUy altirm �Aai ih¢r¢ i5 a tOnS�mtiion IenUing agenty �or Ihe OetlormanCe o� 1�¢ woM �or w�ith �his Dermii i5 issu¢tl (Setlion 3W7. Civ. C�. LENOEH: aooAEss: OWNEB BWLOEB OECtA8FTI0N: I hereGy atlirm ihat I am exempt tmm i�e Caniractors' State License �aw lar ihe fotlovrinp reason (Section 7031.5 Business ane Pro�essional Cotle: Any cily ol caunry w�ic� requires a permil to consiruCl, alier, impmve, 4emolisR or reDair any sirucWre. prior to its issuance. also requires ine applicanl for such permi� to file a sipnea statement ihal helshe is licensea Oursuant to ine pmvisions of t�e Comracmrs' State License Law �Chapter 9 �commencinp vntn Section 7000) ol DNision 3 of tAe Business ana Pmfe59ons Cotle) or Inal ne/she is exempl thertimm ana ine basis lor ine allepeA exemption. Any violatian of Section 703L5 ey any aDDlicant lor a permit subie��s ihe applicanl to a civil penalty ol nol more Ihan live huneretl aollars (E5001. I, as Owner ol t�e pmpeny or my emyloyees wil� wages as iheir sole compen5dtion, will Uo t�e work, anE ihe ❑ slmcture is not intenOeU o� olfereG �or sale (Seclion 70a4, Business an0 Pmfessional COGe: TAe Contractars' State License Law �oes not apPly to an owner oi a property who �uilAs or imprvveSlM1ereon, anA who tloes such work himsell/he�sell or ��rouA� his Or her own emDloyees, pmviDeO I�at SUCh impmvemen�s are noi inientletl or of�etetl �or Sale. II, however lhe bUilOing Or ' fm0�ovemen� i5 SU�A mt�in one year o� tomplelion. I�e owner will have IOe hut0en ol provinq �e/she EiE nol huiltl ot improve for Ne ourpose ol satel. ,y� I. a5 owner ol Ihe pmperiy. am exClusivety tonlratling wilh Iicen5e0 Con�raCi0r510 tons�mCl �he pmleCi (SeCiion 7044, Busineis i� anG Pmfessions Coee: The Camrac�ors' S�are License Law aoes not aOP�Y �o an owner ol pmperty wM huilOs a� imD�oves thereon antl who con�ratis br Suth pmjett5 wit� a[Onlrat(or�s) litense pur5uanl l0 IAe Canlrat�or5' Stat2 Litense Law�. 1 am aware Iha1 proof ol tlleir WorkeYs Compensation insurance shoul0 be provitleE to me. '� � i am e�empt unaer Seclion: B. 8 P. C. ' lor �his reas/on: o �,,..�/ 0 ale: l u2� ! i Owner'. �N+� OC'�'a^^' c'OC7'""' I tlo hereGy ceniiy inat I am aware ol ane unaerstand Ihe requiremenis ol Califomia He anU Salely CAAe Secti 25505, 25533, and 2559a and Iha� I or any IWure builtling occupant willlwill noi (circle one) neeU 10 comply ilh saiA s�ate cotles an01�e reQuiremenls lor a permit for con5lmciion or modilication Imm �he Air Ouali�y Managemeni DiSlricL ReSitlen�ial cons�mction apPlication5 are exemp� imm �hese pmvisions. ///�� ///�� 1 ^ / ale: �� / ApPllcanl: '^+��y_��'��- K4�� ii ii I hereby cetlilyiha� I havereatl Ihis apPlicalion antl sla�elhallhe a6oveinl0y�yd�ionis cortect. lapree IQ.tomply wilh all ciiy anU couniy orQinances and slate laws relating �o �uiitl�ng constmclion antl heB�y aWhorite reD�esenlalives of ��is cily Ib enter uDon t�e a0ove�mentioneU properry foi inspecuan purposes. n�� C�� Signature: ! �D�1�— oriver's License ar Social Secunly a: 16at�a6 Wnne—Bwltlmg', Green—CODe Enlorcemem: Canarv—AOPlicam: Pink—Pevenuo: Golaonrotl—Assossor CITY OF COSTA MESA — HUILDING PERMIT . PERMIT NO: E 051921 PLAN CHECK NO: N . . CONSTRUCTION TYPE: S—N PERMIT TYPE: ELE PURPOSE: ALT JOB DESCRIPTION : ADDING ELE. FIXTURES SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 / COMMENTS: REFERENCE BUILDING PERMIT #BEP48421 If iFiF ii iF iP iF if If if �F iE iE jf iF if 3f iE iF 3f iE ib if if �E �FK af iF 3F 1f 3f if iF 3f iE IE iE �F 1f iF if if iF M if �F if IF if IF M iF �f �f �F if iF iE iE %aF iF if �lf±f af if iF iF �F if iE iF If if �E 3E 3F 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 ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 14192706 ZNE: REF NO: PLANNING NfST'ES> i ***+��+��*��***��*�****************�**��*�***��******«��***�*�*��*+��*��*� 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 T S ZONING APPROVED BY DATE; BUILDING APPROVED HY ; ��/ DATE: APPLICATION ISSUED BY: ./1i"/ � DATE: � �� iE iF �E 1F 1E if� k if if if iF iF iE iF fE if if iF if i4 if iF �F �F if iE iE iF iF iF iF If iE if iE �f iE �E �f if if IE if `It�E,ii'iE if IE iF iF if if ikif 3f if if k if IF if iE if if 1F if if iF if M iE iE If 1F iFjk iE iE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 6 75 �Og SMIP/NON—RES PLAN ISSUE FEE 9,50 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DOE TOTALS----> 6.75 4.50 0.00 11.25 11.25 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 11.25 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIP/TOT GRADING PLAN—CHECK 1 1 , 2 5 if iF IE if ak if iE ik 1E K iF if iF iF aE iF k iE if iF iE iE iE iE 1E 1F iF iF ik iF M if iF iE if iE iF iF k iE iF if if iE iE if if �f 11�±f iF �f iF if �FiF IE If �f if IE �f If 1f 1E �F if �k iE iF iE if iE if 1f �f iF if if I N D I V I D U A L F E E B R E A K D O W�N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 2 FIXTURES LIGHTING 1 ST 20 EA. .75 1,50 ELE 3 RECEPT/O�TLET 1 ST 20 EA. .75 2.25 ELE �4 , RECEPT/SWITCH 1 ST 20 EA. . ,75 3.00 � END OF FEES " ' � EXPIRED ; Incomplete Inspectiens Uate �_ _ Sig � O1 Qni�b'.?u'CC �� Si � ' ::e' _... 9?,iE'. f'�/"�,:. 'i�iL _::,: � CONSTRUCTION AND PLANNING PO� _-d SPA � APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector 1. Temporary Electriwl Service or Pole 52. Pool & Equipment Location , Y2. Soil Pipe-Undrgrnd_ 53. Steel fleinforcement - � ��3.�Electcical ConduiLUtility-Undrgrnd. 54. Forms f .� 4:�Electrical Conduir-Undrgmd. 55. Electrical Bonding � � � i,� 5,,Sieel Reinforceriie� 56. Rough Plumbing & Pressure Test - .,;�6`Electcical UFER:Grhd. 57. APPROVALTO COVER�GUNITE `7?'Footings - 58. Electrical Conduit-Undrgrnd. - S. Foundation � 59. Gas Pipe, O Undrgrnd., Test ` 9. Wa[er Pipe-Undrgrnd. 60. 8ackwash Lines, P�Trap, O Undrgrnd. 