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Home My WebLink About3445 SUMMERSET CIR - Building Permits� w .._ ► (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92E7G BUILDING PERMIT �obAddress: 3445 SUMMERSET CI Suite: Vicinity: ROOF ' � Primary Occ: R-3 Dwellings/ Cong Res <10 Type of Construction: V-N Parcel Number: 41207311 Zoning: Rl npp�icant: RON SELL Address: 18032 LEMON YORBA UNDA , CA owner: UYEMURA, WAYNE Address 3500 W GARRY AVE SANTA ANA, CA Contractor. SELL ROOFING COMPANY Address: 18032 LEMON YORBA LINDA , CA Zip: 92686 Arch : Address: �PF EXISTiil�j6`�ROOF. IN v "HING AS NEEDED. 28 S Check: $0.00 Permit .��$18:25 H IP Res: ��0 7 P Com 'i��$0.00 OF Phone: 714-528-1758 Zip: 92686 Phone: Zip: 92704 Status: FINALED Applied: 09/18/2006 Issued: 09/18/2006 ISSUED BY: #4660, 5.5 LBS/S.F., MALIBU, AND REPAIR/REPLACE Calc Valuation: Se,�oo.00 Claim Valuation: Se,�oo.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related ragulations. (Ord. No. 9248, § 1, 12-21-92) - EXPIRATION; This permit shall automatically expire and become void if work is nal commenced within 780 days, or il work Is suspended or abandoned for a period of 1 BO tlays. � � INSPECTIONS: .In order for the work authorized under ihis pe�mil to be considered legal, such work must comply with all appticable codes, and all requlred Inspeetlons and final approvel must be obtained. Failure lo obtain Inspections and final approvel will result in the expiia�ion of this permil. FOR INSPECTIONS CALL: (714) 7545626 �4MW6(N00) � WORKEFS' COMPENSATION DECLARATION: �� I �ereby aHirm untler penaliy o� per�ury one o1 �ne lollowing declara�ions: ❑ I �ava entl will maintain a cendicaie ol cOnsenl lo selt�lnsure for workars' compensaiion, es provitlatl lor by section 3700 ol Ihe Lebor Ca1e, lor Ihe peAormance ol Ihe wo�k lor wNcn t�is permil is issuetl. , ❑ I nave 3nd will maintain workers' tompan4abon insurance, as required by section 3700 01 the L20or Code, lor tho pedormance ol t�e work lor which I�is pennit is issued. My worker5' compensation InSuranCe cal�ier antl p01¢y number are: Carnur. Policy Numbxr: /Th�s :ecnnn nenJ nof De compleled ANe perm�� is valuetl al one hundred dollais (5700) or Iess.J ❑ I Certi�y Ihai in ihe pertOrmanCe ol Ihe wtl� �or which ihi5 permil i5 issued, I Shall nol BmplOy any person in any manne! 5o es lo Gecome 5ubjecl to Ihe wOMerS' compensauon laws of Calnomia, and agree Ihai if I shoultl become sublact lo Ihe workers' compen5aiion provisions ol Seclion 3700 0l t�B LabO� Code, 1 shall fotl�with campty with Ihese provisions. Appl¢am Signalwe: Date: WAHNING FAII URE TO SECURE WORKERS' G[NdPENSATIOfJ fAVEMGE I$ UNUWFUL AND SHnLL SU6JECT AN EMPLOYER TO GRIMINAL PENnLT1E5 AND CIVII T/qLSMJD WLLARE �b100,U00�, iN nODlilp! TO TNE COST OF COMPENS�TION, DAMAGES AS PROVIpED FOR IN SECTIIXJ ]]O60F THE UBOR CADE, INTEREST,. LICENSED CONTRACTORS DECLARATION: I heroby aflum Ihat I am licensetl untlar provisions ol C�a01er 9(tommencing wit� Section 7000) of Drvision 3 0l tha dusiness �orce antl etlecL Lia � Class M Contractur s Signawre: CONSTRUCTION LENDING AGENCY: � I hereby aHiim inal itiere is a consuuclion lentling agency lor t0e peAormante ol iha work br L6ntler's Name: Signaicre' _ OWNER-BUILDER DECL4RATIONS: Lenaer's Atltlress: I nerooy aBirm t0at untler penalty o� Oerlury the� � am E%EMPT FROM THE Coda: Any city or counly which raquires a perm�� to consimct, allaq improv� �o hic a signed SiBiement Ihal �e or sne is licensetl purSuaM to lhe prpVlSk Busine55 antl Prolessions COtle) or tllal he of s�e is e�empt IhereffOfl�i9ni sublecls me applicant to a civil penalty ol not more lhan five huntlreA Cdlau .r.".: r:aa,� ❑ I, as ownar ot Ihe propeny, or my employeas wil� wages a3lheir sda 7U44, Business and Pmlessions Cotle: 7he Conlraclors�.Ckense Lew himself or perseli or I�rough his ot hBr o�'n employees�PiOVN18d M3I� solJ within one year ol completion, Ihe owner-builtler will�have�tfia bui � I, as ownar nf Iha pmpeny, am EXCLUB��ELV LONTAACTINC WIT Cotle: Tne conuactoro Licanse Law.tloes not apply io'ari;owner ot prc license puBuanl to Ihe CoNrac102iLKePse Laws.).��''�'`�� ❑ I am eKempi under seC. Signature: Ownor ID varifietl Dy tlriver's I� Venhcalion of Ownerehip py �' DIVISION OF INDUS ❑ I horeby cenify i DC�mii, 0nd Ihdl 3a i. T iue B, Cai ❑ As owner-buildi oermn to tlo sui Spnalure: �� Divlsion of Intlustrialf �ol3tlaciimeil� e. - p;i�o�p�e�rly�t�ea hill or tl� =7Y VERMIT CERTIFICATION: {';�.�;a+;.:p.s vation live (5) or more:f68t in tleplh imo stmcture. sGafloltling?.khework, or den nisval�ve Code). �:'��'%'�'-� KAn��,.o,«;? a employ anyo�e lo tlo�,wo'rk�whiU. � � �-+N �Ihedrvisron. ��ti,•.�u''(��:M Data: , or repeir�aify,stmcture;�prior,Fo i�s issuance onvetlw6Llclnse Law'�C1�6pter 9 (mmmei for tlie alleped e.emp�onylAny violation ol £ �`�tt�.� ,�.} � ion, WILL DO:THE;WOHK}entl Ihe slruaur �ply Iti;dn cwiix,-Of propB�i�y�who builtls or �m vemanb,ere'.r1ol.NtentleC�or otleratl lur sale. �ing ��et t16 a ehe did"nof�build ar impwve ic avrn,:.,,...�. *e,,.�. iD COHTRACTOR9 to constmct Ihe pmjecl luiltls�w iinp�ovea Uieieon, antl who r.nntrac �„-'`$.� °^F.'�,��'Mtt+'L� x.� ons Codo'for�inis reason' _ F'.'�`..S Daio: UP 1 O ONE HUNDRED my license is in �ull 1.5, 8usiness an0 Prolessions s Ina aDP��ant tor sucn permil :tion 7000) aI Division 3 of ihe i �y any applicanl lor a permit aetl o� ofle�ed lor sale (Sec. on, and wno tlnes such work me building or impmvnmeM is sale.). Business antl f'rotessions �o�ect with a conira[to��s) Espires: fescend, wdl he matle in wnnection wit� work authorized Oy t�is will be mo�e Ihan Ihrtty�six (36) teet high. (Chap. 3.Z, Grp 2. Atl 2, Set. Ihe Drvislon ot Intlusirial Sefety, as noted e�ove, unless such person hes e Dale: i Will Ihe aOP��anl�or�D��em o�lufa,buUding octupant naetl to file entl cenity a Business Plan for emargency response lo reiease or �hrealened release ol a hazertlnus inai�nal? ❑ Vea^ ��y'��_No� c-a �;r,;,;�..