10. Structurel Floor System 61. APPROVAL TO DECK � 11. Property Sewer Line & House Co�nection 62. Backwash & Receptor-Final " 12. Sewer Cap , 63. Heater & Vent-Final ' 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing " 65. Electrical-Final 15. Rough Electriraf-Conduit 66. Solar System-Final � � 16. Rough Electric;Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING - 78. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT _ ' ' . _ _ _ :7��-•�.' 3: _ .c'r,�.. 20!.Rough�F.actory Fireplace . r:• �. ' � O Q'� •� : APPROVA'LSJ�' Permit # ` " ��"' = Y N7 � �. ¢ i .. O:: , K G::.._ � - .n,t�l. � > ; .� r.? �1-4 i.D { .. � :a.l•i� 3 :a:J-]' �:7 - :n 21 .'Oucts, in SfSucture; , .. .. ;., _ '� S :� . • , 70. �Undergros�nd Hydro = 22.Ducts,Jfentilating�� ! :.� -; � •:�'*'��^71.Produci�PjPing�'Gas ❑Oil �•- > � .1' -Y w �f rr. 23r,Gas Pipe-Rough &.Test ' ;�� '` ^ �T r �-j� � "72. Undergiound Flusfi� . ' 24rRoof Framing � - �•:- � :� O � * . � 73? Undergrrid. Storags,Tank�'� Gas ❑ Oil� - � .. 25. Roof SMeathing � y., 'j �' ` n•" � �� j* � 74:, Overhead'Hydro ;'' J� 26. T-Bar Ceiling (Structural) &,j`Aonocoat �= - .*< �� 75: Dry Chemical � = a � - - . .- ,� �_ .• �.., 27. Frame and Flashing .,, t� �� y. �� ^ � �; � 76.`Dry Stancipipe '� �` '�„�.'� - .28 Lathinq=&Siding�:. �: �;o��i x �. �. •• �++ 77: FIXEDSYSTEM',FINAL v ,,� - '29. Insulation - ' " �;' ' `' � , �� 76� FIRE PREV. FINAL • � �'%�� -30. DrywalkNailing5�a �� i („ `f- w HEALTH�DEPT. REQUIREIVIENT � � .*..� _ 31. Plaster Brown Coai _ ; ,i.,,. � � � �; �` �,79?FINAL INSpECTION; � - '� :i �' ��32.- Electrical Power Meter-Final �y� � �a ` � ,80.nFOOD CERTIFI_GATE ISSUED . : .33'-Final Etectric � t ' i � �1 � '7No'tes: " _� ' _ � '� :� n �r -� - r . . .- �r - _. :... � . ,� ,�� , ,. �,� 34- Final Heating &Aii Conditioning� ;r I i 4, � „� .;,: . � • �y! y ,y - 35F�Final Ga's Pipe-Test � = �y � ,P * _ � ,-' ' '�� tT'S ' �r � �i ..^.�C T. SV �.��i�J 4 .,36�Hood or CanoPY�: �: � ` � ,� _ -• .i n , 1 � , }. ,:� _ .. ' �:� � .`.� ., �37::FinalFactoryFireplace � � � �'' � µ� - ' "`�='`� - I. ,v . .. . -, • �., ." I . '38. Final Plumbing -, ; �. r. � . .; - = .o �39. Water Service-Final � '� � i � �' " � � - `� "� � - • �r i . r : . . .z.�.�. ' 40. GasService-Final ; ,� ��_ - �. ; _ , � �� ' �: r'41. Solar pomestic-Final=. " r r � � r+ '• ^ .� ,r ;�...� x "'42:�Backflow Prevente� - ; � , � ; v '- ' .' � � !• - � � R E`.D= 43. Backflow Irr.igation � ~.s � ; ;: ,,,. Incompleie'Inspecbons `,44. Landscape iriigatiqn SYstem��;`� ,• � � ;F ' p� �= - < � '�.� , �45:Sound Attenuation �- . �� ?� � -'* � ' :� n : ' '. 46. Handica,p Regulations - � � �� ' " ' . =;' � � C �; . r ��47..FINAL STRUCTURE & BUILDING � � � ' a � ' .�i - � � t � �� .. �� 48';FINALPLANNING ' ` �� . � �� r �" . , ' - � r � I � �i n: 8 _•49:. Electric Release to�Edison i j � �_ �� " � � ! ` . :i .�r "'50rGas Release to Southem California Gas Co ; � � !' ' ' ` - , ` ' ; ; ; " i r ., . 51. CERTIFICATE OF,.00CUPANCY _; � �-, �,�' „ , F. _�-.�,�, N0. Date reaecT �ooxEss: g q 2 S EARA WY OWNEP'S NIIME: MARK JACKSON �...110D?F.3=: (392 SERRA WY COSTA MESA CA 92626 �acxieNcixeex: (�14)662-3656 �DOHESS: NEO.NO.: uxrt: uxrt: PEHMITTEE: MARH JACKSON ( 714 ) 662-3656 aooness: g q z SEARA WY COSTA MESA CA 92626 LICENSED CONTMCT08 UECIAIUTION: I hereEy aflirm ttat I am OcenseA unAer D�ovisians nl Clupter 9(commencinp wi�� Section 7000) of OiWsian 3 of tne Busineu anE Pralessians Coda, anA my license is in hll lorte anA ettect. CITY LIC.: STRTE 11C.: MSS: Date: SIO��ure: WOflNEBS' COMPENS�ITION OECIAMTION: I hereGy affum that I have a artiilcata al consent to se11-insure or a cehifiute ot Workers' ComOensation Insurance. or a certitied copy Ihereol (Section 3800, Lab. C). '-"<Y NO.: E%P. U1TE: PRNY: ,;eNfietl caDY �5 �ereby IumisheO. ❑ CeN1ieC copy is /ile� wtt� Ne cRy BuilOinp D'nision. Daie: M7�� EIIEMP110N FflOM WOBKFAE' COMPENSITION OELUMTIOM: (flis secUon MN noi Ee co�IMeA il ihe permt is fa arie hunOreU (5100) or less). I certity that in tAe Oe�ormance ot Ne work tar wNch tlds permit �5 �sweE, I s�all not empby any person in any manner w az m Oewme su6jttt to Na Warkers' Compensation Laws af Califomu. �ate: Sipnature: NOTICE: If, atter maltlnA �ms tleclaratlon, yrou SMuIE 6ecome subject ro I�e Workers ComDensauon D��sions ol the La�or CoOe, you must forlhwith mmpty witA wcA pro�isions or tNs permit slull he EeemeE rewkeE. CONSTHUCTION IEN�ING 1GENCY: I Aereby attirm Wt Nea is a cortsirucUan IenEinp a0en�y for tAa peAormance af the vroM for which Ihis permit a issue0 (Sectlan 3097, Gv. C). IENUEfl: ►O�flESS: OWNEB BWLDEB OECIAMTION: I �ereby atlirm tlut I am exem0� ��om (Ae Cantapors' State �icenu Law tor t�a followin0 �eazan (Section 7031.5 Business anE Professbiul Caae: My cry oi munry wNc� r¢puires a Dermit to consWct, alter, impmve, Oemolish. or reDair any siructure. D�w �o i6 issuance. also reQuires the apD�� or such Dertnit to lile a sipned SWtement that hels�e is licensed pursuant m tAe D�ovisions ol the Convacmrs' Sute License Law (Cnapter 9lcommencin0 �+�h Section 7000) ol Division 3 0l Ina Business anA Protessians Code� or t�at �dsAe is exemDt t�ealrom an0 ihe Oazis 1ar I�e allapaG eMemptlon. Any Nolation ot Section 7031.5 by any applicam for a OermR su0ject5 t�e aDD�k�� ro a civil penatty al not rtwm tlun INe hundmE Gollars (5500�. I, u awner al t�a pm0erty or my employees wit� wapes u tAeir mle compensation, will tlo the work, anG tAe � stmcWre is not inlen0e0 or ollereE lor sale (Section 7044, Business and Prolessianal COCe: Tha Cantractors' State Licanse Law Cces not apDN ro an owner ot a Dmperry wlq EuIIEs or imDroves IOereon, and who does such work MmmlB�ersell ar thraup� his or her own empbyees, DroviUeO IAat suU improvements are nat IntenEeE or otlereE br ule. 11. however Ihe bulltlin0 or �� impmvement is SoIA within one year al wmpleGon. t�e owner wiil twve ihe UurUen of pmvinp �e/5Ae EiE not 6ui10 ar ImD�ove tor tne ouryosa of sale�. I, u awner al t�e pmpeny. am exclusivery contractlnp with IicenseU wntractors m canstmct the Dmject (Section 7044, Busineu � anC Profesvons COAe: The Contrapars State Licensa Law dces not aODN �a an owner of D�ocer1y who EuAds or improves t�ereon antl wAo coniraps br SucA pml��s with a canirattor�s) licanse pursuant to Ihe Contractors' Slaia �kense Law). I am aware tAat D�� ol t�eir Worker'S Campensatwn insuranu SAouIE De proviAeU ro me. i� I am exempt unAer Senion: B. 8 P. C. /ar tAis masan: _ / , ...