„::� �Secnon 255C5 oi I�eyCelifpmie Hqaltti�9ntl Salety Cotle requires, wilh some exceptions. ihat e Business Plan be lilntl with the Costa Mesa Fire Depanmenl by evary business which fiae et eny;pre,Wrie Curin9 a reponetl year a quanlity of �azarGous maienals oQual to or greater Ihan e weight of 500 pountls, or a voWme ul 55 gallons, nr 200 cuo¢ teel ct coinD�esseA g23 et s�antlartl temDerawre antl pressure�. ......_ ... .. . ................ ...,..`...._ _.....�...�. ..._...... .............._.. ... ......._._....... ......_.... . ........._... . ........... . .......... ... ........... . .. .. ...... .... .... 2 Dces or will 1he dppliCetfLIX�pfB5B�Y0� I��u�e bwltling occupa0i ne¢d Io lile d�ByiS��aliOn lo�m 10� dtul2ly h2edrtlous mpl8�id157 ❑ Ves ❑ No ISer.Uon 25533 0l itie�Celitornia�Health antl Sately Cotle, wM some eviceplions, reduires registrabon wnh ine Costa Mase Pire Depanment Ey eac� businnss whicn el nny una tin�e has un �an`A;a:quanlily ot acwely haza�tlous matenals equal m or greater than e weighl ol SW pounds, m a voWme ol 55 gallons, or 200 cubic inel ol compressea gds a� stantlam iemperalurB antl pressure). .......... . ... ............ ... . ........... . ..... ... ........ . ............. . ... ............ . ......._ .. .... .... . . .............. . . ........,... . ....... ... ... ...... .... ...... 7 Does or will Ihe apo�iwnt or present or t��ure builtlin9 occupant neetl to prepare an PMPP (Pisk Management and Prevenlion Pmgram br aculety hazartlous malerials)7 (] Pes C] Idu ISeclion 2553a ot Ihe Caldomia Heal�h antl Satery Cotle pmvidas ihal ihe Costa Mesa Fire Depanmenl may require I�e preparation, caMilicalion antl liling with Ihe Fire UCpatimanl oI an RMPP Uy Ou5ine55e5 Wh�ch a�e reqUuetl to reqi5ier aCutCly haZartlDuS malerials wilh Ihe Flre Depa�inanl. .. . ................. . .................... .......... .._ . ............. .,.. ....._.... ... ............. .... . ........_. .. ..,. .__... . .... ..............._.. ..... ,. ,.....,.... . ......... n an NMPP is presentty require0, has Secfion 25534 0l ��e Cahtomia Health antl Sale�y CoOe Oeen lulty complied wilh7 ❑ Ves ❑ No Uons or will �ne aoohcanl or presenl or I��u�O pUllOrtl9 OCCuPd01 fBQ�I�B 10� IM1B wO�k whlCb IS II1B S��IeCI OI Ni5 a�pl¢afion a�ermit for suc� consim trom ihe Soum Coast Au Uualuy ManagFmom Dislucl or Irom any other air pollulion coNwl tlisind o� agancy? �� Yes No ISecbon 65Pti0.[ o� Ine Cab�omia Governmenl Cotla requires Inat Ine requestetl inlormation be Iumf50ed on applicalions lor nomresitlen�ial Ouil�inq 0 .. _.._...._.. . ...__.___. ....._._... .. .. ...__.. .............. ..........,._. . .... _....... .................. ...... ......... Wtll any part ot Ihe facibty io be conslmded untler Ihis parmil be wilhin t0001eet Irom ihe ouier �ountlaries ol a schoul> ❑ yes ❑ No I�� yes". Ine taciliry musl mee� �he requfr6ment ot Sections 25534 entl 42303 0l �he Califomia Healih and Salety Code). ... . . ..... . ......... . ........... .._. ... . . ........... . _............ .......... . . .... ...... tl a pern � irom mu SON�� Coas� Air Oualily Managemen� DisVict or other air pollution coNml distr¢t or egency is requued lor Ihe work whic� ��, �Vul¢duon nave all ol Ine disciosures prescnbea by Caltlomie Nealih and Salely Coae Senion a230J baen matle? [] Ves ❑ No .._...._.. ............_. . .......... . ......... .... . ... . .... . . ......_.. . _.. _.......... . .......... . . . ......... .... �I�'yes atlacn cetld�cale ol complian�e ��om inn appmpriata air pollution coNrol oflicer) CERIIFICA7[ OF GOMPLIANCE: I ced�y ibal under penalty of perjury ihe inlormation given above is correcl. I agreo lo comply wilh all stale laws regarUing Hazartlous Matunals and Emi45iun5. SignaWre: Dato: L•L Ihis �A city orctinanr.os CERTIFICATE OF COMVLIANCE AND AUiT10RIZATON OF ENTRV: I cenity untler penelry ol Oerjury Iha� I heve reatl Ihis applicalion antl sta�o IOat ��e intorma�inn given is rorrecl. I agr99 lo comply witn all slate laws and city ortlinances ralalmg to builtling consimclion, antl authoriza represeNatWes ol Ine Cny ol Costa Mesa to enler upon ihe aoove-tlescnbetl propeny tor inspection purposes. I agree not io occupy or allow occupancy ot any builtling aulhorizea by this Dermit umil Iina1 inspeclion. QpDE r. iNSGECTIOHTYPj 1616 FixeG $ySteT_ 2� Fire 203 20a S�gnalure OI Le9al Owner�s) Antl/Or AUIhonZetl AOPI¢anl wail �1j[ I TIH il�t5 CQOE � INSPECTIOH TYPE 21 D�IE NI TRI1L5 r (71a) 75a-52�3 • Fax (71a) 75a-a856 • www.ci.costa-mesa.�.1�tlLDING F'tKMI I JobAddress: 344$ SUMMERSETCI � Suite: Vicinity: ROpF Primary Occ: R-3 Dwellings/ Cong Res <10 Type of Conslruction: V-N Parcel Number: 41207311 Zoning: R1 Applicant RON SELL Address: 78032 LEMON Phone: 714-528-1758 YORBALINDA,CA __ �. -,- , Zip: 92686, ...�.' ' _ - . . .' .. Owner: UYEMURA, WAYNE� Address 3500 W. GARRY AVE ` � —_ � , ' - Phone. � - ' SANTAANA,�CA� :� , � " _ - Zip-� 92704 _ �•. i`/' . � - ._ . _ - ' " Contractor:�; `SEL'L ROOFING�COMPANY � -� � � Address�. = �18032 LEMON�'�- - ", ; � .� ' � -_ . �� :%�. ��' Phone: 714-52&1758 , ,-'il' , _ � i,r. - _YORBA CINDA , CA � � � Zip: 92686 . License: 323842 i Arch : " ' Eng: Address' �_, � � .. �- Address: . , : ;� Phone: . � Zip: � � � � , Licensei ; .-- '.. 77 FAIR DRIVE, COSTA MESA, CA 92626 S � 5: ISSUED ied: 09/18/2006 : 09/18/2006 ISSUED BY: , � � ��\ � \� � �. ' �;.A � Phone: License: .. � � � - . SI:UYt Vh YCKIVII I - � � � . TEAR OFF EXISTING ROOF. INSTALL 2 LAYERS OF 30# FELT, 8:12 PITCH, EAGLELITE, #4660, 5.5 LBS/S.F., MALIBU; AND REPAIR/REPLACE SHEATHING AS NEEDED. 28 SQUARES INCLUDES ATTACHED GARAGE � � ' .. � t, � � . � . ' . _, FEE SUMMARY . _ � � • �' � Plan Check: � $0.00 � ,.�. _ ,�, �. � � �' � `r � '� '. .'- ' � Calc Valuation: ' � Ss,�oo.00. " Permit` $18125 Claim Valuation: � ss,�oo.00 � SMIP�Res:� $0.97 � � � �� SMIPCom: � $0.00 ,ti,,,, _ � , . Othec.. $0.00 --- - - - - Inspection: $0.00 � � � ,.. � - Total: � �� $182.22 � _ � � ��+�� , ��; - -. - -. � � . PLANNING & ZONING SETBACKS � � MAINSTRUCTURE FronL�_0-0 Rear; �00-�0�' � Left� 0��0�� • RigM 0=0 � - . � `� " :. �:-.:'. ��%..: . . '-p: .� . - , . . ACCESSORY Frent 0-�0�,;� - �.Rear. 0-0 - Lefl 0-0 �� - Right �0-�0 � � � �. , _A . ' /� � '�.� G � �._ _ , '" '-=� � - ' - � �. , PAfii��id(�i � Existinq %. 