�p� i��L Date: g'"2 ( � Qrmer. ![G I Aa �arehy cenity that I am awam of anA unUerstantl t�e reQuiremems of Califomia Healih antl Satery Co aclions 25505, 25533, anA 2553A an0 tAat I ar any NNre 6uilUlnp occupam xill/will not (urUe ane) neeG ro compty with uiA state c Oes an0 the apuirements for a permit for consimctlon or moGiliwtion iro� tir Dualiry ManaOement Disirict. FesiOential wnsimctlon appliwtions are exemD� �mm ihese pmvisions. • n _ . _ - - - • Oate: ' � •�.Applicant: I hereby ceNry t�at I have aa0 this applicatlon antl state ttul the a0ove informatian is carrect. I apree to compty with all city ana counry ardinances an0 slate laws relatinq ro EUIIAinq cansimc6on anC hea6y aNha�se�of t�is ci o�n ��e a�ova-mentioneU pmparry foryr inspeclion purp,,o,syes. ' �"� Date: n � � / � ��q�wa: ` onver's License or Sacia� Securiry d: : Carury—Applica^t; Pink—Revenue; GdEenroE—Assesnor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: HEP 048421 PERMIT NO: BEP 048421 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE; 5—N PERMIT TYPE: ELE PLU STR PURPOSE: ALT JOB DESCRIPTION : REMODEL EXISTING SWIM, POOL 6 DECK SQ FT: 2,500 CLAIM VALUE: 2,500.00 CALC—VALUE: 2,500.00 GROUP OCC: R-3 / COMMENTS; SMOKE DETECTOR("S) REQU.IRED IN FIOME. x�*x�rrt��r+r********�***�r***��**�r+t��r*.�r��*��*+t**x�r*�+t*�r*�**x�*+t��r*�+r***�r�**+��x�***�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 BUILDPNG'.==—.------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT;' . FT IN LEFT: FT IN RGHT; FT IN PARKING REQ: PAOV: PARCEL: 14132706 ZNE; REF NO: PLANNING NOTES> > *�r***�t�t�r�r**�r�t+t�t�t�tx�t�t�t�tx�*****+t�r�t�t+t�t�t***�t�r�t+t�t�t�t�t*�r�t��t**+t�r�t+t*x******+t**��r*+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 T S ZONING APPROVED HY ___ DATE: HUILDING APPROVED BY ; DATE: APPLICATION ISSUED HY; ,�F�� DATE: �� iEikiF3E�EifjF3k�FiliEiE1E1E�kiFiEififiEMM '�'1F'iFi(�ifiFiEikiFiflfihif 3EiE ifiFitiFif�EititikiFiFiE9tiFiE�EiF1EiElEififitlFiFlfiFitKiFiFiFiFik iflfiklEiElfi ifMif 1F3fifMMiEiEMiFMi(�ifiPiElEifiFiFiFiFitlfiliFifiFiE1E1F3F�tiF LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y HLDG PMT PLUMBING ELECTRIC MECAANZC FIRE SMIP/RES GRADING PERMIT 54.00 2,00 30.'00 ' •50 252 • SOx SMI-P/NON—RES PLAN • ISSUE FEE 3.00 15.00 �. BUILDING—DIV—> PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE TOTALS----> 86,50 18.00 ,� 0.00 104.50 104:50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 104,50 OVER/SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 54,00 5.00 45.00 ' ,50 � ±! ik 1E iE if if it if if if iE M it k ik ik ik ik jf k it if 1k 4 ik iF it 1F iF fF ik 3t ik it 1E ik iF it it i! if ik if ik iE ik it 1E iE iF iP it ik if it iE iE iE ik ik 1E it itlk iE �1f It ik iF iF iF iF iF iE 3E �E 3F iE �F I N D I V Z D U A L". " F E E 8 R E A K D O W N� TYPE (jTY D E S C R I P T I O N SFR 2500 ALTER HY VALUE RES�IDENTIAL NOZONE ELE 1 SWIMMING POOL — IN;GROUND — NEW EA PLU 14' SWIMMING POOL �q � ENDyOF FEES i EXPIRED __ incomplete Inspections � Uate ��_ __ Sig �\q, ` , g p C r. UNZT COST TOTAL COST 1.00 - - 2,500,00 30.00 30.00 2,00 2,00 01 DIIOb677c—OOObb730 3'r_�'� 10�.5G DAiE: 08lQ2/9E� TIfi'c: 15��8 CONSTRUCTION AND PLANNING P� & SPA- � Date Inspector ' Date Inspector P:PPROVALS Permit # APPROVALS Permit # 7. rTemporary Electrical Service or Pole 52. Pool & Equipment Location . ' 2. Soil Pipe�Undrgmd.� 53. Steel Reinforcement ' - 3. Electrical Conduit.UtilitY-Undrgmd. 54. Forms . - '4.-Electrical Conduit-Undrgmd. 55. Electrical Bonding � S(/Z��A C.f$� � 5. �Steel'Reinforcement: 56. Rough Plumbing & Pressure Test ZflC(jj L/L9 '" 6.• Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE ".7. Footinqs ' 58. Electrical Conduit�Undrgrnd. • 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe�Undrgrnd. 60. Backwash Lines, P•7rap, � Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK �. . 11. Property Sewer Line �& House Connection 62. Backwash & ReceptorFinal - � 12. Sewer Cap - 63. Heater & Vent•Final � ' 13. floof Drains - - 64. Plumbing System � Final i 14. Rough Plumbing 65. Electrical�Final 15. Rough Electriwl�Conduit 66. Solar SYstem-Final 16. Rough Electric Wiring � 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Fiough Heating & Air Conditioning � - . .FIRE DEPT. REQUIREMENT . 20. Rough Factory Fireplace � � � � • .APPROVALS Permit # 21. Duc[s, in Structure . �� ' .. 70. Underground Hydro 22..Ducts, Ventilacing� : � 71. Product Piping OGas ❑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�Bac Ceiling ($tructural) & Mopocoat 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 Browri Coat .� ' � 79. FINAL INSPECTION ' ' 32. Electrical Power Meter-Final . ��80. �FOOD RTIFICATE ISSUED -33. Final Electric ' . ' ' � ' Notesr ,�� 34. � Final Heating & Air Conditioning -_?,. � - (y(�_ - r 6U 35. Final Gas Pipe�Test - ' � ' , � ' - .�. _ . �36. Hood or Canopy - . � �. , . - 37. Final•Factory Fireplace - - .� ; � � 38. Final�Plumbing - ` � --- -� . ,' r. 39. Water Service�.Final • �� - - ' ' � 40. Ga: Service-Final � � - ' ' � . " . - 41. Solar pomestic-Final - 42. BackflowPreventer' ' .. � � 43. Backflow Irrigation �_ ' � E X P I R • . •� � 44. .Landscape Irrigation SYstem . - .- . " �� - � �45. ,Sound Attenuation • . • _ . - • - , dtQ .