0 Reqmred ,'0 � 'Pr000sed: 0 � �� - '/ � _ „ .. � _ .v � � , / . ' � , . . . � �� .. ; , __ ' ' ' . . , i �. � � . , , . j ., __ ' ' ' ' . . , ,-� ,, , , /�� . ' . . � . , � ' � � 1 �" � . ' � -... ' . , - NOTICE: Tha work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-g2) EXPIRATION: This permit shall automatically expire and become void if work�is not commenced within 780 days, or if work is suspended or abandoned tor a period of 180 days. .' �,' '�� INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspectlons and final approval must be obtained. Failure to oblain inspections and final approval will result in the ezpiration of this permit. FOR 7NSPECTIONS CALL: (714) 7545626 � eaae-aa tmul WORKERS'COMPENSAnON DECLARAnON: � I hereby eflirm under penfllty of perjury one of the following decleretlons: . ' ❑ I heve end will melntein e cenificate ol �sent to setl-Insure tor workers' compensatlon, es provltletl for by section 3700 ot the lflbor Catle, lor ihe performance of the for whlc� Nis permit is Issuetl. I have end wlll maintain workers' compa2seUo insurance, as required by sectim 3700 of Ihe Lebor Cotle, for Me paAamance of I�e work for which Ihls permit is issued. My workers' pe tlon In ur nce carrie nd policy number a�e: / � �� Polioj Numbef: - /� � �d SS� (Th/s section need nat be compl !ed i/ the pe 't is valued et one huntlred dollars ($f 00) or less.) ❑ I ceniry thet in the pertortnance ol ihe wo�k tor which Ihis pertnit is issued, I shall not employ any person in any manner so es to 6ecome subject to tna workere' compensation laws oi Califomia, entl dgree that if I should bemme subject to Ihe workers' compensation provisions ot Section 3700 oi theLLL///M1M1M1 or ppp6tla, I shall forthwith compty with these pro�sions. . �� / , /� � ��Sigaehire: . Date�:o �`- � � �� MNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVEMGE IS UNUWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND G L FlNES UP TOONE HUNDRED T/10USAND OOLLARE (E100.000), IN ADDRION TO TME CQST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]p5 pF 7HE UBOR CODE, INTEREST, ANO ATTORNEI"$ FEES. LICENSED CON7RAC70R5 DECLARATION: I here�y effirtn that I em licensed under pmNsic CONSTRUCTION LENDING AGENCY: 9(commencing with Section 7000) of Division end my license is in tull ❑ I hereby aflirm that there is a conswc�ion lentling agency for the pertormance ot the work for which this permit is issuetl. (Sec. 3097, Civil Code). Lenders Name: LendeYs Atldress: Signature: _ OWNER-BUILDER DECLARATIONS: Date: I hereby atlirtn that under penelry of perjury ihat I am E%EMPT FROM 7ME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Cotle: Any ciry or wunry which requires e pertni� to construct, alter, improve, tlemolish, or repair any structure, prior to its issuance, also requires the epDlicent tor such pertnit to tile a signed stetement ihet he or she is Ifcensed pursuent to the proNsions af Ihe Contrectore License Law (Chapter 9(commencing with Section 7000) of DlWsion 3 af Ihe Busineu entl Professions Cotle) or that he o� s�e is axempt therefrom and the besis for t�e alleged exemption. Any violation of Saction 7031.5 by eny applicant for e pertnit su6jacLs the apqlicant to e civil penelry N noi more ihan five hundretl tlallere ($500�.�: ' ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO TME WORK, and Iha structura is not Intentletl or oHeretl for sele (Sec. 7044, Business and Professions Cods: The Coniractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herseH or through his or he! own employees, provided that such improvements are nm intentletl or oflered for sale. If, howaver, ihe building or improvement Is sold within one year ot completioq thA owner-builder will heve ihe burden oi proving that he or she did not build or improve for purpose ot sale.). ❑ I, as owner oi the properry, am EXCLUSNELY CONTRACTING WIT1 LICENSED LONTRACTORS to wnstruct the project (Sec. 7044, Business and Professions Code: The conirectors License Law tloes no� epDly to an owner of propeny who builds or Improves thereon, and who contrects for such projeci wl�h e comractor(s) license pursuanl to the Contractors LiCense Laws.). ❑ I am exempt under sec. Business and Prolessions Cotle for this reason: Signature: Date: Owner ID verifiad by drivefs license. a Ves ❑ No Onvers License No. Eapires: Venfication Of Ov.•nership 6y (h/pe of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERM�T CERTIFICATION: ❑ I hareby certify ihat no excavation tiva (5) or more fee� in dep�h Into which a person is requireOlo descend, will be made in connection with work euthonzetl by Ihis permit, and that no building sirucWre, scaHolding, falsawork, or demoli�ion or tlismantling thereoi, will be more than thirry-six (38) feet high. (Chap. 32, Gry 2, An 2, Sec. 341, Title 8, Calitornia Adminisirative Gode). ❑ As owner-builder, I wiil not employ anyone to do work which would require e'permit irom the Olvision ot Intlustrial Satety, as notetl ebove, unlass such person has e permit ta do such work irom the division. Signa�ure: Date: Divisian of Indusirial Sefery Pertnit Number: CEHTIFlCATE OF COMPLIANCE AND AUTHORVATON OF ENTAY: I certi(y under penalry of perjury that I hava read ihis epplication and stele Ihat the informatlon given is correct. I egree to comply with all stete laWs entl ciry orEinances releting to builtling construction, end authonze representatives of ihe Ciry of Costa Mesa to enter upon the above-descnbed property for inspection purPoses. I agree not to occupy or allow occupancy ol any building authonzed by this pertnit until final inspection. P71 COUE t. INSPECTIONTVPE 1616 Fixetl System Final Fire Prevantion 1266 Pool Spa Final 200 Final fiaRoot 201 Finel BIocWRetaining Wall 202 Flnal Factory Fire Place 203 Final Sign 204 Final Demolition ^ o�re L� �� 2 S-O$ � CO�E� . INSPECTION7YGE , 206 Finel Mechanicel 208 Final Plumbing 210 Finel Elecincal 212 . Finel Fire Prevention , 220 Final Planning Approval 222 Final Site � � 250 �� Final Building/Occupancy C1111LtS PBOJECTP�UNESS: j�QS Si1MN�ERSE'P CI uxir: OWNEfl'SNRME: UYLVURA, GARY' S � aooaess: 3445 SUMMERSEI CIR COSTA MESA,CA 92626 � PPCHIENGINEEfl: THE D �S IGN CORPS flEG.NO.: C O nooaess: 501 N ALFRED S'C uNiT: L.A. CA 90048 PEflMITTEE: U' CALLAGHAN CONSTRUCTION ( 714 ) 558-1306 AODHESS: ZSZO N RUS$ � SA CA 9?.706 UCENSEO CONTFpCTUB DECNflFTION: I hereby a�firm �hat I am licensea unaer pmvisions n� CM1apier 9(commencing wiih Sec�ion 7000� oi �ivision 3 ol Ihe Business and Pmfessions Code, antl my license is in �ull lorc ana elfecL ' cirr uc.: 0 513 4 9 sTaTe uc.: 4 31 D 58 cuss: B oaic � — � � � 9� Signalure: _ _ WOflREPS' COMPENSATION DECUflFTION: I �ereby a�firm Iha� I have a certilicate ol consent la sell�insure or a cehificale o� Workers' Compensaiion sura e, ' cert e copy thereol (Sec�ian 3800, Lab �iv�,:`S�- � �6/O1/9� pOLICY NO.: E%P. DATE: �comvaxv: S'TA'fE FUND,y r7 Ceneied caOY is hereby iumishe0. L'1 Ceniliea coOY is filetl with the ciry Builtl�a \Drv¢ion. �aie'.