� � ' S��✓ 46. Handicap Regulations . ,. � - . - � , 47. FINAL STRUCTURE & BUILDING . i 48. FINALPLANNING . � ' '•' � - � 49. Electric Release to Ediso� � 50. Gas Release to Southem Calitornia Gas Co ' ' 51. CERTIFICATE OF OCCUPANCY No. Date � owrrER HAYS, M. & STANLEY, C. � nnTF 6=25-5� JOB ADDRES5 9l�2 Serra W8Y � BUILDING PERMIT G�N�RAL CONTRAC'COR AnthOriy POO15 VALUE $ 2tl00.00 AP rro.141-327-ob LOT TRACT FIRE 7.ONE DFSCRIPTION OF WORK Pvt. Swlm INSPECTIONS � Signature DATE GROUY J TYP� III ZONE R-1 Soil YliRMI'I`S ISSUED n..,, , ,. , _ _ SUBCONTRACTOR ,�,,.,,r, ,,.,.,,,�„n Building, Final -/7/ - �� OCCUPANCY . HOL - :(1GY 11116 . 5Y � ].f.l � 17407. COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 9f7 C08TA ME9A. CALIFORNIA For Applicanf fo Fill In Completely � TYPE OR PRINT C05TA MESA. CALIFORNIA MAIL �j ADDRESS TEL. � CITV �— NO. ARCHITECf TEL. �� OR ENGINEER NO. ADDRESfi CONTRACTOR ..,_____ 5871 FIRESTONE BLVD. TE�. SP32210 NO. INO. OF B1D09. � � � ��i�� JUN 2 5 1962 �IN�N�� fi� GifiY @� C��A M�� APPLICATION FOR PERMIT BUILDING For Office Use Only HECEIPT NO. _ PERMIT NO. ADDRE65 942 SERRA WAY COSTA MESA. CALIFORNIA APPROVED ZONING ' ,�r � I Pu eF YI eu �oirvcew d�` LflT 5 7 TR �ece� use or YARDS EXISTING BLDG APPROVE� 9HTBACK LINB FPOM �� ICeNT6R LINE 9TJ c¢NTCR oF BTREET �—�REAR YARD FRONT 61DE YARD I IEFY '�—' I RIGHT R. SIDE � DESCRIPTION OF WORK _ r BUILDING NO. OF � 81ZE �� ROOMS STOi EXTERIOR WALL -�— ROOF � WVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED swzM rooL � � � � r � ��T EVES HOLD FOR SPECIAL 1 HEREBY ACKNOWLHDGH iHAT 1 HAVB PEAD TH�B MPLIGTION �pe AMOUNT BHOWN UNDER VALUAT�ON IS FOP TME AND BTATE H ABOVH IB CORqECT AND AGREE TO COM- pU�OBE OP HBTABLIBHING A PERMIT FEE ONLY. PLY WIT ALL CIiY OPOINANCE9 AND W9 R¢QULATINO euaoi w mV�n � VALUATION / � SIGNA U PERMI7 FEE $ J� PERM� --- _ � � $ 2HOO�OO PLAN CHEGK S �� ' 5 owNER STANLE7, Clarchen L. & HAYS, Mary Ruth DATG �J-5-62 BUILDING PERn4IT NO. GENERAL CONTRACTOR OHriET-B1dT. VALUE $1�000.00 AP No.liFl-�7-OG LOT TRACT FIRli 7.ONE DESCRIPTION OF WORK��'--�9't"G�T't0 D..n 9_ 11.i.i T....l IN5YECTIONS OCCUPANCY DATE I GROIIP Tr TYFL v 7.ONL SUBCONTFACTOR i =� I �i54 COSTA MESA BUILDING-SAFEN DEPARTMENT � E E R ECL ��l E D� P. O. BOX 917 COBTA MESA. CALIFORNIA SEP V For Applitani fo Fill In Compleiely APPLICCIt'i�i�O�El�TtMIT TYPE OR PRINT ��E�� MESA� BUILDWG �j ADDRESS �IL. � CO5TA MESA CALIFORNIA � FOI' Office Use Only ` L REC6IPT NO, E ' pi OWNER Q S' 1{ ^ �¢ MAIL AECEIVfiD� I OA qQCEIiEq � DATE IBSUED aooaess .'� �� I Lc.� Q G , TE�� BUILDING CITY NO. ADDRESB ' nRCHirecr � COSTA MESA. CALIFORNIA OR ENGINEER NO. ADORE55 I FIRE ,/ ZONE TYPE ✓ GROUP . / CONTRACTOR ✓. � i� APPROV _ / BY DATE v� ADDRESS ZON I N G ZONE NO. OF USE OP NEW (�'�'jy � J I PLANB I pUILO1N� STATE TEL. �ec�� — c LIC. NO. NO. DEBCRIPTION J � SIZE /� �-f no. or e�uce. OF LOT %/ G NOw oN LOT A P ND / L � 3� � � USE OF YARDS EVES EXISTING BLDG. �f � P APPROVED ALLOWED 6BTBAGK LINB FROM n/ IC¢NTCP LINE si.) cEniER oF eineei / REAR YARD ^7 FRONT FT. IN. I „ �� 61DE YARD I LEFT I RIG G� R. SIDE FT. }N. DESCRIPTION OF WORK _ L. SIDE FT. IN. NEW 0� II ALTERATION I II ADDITION I REAR i�FT. IN. REPAIR I II MOVING I II OEMOLISH I ByPROVED � �� DA7E ��—(/ BUILOING NO. OF j SIZE �z y ROOMS STORIES ! EXTERIOR WALL / ROOF D COYERING OO Q COVERINGA PP ' 1 USE O� IL ING .