� �� r q/ Applicant � /\ 1 EMEMP710N FROM WOPNEBS' COMPENSP710N OECLABFTIQN: Qhis seclion nee0 nol be campleteU i(ihe permil is lar ane AunOrea (5100) or less�. I cenify iha� in t�e pedormance of t�e vmrk for which Ihis permi� is issued I shall noi employ any person in any manner w as �o hecome su�jeci la ihe Warkers' Compen5aiion laws ol Cahtornia. . Oale: SignaWre: ' • NOTICE: If, al�er making �his declaration, you shoWd hecome sublecl Io �he Workers' Compensa�ian pmvisions u� the Labor Cotle, you mus� fonhwi�h comply with such pmvisians or ihis permit shall 6e OeemeO revoked. �� CONSTBOCTION LENOING AGENCY: I �ere0y aflirm that Nere is a conslmc�ion lentling agency lor Ihe pedormance oi Ihe work for which I�is permi� is issuetl (Section 3097, Crv. C�. . LENOEfl: ' " nooness: OWNEfl BUILOEF DECLANRTION: I hereby afhrm �Aa� I am exempt trom lhe Contractors' Slaie License Law �ar �he following reason (Section 7031.5 Business antl Pmfessional Cotle: Any city of county w�ich reQuires a permit lo consirucL alter, improve, tlemolish, or re0air any s�mclure. prior to i�s issuance, also re0uire5 �he applicant �ar such permit �o �ile a signetl statement tha� helshe is licensed pursuam to ihe pmvisions of the Contractors' Siate License Law (Chapter 9(commencing wilh'Section 7000) ol Division 3 af Ihe Business anU Pmlessions Cotle) or �ha� he/she is ex¢mp� Iherelrom and �he basis tor Ihe allegetl eKemp�ion. Any violation o� Seclion 7031.5 by any applicanl �or a permit sublec�s ihe ap0lican� �o a civil penal�y ol no� more �han five hunOreA dollars (4500�. I, as owner ol Ihe pwpehy or my employees with wages as I�eir sole compensa�ion, will tlo !he work, and �he ❑ stmc�ureis natinlen0e� oroltere41or5ale�Section 7044, Business antl Profe55ionalCotle: The Contractors' Slat¢ License Law daes not appry to an owner o� a pmperty wha builds or imOroves ��ereon, antl who tloes such work himSelUhersel� or �hmugh ' his or her own employees, pmvitled ihat 5uch impmvements are no� inten0e0 or offeretl br sale. II, however the builtling or impmvemem is soltl wit�in one year oi comple�ian, Ihe owner will have Ihe 6urden ot pmnng he/she Oitl no� bui10 or improve �or Ihe purpose o� sale�. . I, as owner of ��e pmPeny, am exclusively con�racling with Iicense0 coniracbrs to consiNd ihe prolect (Section 7044, Business ❑ ana Pmfessions CoOe: The Contractors' Stale License Law tloes not aD01y to an owner of DmDeny who builtls or improves thereon antl who ConiraCtS lor 5uch pmlecis with a cOn�raclor(5) license pursuan� �o lh¢ COnlratlorY Sia�e LiCense Law). I am awate Ihai pmo� ol tlteir Worker's Compensalian insurance shoultl be pmvitled �o me. � I am exempi untler Sec�ion: B. 6 P. C. 10! �h15 1Ed5011: Date: � Owner. ' I tlo Aere�y cerlity thal I am aware oi and understand Ihe reQUlremenis of Calilomia Heal�h and Salely Code Sections 25505. 25533, antl 25534 and �hal I or any luture builtling occupani willlwill nol (circie one) nee0 to compty with saitl s�ate cotles and the requirements �o� a permi� for consimclion or motlificalion imm Ihe Air �uali�y Management �i5�rici. Fesidential wnSVuction applicaiions are exemp� �mm IAese pmvisions. Date. Npplicam: I here�y certityihat I have readihis applicalion and slale�ha�ihe above informaiion is correci.l agreeto compty wi�� ail cily an0 county ortlinances antl s�atelawsrelatingto builtling conslmction and hereby au�horizerepresen�atives ofihis cilyio enlerupon�he above-men�ionetl- p�openy larinspection Ourposes. � \ Date: v l� � r / / Signature: � J �rivefs Li�ense ar Socizl Sewrily p: tfiat�a6 W�i�e—Builtling; Green—Cotle Enbrcemenl; Canary—Applmant: Pink—Revenue: Goldenrod—Assessor � CITY OF COSTA MESA - BUILLiNG PER�ZT rFfi ,, . �� PERMIT NO: G 052364 PLAN rAECK NO: 00839-91 S ��s�--N-��P—t� CONSTRQCTION TYPE: � PF.RMIT TYPE:�BLE MEC PLU STR PJ�FOS�: AI.'P JOB DESCRIPTIUN : SFD REMODEL,OF KI7'CHEN � SQ FT: z,00U Ci,AIM VALUE:� 2,000,00 CAliC-VALUE: 2,000.00 GROUP OCC: R-3 / CON:MENTS: SMOKE DnTECTOR(5) REQUIRED IN HOME. f4-14 iE 3F 3E jE if 3E �(-�lf if �)f iF iF IE iE iF 3F If K� 3R fk �E N� )E 9R if iE if �tf iF 3h iF iE iF i'r �lE 1h 36 k iE iF 3f �(� % iE If lf iF iF i'r ih-li� �h 1E lf li� if 3E if� %� iF i!� aF N� N� iE af- iF �F #} IE N� #- lf 3F )E %� Z O N I N G R E Q U I R E M E: N T 5 sETBacxs ------------ NAIN HUILDING ---------- ---------' ACCESSORY 3UILDING ----�---- FRNT: "r'T IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT: FT ZN RGiiT; FT IN LEFT: FT IN RGiiT: FT IN PARKItdC- REQ• 2 PROV: 2 PARCEL: 41207311 7.NE• PDR- REF NO: PLANNING NiSTES> INTERIOR ALTERAT'ZONS ONLY TO EX, SF RESID"r:NCE • , % 3E �61f �R K� 3h if iE 34 iE If if 3f K� If if if iE 1E if ik 3f iE M 7E �F IF if iF 3F )f if %3't �E 3E iF iF iF iF IF iF If ak M�1F lf �f� 3(� N� �(� IF )E iF iE IE IE 3f� 3F if �E %� iF iF �k % k� lf !'r �f aE 3f i(� �(� k� aE ih if D E V E i. O P M E/ 1N T S E. R- V Z C E S R E Q[i I R E M E N T S ZONING APPftOVED BY ; t9-�.E/- DATE: .� r� BUILDING APPROVED BY : S J` DATE: �(O!`( APPLICA'iION ISSUED BY; •'' ' DATc: ,6' (O kibifiEiElEiEif-iE1E1EiEihififiEiflflEiFiflE i Te'iFiF- ifiEifiEiFi't�1fiE%ie iF3f Y�iEiE�FiE�7F1E�lE3E�ifiElEiE1EiE3Ek1E1EiE1EiEititi4lf��ifjEifiF3Eif�7E3f1E f3Fi iE iPikjt3eiEiEiEiFiE3f�li�k�%3f1Eii�3E3F?Pieiflf�iFi'rkf"rii3Fit3EiFaFlF3()Ej'r LEGALI2ATION:N F E"E' U M M A R Y� STRUCTURAL SEGNENT:Y BLDG PMT PLUMBING ELECfRiC MECHANIC FIRE SMIP/RES GRp,�TNG PERMI'P � 45.00 2 00 36,00 6,50 50 25� SOY 252 SMIP/NON-RES PLAN 29.25 ISSUE FEE 3.00 15.U0 15.00 , BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUO TOTALS----> 90,00 33.00 29,25 152,25 152.25 , REVENUE DIVISION TOTALS--> COLLEC7'EU• 152,25 UVER/SriORT• OU BLDG PMT PLUMBING cLEC'TRIC MEC'tIANIC FiRE SMIP/TUT GRADING PLAN-CCF;'K � 45.00 5,00 51.00 21.50 .50 �, 5 �43f aE?k if� iF �If !f� 3f iE iF 1E jh iE iE 3f iE iF iE if 3F 3e IF iE if� 3E:FlF R 3h iE �%iF if iE if iF i6 3E if 3f i(� if aE lE i(� iE jE 3F 1E R if 3F Y� iE �f I4+F aEjF fE iE-%� 3E if 1� i(� �k 3F iF 3e,i� ii�+i �{p iE if �1(- I N D I V I D IJ A L F E E B R E A R D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 2000 ALTER BY VALilE RESIDENTIAL N07,ONE 1.�0 2,OOU ELE 15 cZXTi7RES, LIGHTING i S'I' 20 EA. � . 75 11'Z5 ELE 15 R�CEPT/OUTLET 1 Si 20 ' EA.' .75 11'�5 ELE 10 RcCEPT/SWITCH 1 ST 20 EA, .75 1�50 ELE 2 RES APPiIANCE NOT OVER 1.0 HY 3.00 6'pp MEC 1 INST HOOD W/DUCTS FEI) HY MEC EXHAUST 6.50 6;50 FLU 1 SINK, RITCAEN 2.00 .UO END Or FEF.S � Q1 404S9�E&-OOOE9293 Ti"f� � -� , OAiE: G6/21/9: TIYiE: 1h:�3 '`� ` j �, I ' � CONSTRUC710N AND PLANNING � P 'PA Date Inspector Date Inspector APPROVALS Permit # i� APPROVALS Permit # .i ' 7. Temporary �lectrical Service or Pole " . 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd. '� " 53. Steel Reinforcement � 3. Electriwl Conduit Utility-Undrgrnd. _ 54. Porms ,; .. 4. Electrical ConduibUndrgrnd`' 55. Electrical Bonding . � 5. Steel Reinforcement 56. Rough P�umbing & Pressure Test 6. Electrical UFER Gmd. � 57. APPROVAL TO COVER�GUNITE 7. Footings � , 58. Electrical Conduit-Undrgrnd. 8. Foundation � 59. Gas Pipe, � Undrgrnd., Test � 9.. Wa[er Pipe-Undrgrnd. j � `• 60. Backwash Lines, P-Trap, O Undrgrnd. � 10. Structural Floor System • 61. APPROVAL TO DECK I 11. Property Sewer Line & House�Connection '� 62. Backwash & Receptor-Final � 72. Sewer Cap . � � 63. Heater & Vent-Final � 13. Roof Drains 64. Plumbing System � Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical�Conduit '� 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING . 18. Rough Electrical-T 8ar Ceiling 69. POOLlSPA SYSTEMS FINAL 19. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace APPROVALS Permit # - 21. Oucts,in St�ucture . - 70. Underground Hydro � 22. Ducts, Ventilating - _ � � , 77. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72, Underground Flush 24. Roof Framing ' ' . ''" 73. Undergrnd.StorageTank'OGas �Oil 25. Roof Sheathing. . �.' 74, Overhead Hydro � . 26. T-Bar Ceiling (Structural) & Monocoat � � 75. Dry Chemical � • - 27. Frame and Flashing ' �. . 76' Dry Standpipe � � � 28. Lathing & 5iding - 77: FIXED SYSTEM �FINAL � 29. Insulation . � . � ��'' i� - --r ', 78. FIRE PREV. FINAL - 30. Drywall Nai�ing � :� � HEALTH DEPT. REQUIREMENT � .� 31. Plaster Brown Coat ' • " y, . 79. FINAL INSPECTtON � 32. Electrical POwer Meter-Final • � � ��;±� 80: FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heatin9 & Air Conditioning ��j(qi � L - ,_ , � 35. Final Gas Pipe�Test � �}- ��'"� l _ 36. Hood or CanoPY . . _ . %j ' �� , . .. - , i 37.- Final Factorv Fireplace � � � - � 38. final Plumbing � Gj� L� � ' , 39. Water Servite�Final ' • �- - 40. Gas Service-Final ., . � � - ' , 41. Solar pomestic-Final � � � � ' 42. Backflow Preventer _ . ' _ _ . 43. Backflow Irrigation � � � - 44. Landscape Irrigation System ;' � � . , � � - 45. Sound Attenuation . - � 46. Handicap Regulations � � , 47. FINAL STRUCTURE & BUILDING .[�'',. � � 46. FINAL PLANNING '� , 49. Electric Release to Edison ,.,� �„ t�. 50. Gas Release to Southem Califomia Gas Co ��- - - ' i � 51�. CERTIFICATEOFOCCUPANCY - No. Date �' U`' 1\�'� CITY OF CCLSTA MFSA ry/ Ll Y�� \ �� RDQUEST FOR OCQJPANCY I �cr No. /G„L � � � IOP N0. •��'�• n��e: /.�— ,�h1- � 'Ihe developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been conpleted and its streets accepted tr� the City of Costa Mesa. By executing this agrc�nent, the undersigned ackna�aledges that he/she/they �ras/were advised that this tract has not been given final inspection nor has it been accepted b� the City of Costa Mesa as having conplied with the oonditions of approval which kere inposed b� the City at the ture the Final Tract Map was approved. R The City ass�nnes no liability for the enforcen�ent of the oonditions necessary for approval other than those oonditions protected t� surety bond. The undersigned agrees to indemnify and resuiting-in dam3ge or per�nai .3.n�iTiy� co T aforasnentioned uncort��leted ��GtIVE� r.i7Y pF CnSr4 U�SA p��;:i1979 AM PR1 '7i8i9il0illi12e�i2i3i4iSi6 Q . 4j79 (s m m City harmless fmm any claun � iyr...� br :�a.^-.c^ cf rho HOME SAVINGS/�! LOAN ASSOC. �._�..._.�. _.. .�.. ... _. �..j�A_._ 1 i�Ii.JVuc;� ' i',t. • . . _� I r � i'i:, �, .' . , •. . � , EIR��.�N. � .�Fi..-�i ��o _ n,,.a ;«.,-::'�'7T�v.,r.�_�. '�-�-=G� � � l.J �%f��-�C.AL W�rZ1+V4 /�V (�A�tAt.�: SGEA� CoMA�-`( � �-� W iTi�i C�D�: I l� �-o M�3u s i� u v A� R. To �v � 5 u�,o t t c. u'ro � �.vATE2 Ht=r1-rC,e $ G.,4.u. � � SJ O l�.-c-s i e� /. � T� -ro f3t C� r Z P2.+e-rc e'r � J � iLC%LU' ��}TC fPL:�LCr MOQ.L ��/�AN �D` r�`'; M SPfl I "� A �?_ A ��.� �j. I (� S�A tcp w� P. i.v C.�+2Ae.c: S�+Au. '�� 6��RecD 50 0.s To PR.u�/�Ot MiN�,�NM a•0�X2`O� I� �Ll�IOn'J�TRKGTLV �kAk�;JL R2�:R�- � � t�ihkt�=iir6�7:1�rn�-� C.,�L•. ' �� TG C�i� $InS P��v'�cj M t N t nti.,.,tn G i , _ j >�. � . . ..... � — . .. . , A�PRO�E� CITY Of COSTA i�ESA �Electrical Section ❑ Mechanical Section � Plumbiag �ection---'—.�=- Building Division_�� G:— � ---- APProved..........L.e ........................ Date.`.:�!.. � THE ISSUANCE OF A PERMIT BASED UPON PU1NS AN I SPECIFlCRTIGNS SHALL NOT PREVENT THE BUILDING OFFICIA ' FnOM iHEREAFTER REQUIRINGTHE CORRECTION OF ERRO�, IN SFID PLANS AND SPECIF�CATIONS OR FROM PREVENTING DUILDING OPERATIONS BEING CARRIED ON THEREUNDER WHEN IN VIOLATION OF THIS CODE OR OF ANY OTHER ORDINANCE OF THE CITY. FOR INFORMATION CALL 754�5273 I . � � � i I _ __ _ _ _ . e . . ._ _' L d�� ' Q1i01ECT T�� 6LDG. 0�1: I ° p� '� DAT��'(��-7�/�. � 0/ �LANfiINO 7 [1:0`::,�:- : 6_ - ' , � � i t,r . . `r I I , i i � �\. .�.L' `. .__ f: `i3y�". � ' ! F.:.