�+ND WORK TO BE PERFORMED G 1 t „ , � ,��d �s° 1 NEREBV �GNNOWLBDOe THAT i HAVE READ TH�9 APPIJGTION TXE �MOUM BMOWN UNOEP VALIIATION IB PDX TXE AN� BTATE THAT TH6 �BOVE Ie GORAEGT AND AGN@H TO CON- pUftPOBE OF EBTABLIBHING A PEflMIT FEE ONLY. P{.Y WITH ALL CISC ORDINANCEB ANO BTATE L./.W8 R66UUTN6 eu1tDlNa coneTfiurno . VALUATION / SIGNATURE OF� � � PERMIT FEE E IO � e PERMITTE� � � $ � p DO � pLAN CHECK $ � q�y�J �♦ // AUTHORIZED AGEN7' '" % i o TOTAL FEE u �;��oi'� 5 3 1�,�' OWNEFi J JOB ADDRESS � r.unru.aar. cnr STANLEY, CLARCffIENN JUN 2 3 1966 BUILDING PERMIT NO. VALUE $ 1 -32 DATE I GROUP J TYPE SUBCONTRACTOR '' � 224g3 � C057A MESA BUILDING-SAFETY DEPARTMENT P.O. BO% 1T00 � COSTA ME8A, CALIFORNIA Y26f0 For Applfcant fo F711 /n Completoly TYPE OR PRINT MAIL C•]J COSTA MESA. CALIFORNIA DESCRIPTIOM OF WORK nno�. 1 H!RlBY ACKNOWL6D06 TXAT 1 NAV[ RCAD THIO APPLICATION AND BTAT6 THAT T18 I180V6 1{ CORR6CT�ANG 110Ref TO COM. PLT WITN ALL CITY OPDINAXCO AND RAT[ {,AWD p OULIITINO BWLOINO CONSTRUG�/�IO�j� /� // 61GNATUREOP YS �4�D_._ / A _ // . AUTNORIZiD AG[NT � FEE RECEIVED JUN 2 3 1964 FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMR BUILDING ro� Offlce Use o�y n�c�irt no. �earir ZONING 3 / HO.OI+� ' YY[OIN[W � � 1 �LAN1 /� eu1LDIN0 � l o�a eimow T� 5�.2 �Q.S �b%� J�� P.No. /�/-3a'�— n� NOTQ: NOGV60V[RNAN68HALLBBLl88THAN YARDDMPROVHD I YARDSAPPROVfiD MAIN BUILDINO AGCEIISORY BUILOIN6 VAR• # ear. Mwin a ACCESB. BL[ DATB TX8 IIMOUM ONOWH UNOBR VALII�TON 19 FOR TH6 �URP086 OP UTABLI8N�N0 A PHpMIT P88 ONLY. VALUATION PERMIT RH8 �� a /y�— _ � ' 1��3 Lot 57� Tract �285, P�a�� C�IVED COSTA MESA BUILDING-SAFETY DEPARTMENT �FINANCE DEPT. P. O. BOX 9f7 COBTA MHBA. GLIPORNIA p�TY Of C05TA MESA For Applicanf to Fill In Compleiely APPLICATION fOR PERMIT TYPE OR PRINT BUILDING BUILDING 1� ADDRE63 942 Serra Wa COSTA MESA. CALIFORNIA For Offite Use Only xece�vr NO. .P88A111 NO. ADORESS 3800 E• CiOa$ti urr Comna del ldar C ARCHITEGT _. _ del '°ar, p Calif. .. __ _ TEL. __ IOF LOT 7SOZ S F I Now�o USE OF 16 pPOM iTiilef li% � REAR YARD 1.]. � ILEFT 2O� IRIGHT ��%�� DESCRIPTION OF WORK ' BUII..DING �Q � C� rtecENgn�er I DATe/P�cgrvgj I oAre ,�� /i� G BUILDING ADDRESS COSTA MESA. CALIFORNIA FIRE ZONING iONEn NO. OP U88 OP N rY / I PLANB � BUIIDINO " �� ."o,m,,,W tn �f2�T VAROS APPROVED ICBNTtR uNs aTd/Jry FRONT "/ ( R. 61DE / / L.SIDE ZD REAR /� MPROVED W�G RV arna area �vxa � � S S I HEREBY ACKNOWLEDGE TXAT 1 HAV6 RGD TH18 APPLIGTION THE AMOUNT BHOWN UNDEP VALUATION IB POH THH AND BTAT! THAT TX8 ABOVB 18 GORRBCT ANC AGNHB TO COM- PUHP098 OP ¢BTABLIBHINO A PlRMIT FeE ONLY. VLV WITX ALL GITY ORDINANCE9 AND 9TATC lAW6 f16GULATINO eUiLDINO CONBTRUCTION. VALUATION SIGNATUR6 OF �SE DEL DEVEIA-PMENT CO PERMIT FEE $�� 5.— PERMI'RH �j Bjr �� j s 15,326�� PLAN CHECK $//��J � AUTHORIZED AG ��1iiL . .�Q�[Q