� �. � � ,�� , • i ; \�",,, ��.J / C� � � IJ, ,d.__. _ —._.-� . I � v___--_- -- L.'v . n: � ! ��, �' .. . . ,. , .��, �c,4 � , �n�, �. � A�`�} u � c�v�� ,� „�-- � �-t �-1 �' Sw..,,..�.. ��s� S.p-��5 L�--- oS�.�� -��oz w��r�-�.A�S- ��/- 393g ✓ � AOPlicant to fill in all spaces e:eep! l�ou wlt�in �eavy borEer Iines an0 si9n all aoCroGnate Aeclantions. � CIT� OF COST'A MESA� — -� - - -- � - � - _ _. _ - _ .. . _ _ , _ _ , . -� ,, ._ � , . --� � _ . I.. � PERMIT NO. � TRACT O. LOT NO �� BL � � Crl�STRUCTIOnfPERMIF: �- ' ' - - �� ' "� <`. Si .'' -;''', _ + ' - � `- - � i " , � , , � _ , ' ` i '. { :, i ; `?s �'� � � � �:It� 19 6/24/83 �� 16.00; 'TL � 1'i6oz •w��o':A .�, i , � . � �4 i i �•, i<� ' Appllcant'S Mailing Addrea , , ' T/PE OF CONSTRUCTION - � NEW ` ADD. ?.LTERATION " ' REPAiR �: , � - . � � ' , I (•! , ProjectAddress� j�`'�� - 5��+n.+�3w''bC i � I = { .❑ CONVERSION ❑ DEMOLISH '.OTHER� � I : ^, "' ' '� : , � ' � � _� � ' ' I � t ' � ; �,•` 1 . (� ' ' " � � � DESGRIPTION OF WORK � ' -� ' � L � r .' Owners�Name .ijML�{ 1.��bw� .��var �hone� , . � I � , � I r .,r , � ; - s v i . �Z NI G EG I S-� - � � . (� Address ' S 4 4 S S..'�� ...-5 1._.4.s.f � � � ` - � � � �.- - . �-O _ ;' � _ :. . � _ . : � � � � -, _ � � ^ TVPE OF PERMI �GRADIN FOUNDATION STRUCTURAL � - . . 'A. P. ZONE _ � Arch/Eng:' • � � "' Lic8n5E O. - ❑ TENANT � ELECTRICAL�PLUMBING ❑''MECHANICAL � " � � �•. � � ' • -' ' BUILDING� "' '' � 1 ' � /I/e ? I 'PING. REF.'�p � - � � i .. " � I ` . � � Address, - � �V L+L -SQO C � . .� OTHER � ra� 7 �" I . � .. / ' : — ' , -,. i `c . ; . , . _To eui�oiNcr i . � . _ . ; . . � ,� M ' ' "� S `PRQIECTDESCRIPT�ON� sq F7. - � � �-� • �' �pCCUaataCv '' �� .~� ' � ! � � PR PE TV I E ' � LREAR VARD (TO P/L) � � " i - ContractoPs Nam - �ne � Addresslmeiling) � Q- �� ^��Ei- ' CONSTRVCTIONTVGE � � " : � �'VA�LUATION$ . " !LEFTS.IDEVARD ` � flIGHTSIDEVARD �*' . � i m �-c I ' � licenseNo. O C� '/ -� � �IR �ZON� ' � � � GRADINGCU.VOSC' � ACRES � � PKG.SPACE�REQ. )1 �PROVIDED ^ � ` � � L`ICENSED CONTRACT 'DECLARATION � � �„ + 'f � � Remarks: � .� � � � . . ' � ' � I � j , ' STREET WIDTH t , ' � qK FEE $ 'r � - ( �= �� 1 1'hereby afflrm that �Pam IlcenseG untler proWsloni oT Chartar.9 (commen<Ing . ' • ' ' � � , , , � ' wltli section 7000) of Divislon 3 of the Buiineis antl Protes{Igq(�pp��ytl � � ; i �`� { . � � '� i � ; � ' � SPECIAL CONDITIONS: � • �� !�'. � my Ilcenie'ISIn full (orce antl: tac � . ']«•bC�y7'� • � , , � . . . . . . . . ucan'se iass' � -� Lice�s� o. � � � ' � ' � PLUMBING ; '� f '• ' � � � � ' � {k�.� � - _ 519natura.. , � _ ! 1 ' ' i i ' � . • t�' � "�IKERS' COMPENSATION DECLARATIO ' `' • � � Ber Siak . $ew2� Cep ' � � i - - '. ; . ' ELECTRICAL . � � � „ j : . � � � _ _ x z8byaffirm.tltat.l �ave.a Certlticate.ol.mnuM�tO sElNniure or a cartlfl�'ate...i.. . " ' _._,... � _ .,_. _ ' .,.-__ ___•,. ,.,. . _� . __, AutOmatiC Wa5h2r_ „ _. __.. ,.�_... _.M2tEL �Ov¢r 10Z1 amp5; � � ` ).. , 0* Workers' Compensation Insurance,'� or a certifle � Y the e -Sec ��`I- Backtlow Preventer SBwerConnE[tiOn i � 'f""' , . . -i �, , . . ' Backflow Irrigation j { Solar Collecton i � I . . � ( � Sub PaneC ' ; � '�� , � 3800, l.ab. CJ � I � �� • � � ' ConstrucUon Pole ! , aoli<r No. li��-S� j''ComPanY � I ' � - ... -. - ; ; � Cooking Umt ! 1 i �Sub Pole i , l. ' � � � 8 CertHleC-copy is hareby furnistietl, y , '�: ; � f � � � BBthtubs , � � $ple� Piping ( � � � � . , . i � . � Certiii tl copY is illetl wiM the city Builtling Dlvls9n I � � j • , i � � - � � � Dishuvasher � �Motors .�04 HP ❑iK$ � � '_ .Date APplicant .. , -_' . 1_ � _ ' _ _'. °k i' _ t ' , I . '. , . _ . , � ' . F . ' � � _ .'_ . ., Oishwasher i I Swimmi �-� '_ "' � ' � � , . . ...� . . , .....,..• •- .•. . . � .- i L'LU Clarifiers _ J So1ar Ta EXEMPTI ROMWORKERS'COMPENSATIOND ARATION • � - . � �Dryers ❑Ga5 ❑El2ctnc 'InC.SOlar�'�9-15HP �i6-05+ _ � - 7nlsuc n need n e com letetl Ii , ' , n Pool w/S a � � 4 ( p permi[ I5 f on �untlretl (S10 r � t 9 P� ' ' less)° i � i : ' � ! 1 � 1 • ' � ' - . � . ; Fan' � I t �MicrowaVe I- � i I � I ce� y�that i e perto�Tdnc f the wo�k f dich this perm ISiuetl 1 Dnnking Fountains � ,� i Uflfldl_ � � � ' � � . � . : i v : , � sha not em y any perso any mann o! 5 to b om Eje<[ to ti�e I � ' ' ' ' � i � � 1, , W rker ; penszHon� s of CaliTor � '� Fluor D'tain5� � � I � � . � . F�A�� j , ; Pole,Li9ht . - � { ' ' i , Water Closet � - � ate', . 519nature ' ' ' ' ' ' ,_,I.___! IW,,,_ ' -�. _ • � •' Fixhres.'_� � ' 'Ran9¢..-� �� . NOTICE:df, after making-this�tleclaratlon u-sHo �d�becaT - �bjec[ [o-thB`�1 �`r Floor Sinks-�� -. Water Heater - -j - �- �--� - �- �— . -. --r-� • -- y- - �. --I - - - � i � Workers•. Compenwtiom provisions o( th iabor Cotle, you. uStAorthwith '' 1 <omply 'wlth� such ,provl5ions,or' MIs+DermR lSpall� be itleemetlj revuketlr � � Ge55efVlCB� � 'OuUets � - .Water,Service +� ��'� - � - ' { DeViCe BOxes � � � � �Signl : ' , � ! � ' CONSTRUCTION'LENDING�AGENCV' `" � � � � j �' { � � � ' n ' � � � OUtletS ' � � • ', 1 �ereby aiflrrim t�at thera is�a�construction lentling a9e��Y.for the{performance � Inte�cepta�S � .' � �T i ' ' ' � � � , � �S[anding Sections � � � � � � � 07 the �work fbr� .wl�ich� [hisj permit -Is �Issuetl� � (�ction :3097' Civ: CJ; � _ � � ' � ' ' � ' ' � � . � � . .: . • � � Lender's• Name_ - � � ` - ' �� " ' � � � - �� r . � '� ' � � � Switches � r ! Trasfi Com actor ' � I - ` I": !> ��. •; 1 u: i '� i. �� I Kitchen'Sink .� � c i . t t I � � , 1 . t i P , t ' � �Lnntler's AtlCreu� ^� ; �, _ w i -. �_ : � Garba eDi Oul � � � � � � � . � OWNER'BUILDER DECLARATION � � � � t ..' + � .y '� �, � LaVatOrieS.� � i f y � � � '- . . � 1 : B SP ' . : t � i i � � I hereby;affirmShat I am'exempBfrom the.ContraktoYs Litensa Law forthe � .. - � i ' � ' + ! i ! � � � . Generator, 00=5 KW �5-15 KW � following reason:(Sectlan.7031:5 BuSiness antl Protesslonal�Cotla: Any tlty oi ^ P Ttep� ' � � � � .� j � < < ' � 1 ' . . � "' i � ; � county wnlch requires a permlPto construcP, alter, improve, aemolish or'rapmr j � ., - _. _ _ � � ' Transformer � 15-50 KW 1 � struthre; pAor to its;issuan<e.'also raquires the'aDPlicanbfor such permlt, , r • Roof Drains: �' ? l • " � ` ,- j � i � � � I � ` � 1 ' 'le a si9natl statement'that he/she is IlcensaE pursuant to the!proviLons of � ' ' � ' � I "`�''ontractor's IJcense law,(Chapter 9 (mmmencin9'�+�th $ecHonJ000) of � ; .S � � } - � . 1 --. . � f � ❑5U+ KW! � � � iReinipact�on Fea 1 • � $15' ��•:':lon �,3^of the ;Businesr antl� Protessionz' Cotle); or tha[{ he/she`i5� exemp[ �- Showe�5 ^� �_�5 . I �; � � Reinspection'Fe` � �$75 . , , I ..}efrom antl the basis for the allegeG exemption; MY_vlolation�of;5ectlon '''. . ; ' ' - ; Met2r �up t0 100'amps � ,ISsue FeB 7 � �� 3 ��7031:5 by-any applicant for�a:permit-5ub�ects��he�aOPlicant to a.civll Service5ink µ� 1 - -- � ��enalty ot not more than five'�hunAreG tlollars (E500)'. , ^ � ; - , j �, � � , � ` �- I� � laue Fea �� $ 3 2oning Approved By ' � � , � � Date I;ies.owner otitha property or•my employee4,'H�th wages,as their sole ' . . , . '' i � � , compenwtlon' wlll.tlo the work, anO�the structure��s not IntentleG or otferetl � ', j�- � S�.: �� MECHANICAL I i � �� .-' _ ' ' Appliption Approred By � � Dete �for ule'(Sec{lon 7044', Buslness'ane�ProteSSlonaL,Cotle::ThelContractor•s � � � � � ' � , , �/�J - � � � License Law Aoes not apply taan owner of a propeYty.who builtls or improves ; BoilE� • I�n �� i�� Retrigeration Syscem : � f ppP��mtion Is4ued By ', !�� -' Datd �� 3i"�� thBrBOn,�dntl wh0 iJoes such'wo�k hlm5elf/h¢�Self O� th�0u9h �I5 or �er own � � .� i " � ' ' � � . . , � ' employeas, provitled that such�lmprovements ara;nol�intentled or oTTeretl for ' �- '^ i ❑0.100,OOOBTU ❑100,OOOBTU� � � � safe. H. �owever, tha Eullding or improvement Is solG within one'yeanof com- � � Duo{= Under:Ground � � . . � ' . i ' . � SUMMARV OF FEES i ` '� i � � � � pleHon, the owner,will have the burCen'of proving ne/sha tlitl not bulltl or Im- f � � � � � � ' � � ' . '�rovaforthepurposeof.salep. + : , �.:y � 1 ( F , . ( Duct-Structural � ; SystemRepair/Alteration � 'BUILDINGPERMIT $, ' ; SMIP � � ; $ , � LJ I, as owner of tha proparty, am exUusively con�racting:wlth�licensetl <on- � - , - . , � � � ' � � } '� tractorsto construct tha�orojact,(Section,7.044„Business antl�Protesslons,Code: . : , Duct„ Ventileting _� 1 ,,.,,'y� ) „_ ' _ .,' _ _ � _ � �PLAN CHECK� t $;. � ' � PEHMIT j . �The Contractor's L'Icense Lawitloes not a I to an owner ot ro ert who ' - " ' � . buims or� improves thereon, antl[who contracfi�tor such prqecs with a'c6n- � i Exhaust S�stem ❑ Multi le �' ''� � ^� � !PLUMBING j $� �� . ' ISSUANCE i$� � t [ractor(s) Iicense pursuant to tha Contractoras LlcenSe Law) , - A� r., ! • Y • • P • � � � � � � � ' � � � I i i � GRADING ' � $ � ' - � � �pam azempt untler� ' ' � � ' . �PLAN CHECK� � , � s ` � Section .` ` ' , _ � e. & v C tor this reason ; i Firepl/Fa[t: Blt. ICBO � j � t � � j � . i� $� � � _ , � } $ � q '� ; � r, ' • , � -- . . . , � iELECTRICAL' I $� � , � Date ' �� 1 • Owner r�� - • � �� '� � � � .HeatirigSystem&Ducting � � y � 'I ' I 1 � � � f � � MICROFILM � $ ; � f S-I-hereby certity�-that-l5have•reaA•this•a ' � }•-;� OD0.100,OOO�BTU-0100;0006T '� ��"' �-- , � 'PLAN CHECK� 1 $+ ' � � pplicatfon�antl-itata��thaf the•atiova�;� . Intormatlon is correct. I agree to comply wit� all dty�antl county ortlinances � . r l ; . � . • < ! �' 1 � 1 7 TOTAL!FEH -�$ ' antl�state laws relaHng to builCin9 <onFtruction,�aNtl hereby authorize rapre- � , � , :MECHAN_ICAL E $ C � ' j . ` � � . � tentatives obrthis �Uty•to entar �upon the above-mentionatl propertyi for i f � Hood�or Type I ❑� , � � qeinspection Fee � $15 ;pLAN CHECK� �� I ' ; LESS � � 1 � ' insoection o�uJDosas. �.�// � �� 7 � Cano � S e I I ❑' ?' i . . � t � $� ,` qDVANCED PC i$�� I 519riahre 7` /hN� L"/ .LOC/0 L� Date ��•�' )' I l � � . • � � y` Drivars' Llce�n4e or 55 5, �`� � i 7 � Registers f � j ? laue Fee $ 3 i � � � FINAL FEE � $J� ._._._ ' ." �_:__�_-__. _'_' _ - "_. : _ ' " _.. .. _'... . � . � . � . , . • . CMF 0865-46 rev. 12/82 White - Bulltlinq; Canary -.QPPlicant; Pink - Accounting; Goltlenrotl -Assessor ' /' , . : J.-� ; . . . . .. , .,� - � t. % � ._ _ _ . . _ _ _ . _ _ . . .__ .. . � . _. . �' � � � '� � -� s . _: > - „o- PGw -t', SPA ^„ '-t . _ . - .n o. _ . = t ; ; : .,w (7 �. '• <'CONSTRUCTION.AND;PLAN ING � ':. � '= f . i� ••, : n , _ ' < � E- 7 � .Date . Inspector ` � ` ' � �.,' � ' � � , `Date r �Inspector � n -��APP;ROVALS Permrt�#�� ` . .-APBROVAL$ Permit,# �aYi R -m - 'Y�.>u � a., _ ` c _' n t. Temp"orary Electn�al Service or Pole � � : " • `� n;> - . '^ � .�52-, Pool &`Egwpment �Location�; < < ' � 7.�;b 4'C - ^ " 2! �Soil Pipe-Undrgrnd� �' l F p'._ �� c,� ' �Q f.Y� ��53��Steel Reinforcement ,. �' � Y' �• � , 3:�lectrical Conduit Utilitv-Undrgrnd-� � `� � _ �� .54. Forms.°° � ` -r�! , 'y1 ' "� �. � 4: Electrica�l Conduit'Und�grnd >_ • n, � 4�. � S '55r� Elec[rical,6onding'- a•>• ?� �� 1, . i,�� ,5: Steel �Reinforcement ' ' �:; ` � :; � �. � ` ,; ;; '/ ,56 Rougfi Riumbing,& Pressure�.Test �: .:� %��.� ,fi_C C; i i �' � i , , . ....+ - " .- - „ - ' . ' -. . , ' 6: �Electrical UFER Grnd' � `• '•' � i� � ` .57' APP,ROVAL-TO;COVER-GUNITE, ' `' ' �� `.q�. '✓. � _ ' c � 'i 7. Footings � , �il ' � ; � c. ` '� ��+.' `' � � i << � �-'58. Electrica��Go�duit-Undrarnd - � �' � : z' �► a 8. �Foundatiori _ ,.- I �t ( �' � f' � . �{ °; . .�59. Gas Pipe O.�Und�grnd Test`: _� . �C 9. N/ater Pipe-Undrgrnd.: � :: � � � � 1 � `- . �,rgp. Backwash Lines, P-Tra`p; O Undrgind..' ' � ��, j - v 10. Structural Flooi,System . �'? "a '�,' 2';�' � �61. APP,ROVALTO'DECK � :,;: � � ��` _ = 11. ,Property SewerlLine &'House�Connection` .'; k {� �': _ :�62. Backwash _&-Receptor-Final,: ,,,� = _ J " - � � � ,� - . 12. Sewer Cap � ,�( � ��'� � �`.",•+'� l �+ '0�63. Heater &,Vent-Final �- � 1� +�-;;�: r. t.� 1, =�.$$3 C� 13. Roof Drains � ' ;�' : t' �. �,;' �';��I ` �,� - ; _64. Plumbing:SYstem ��•FinaRr.,. ' .- - � � _ 14. �Rough Plumbing. .�� ' � ' ' � ' • -a� 65. Elecirical=Final= =`- ;. - � . . -. _ . ... �. > 1Y " e 15'SRough'Electrical=Conduit'�'n: �-' 'j"--"; "�""�- ; �' - ; 'T "� �66.; Solai,System-Final� � �� ` �+� � �!T- (1• ' P' ! • � 'y ��,-16. �Rough Elec^[ric Wir� g' , I E I .i �';.'l (� � u i :'� � i :^ �� ,67�Fen'cing & Access�APProval'-=..' -� � - _ ;�:1�y�. ,-�Cr� - - ` � 17.' Rough'Wi�r;ng-Sign�' `, �n � " � , �„= , � � �� '; i :� ; t � �, '68 APPROVED F,OR,PLASTERING �, ' i �' � ` ' "�' ° =. � 18. �Rough`Electncal T;Ba� Ceiling` � i' � _ _ � � { � � � �69 I POOL/SPA SYSTEMS F1NAL � • 7�-�-&3 � � CC' � 19. �Rougli,Heating &�Air�Condrtioning � � � �' � ; , � � � I � j �FIRE DEPT. REQUIREMENT. � � � � `� � � � . .; , , f t i ; . , , � � , I 20. iRough-Factory Fireplace � ' ! � i � ; I i � : APPROVAfLS� ( Permit,# a' �� ' _� � � I ! � � � � � � _ �i.' o-. . .. , . . . , � � - , ; 21. ;Ducts; in Stiucture� `� ` � � � �, � , + j i . i 70.I ,Undeiground Hydro �� ' � � � ' � ; .i� � �� .- � � � , � i t ' � �- 1 ! t ` � � �' . : ' t �.x22>;Ducts,Venfilating'. ;n� I " � � � � �77.�ProductPipingOGas ❑Oil i � ,-;, � - . I ,. -. ; � : ... , : . • - - � �-- � . � -; • � , �- _ � . -�--.- ---}'-- -�- --�---� - - r - - - : �,23: Gas�Pipe-Rough & Test ; � ` kr �; , i �72.� Undeiground Flush, �n . � ' ' � , �; '241��Roof Framing'� � � �� j� ;�� - � p; � �,' c •'' 1 ��' i -F (�� 3.� Undergrnd. Storage Tank,O�Gas _� OiII � ' j � + 25.'Roof Sheathing � ' ' y I �;�- ' ( � o� � _ � ' ' � i74.� Overliead Hydro � y � � F � � r m ��' 26. T-6a`r Ceilirig ��Str�uctural)� & Monocoat' I - ( ; � � `i ; f _ � - .75., D"ry Chemical � o_ � ^ � ' _ � � i ' � ' ; ��..27.'�Frame and Flashing� � � � � ' '; I = � '� � ; � � ,76.� Dr�y"Standpipe j ,'- � ., , - ' , � � '� 28. NLathing & Siding, � �.� 1'•� �� 1 i � - j 77.; F�IXED SYSTEMFINAL ' �� ( � ; � �� . ,�r29;;lnsulation �; ? ( : " n � . ; ,: � � � ' I ' + i ;7g; FIRE PREV. FINAL �. � '. { � � ' �� ' f � � { ' . _ . . . . . i - � 30. IDrywall Nailing � y ! � � � ! � INotes: i � t 1 ' � � � � i , ..� , _ . � 1 � . � = 1 • i .�. � _.. _ _ ' �_" "_" ' _ _' _ . _ . _. . L � r ....;. • � . ' . � � ;� 31. !Pleste: Brown Coat � � � � ' � � ! � � , � . . � ; � � i.n N . . � • � � . . ; , , � . . :�32.:Electrical'Power MeterFinal i ' � � � } � t ? �� ' � � � � � � • i 3 �� i i i. i i . . . ` 33. �Final Electric ' , . I � �-_ � � . � ,i. . I - � .� : �' � � .1. . J. � � � � � T - 34. Final Heating &�Air�Conditioning . � ...I , _�... ^� � � Y � _ `wl , i �y - � t ;� ` ,. � � - - - - ,' ^, - ,�; . - �< �� .. !r; ' -� . . � _ , , _ �v ^l 35. Finai Gas'Pipe=Te'sf� � �!. ,: � -� r '?> � , _ � � � ,; _ . • 36. Hood or �CanoPY�>: � t a ' :l ' � ' � _ � ; , i n � :} � . � � ; - . - i: : � - - ; . .' .. ' '1 {. l '� I t. 'C .� . 37. Final Factory Fireplace�� } �_ � � � j : ' �- � ' 1 �� , , } a �' � : . . �� `� '� ,� -' . . 38. Final Plumbing : j ! � � ! : ' � � � � � <<_ . ' 39. Water$e�,vice-Final. � . -`} i � ::� ' , � ' t � � i � � � ' �' ' ' ' , ' b u, t. •�.i%!. L i � �'- ' � 40. Gas Service-Finsl • �•'. ,E �� ' � � ' i j . � � _ � - � ��r ,j � , .. �- � � . � . , � � � .• - - . � 41. Solar pomesticFinal • -�. - - r--+ - • L -t- �- -- - - -- � - - _ �,�� ! " . . � . : '.- � �' � � :, .� ; 42. Backflow Preveriter �,�.''�. `-.-�.I �..I, - - - i -- _ - - - i � t _� �.` _ , . . � /' ��-" - � . y. 43. Backflow' Iri�igation� � � { � ' �` � - � � - - 1 � . � � � ' •' ', � - .,r,', � , . ;' ;,, ; �. ; � ; � .:. ', � . - , , ; . 44. L.andscape Irri9aiion:SYstemF;.�. � �� ' ' .; ! g i �� f"�?, � ! �L ° �� I E � � � � � _ ` *� . ' . :..,�_, ... . ;f. iy`. . � c. . � 'I :} '" .,� ; � '?� - ii 45. Sound,'Atfenuation � ,,_ I y' � '' ; � ' : : : �. i _ � � � t j ; , ' "� _ r _ 46. HandicaP'Regulation"5�. � T' � � � ' 1 r t j i i � '� ' � �, i . i, ! �u' .; ', � - _ •, m � 47. FINAL STRUCTURE & BUI�DING ' ? ��_- i -� � � � ; � � '' �� 'i , � - 46. Special Requiremerits Cortipleted t; � ; � � � r�' ; � � � � ! � ' � ' , . • . • • . 3 11 � 1 I t � .� � � t ��w' ��'� r 49. Electric Release�to Edison' ; ' ' � ! � �.� � t... � �.� � � � ' � � - �'� �. �� - �� ' ' ! . � • � t 1 � � i' ' I I �"_'1��-�t" j y_ i 1 � ` • '. � 1 � � 1 � � • rw � . , �� 50. Gas Release to Sou4hem Califomia Gas Co � � ; ; � � } , !;� . � � � ,� „ � � � 4 1 L. t 51. CERTIFICATE OFOCCUPANCN �4 r .�__!-�__ � _y�r._t_ *_1� .1�1__T_� _�.;�.�T' , - � ; , � ; No �. tl i � ' Date � I ( � � � I � i � .. .�' � �. :�_ _ r.�,� �L� �.�__i_� y-�;. - ��r.:�;�� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applican[ to Fill in Comple[ely — Use Ink Only ADDRESS Tract 1027'j,�� OWNER McLain Development Co. MAIL ADDRESS 1470 Jamboree Road TEL. cirv Newport Beach N�� 640-68 CON5TRUCTION LENDER BRANCH A�DRESS ARCHITECT �_�t;_/��_..__o..ae TEL...�m rr. APPLICATION .('A�-0 RECEIVED BY �ATE F 1-1 A.P.NO. ��07��0 BUILDING 3y5/t ADDRESS TRACT ],O2 NEW ADD ALT R R P. OWNER MCTain lia� FIRE ADDRE55 661 S ruce S't.. E Oi't Q C ZONE �T APPROVED CONTflACTO BV ADDRESS 1�{ 0 amb r ZONE NO.OF CITV Newport Beach No`b4o-680o OD�/40 "-4N5 F STATE CITV 1'ARDSAPPROVED � ��. No. 273g75 LIC. NO. MAIN BUIID 6�i 1� (FROM C/l STRE 0+ OF LOT 45 X IOO NOW ON LOTS FRONT / F� a USE OF � EXISTING BLDG. .S� F � FSeparate permits are required for L. SIDE � F� ,� electric, plumbing and heating work. REAR ID F' USE OF BUILDING AND WORK TO BE PERFORMED DI5TANCE eET. MAIN BLDGS. � VAF. # aC.U.P.��, . �y New house A�AQVED^� l. � W HOI.� � I hereby acknowled0e that I have read this application and siate [(� that the above information is correct antl agree to comply with �+ all laws regulating builtling constt�ction, antl I shall not employ Z any person in violation of the workman's compensation laws of W tha State of California. 3 I hereby certify that I am properly licensetl as a contractor under SQ. F the State of California Businass antl Professions Cotle, Division 3, THE AMOUNT enapxer 9, and 2ha2 such licenses are in full force and effect, or 1 THE PURPOSE ( am exempt from the provisions of the State of Celifornia Business VALUATION antl Protessions Cotle, Division 3, Chapter Signat�re of \� ,� � � - (y � -- - / Permittee 1�f "L /d�� $ 52,700.00 Autho�ized A e t 0 2/2'.I%79 2%2'1779 PERMIT NO. VALUE 293•14 TG 293.1'9CKTD � IA'_ . _ VSE OF NEW ^�S BUILDING �� YAROSAPPROVED ACCESSORV BUILDING BET. MAIN ACCE55. BI DATE �R rc�.lHV I(c.�1U11CGMt. -IJ n m i � / N VN UN�EF VALUATION IS FOR m 'ABLISHING A PERMIT FEE ONLV: b PERMIT FEE $ oo m PLAN CHECK $ L O o V .6 LL TAX $ � Z TOTALPAID s �93 ].C)