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HomeMy WebLinkAbout2817 SHANTAR DR - Building Permits • PROJECT ADDRESS: UNIT: OWNER'S'NAME: 2817 SHAN TAR DR CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05938•.2 ADDRESS: NGUYEN,. KHANH �. NGUYEN NGOC T PERMIT NO: B 059382 PLAN CHECK NO: N GOVT: N SUPP; N 2817 SEIANTAR DR , COSTA MESA, CA 92626 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT r' ARCH/ENGINEER: REG.NO.: - T VADDRESS: UNIT: JOB DESCRIPTION : REROOF SFD & ATT GAR. ( "EAGLELITE TILE" ) SQ FT: 5, 000 ' PERMITTEE: CLAIM VALUE: 5, 000 . 00 CALC—VALUE: 5, 000 . 00 GROUP OCC; R-3 /M-1 ADDRESS: KHANH NGUYEN ( 714 ) 546-1543 r�r �y 2817 SHANTAR_ COMMENTS- SMOKE DETECTORS REQUIRED PER 1991 UDC! ! ! CC� 11Ff� CnSTA MESA CA 92E26 ********8f**** ************** ******************************g t: * ' xDE'tFEu ,+ r. LICENSED CONTRACTORDECLARATION:MESA affirm that I am licensed under provisions of apter 9(commencing with Section Z V N I N G R E U I R £ M £ N T S �'•'O�� 7000)of Division 3 of the Business and Professions Code,and my license is in toll force'and effect. Q CITY LIC.: STATE LIC.: CLASS: SETBACKS REQUIRED Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm/hat I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section MOO.Lab.C). LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV: PARCEL: 13940238 ZNE; REF NO; 3 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> '_ _ Date: Applicant: *******!E%**d(##lE***********7(-***iE***#-lF***3EiE#************1E************4li')Eif******9f..1(. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Thissection need not be completed if the permit is for one hundred($100)or less). D EVE-."10P MEN T SERVICES REQUIR E M E N''<t S I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become t.:4;-"- subject to the Workers'CompensationCoC� Laws of California. ({.. Dale IO-6'-9!/ Signature: \.r%a . /. ZONING APPROVE1? BY • DATE: ,. NOTICE:If,after making this declaration,you should become blest . the "o ers'Como aeon provisions of the Labor 1 Code.,you must forthwith comply with such provisions or this permi shall be deemed revoked. BUILDING APPROVED B Y DATE: 7i'. _ CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for - whichthispermitisisssued(Section 3097.Civ.C). APPLICATION ISSUED BY: —4.4..4 �/ DATE: 15:449 ***********************#* ve*ions¢* * ae#***it* *> K4 A*#joie*********3F**-itk3s-n it* **# ADDRESS:LENDER: #******#*1f*!F*****#*****#*******!E*****#******** :******##*#*******#ik*4#*****1!•*** LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: Y ilOWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RESGRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT 7 2 , 0 , 5041 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NONE;RES -, and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE /'f I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID 'I DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law — 72 . 50 e does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through TOTALS—— —> 0 . 00 0 , 0 0 72 . 50 7 2 , J 0 .00 his or her own employees, provided that such improvements are not intended or offered for sale If,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED • 72 . 50 OVER/SHORT: C00 for purpose of sale), BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING-WLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 72 . 00 . 50 .,/ ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon . /� and who contracts for such projects with a contractor(s) pursuant to the Contractors'State License Law). I am aware that proof oltheir Worker's Compensation insurancee should be provided to me. *******K*K****lE**!h*******#**#************#*#*ik**kt*#*****#***aii**#**********K##** am exempt under Section: B.&P.C. _ INDIVIDUAL F` E E B R E A K D O W N L Qfor this reason: BP7044 /� ,ALL WORK BY OWNER FAMTLY TYPE QTY DESCRIPTION UNIT COST ItOTAir COST ---1 Date: /O -6 L Owner: I do hereby certify that I am aware of and understand the requirements of California, ealth dtafety Code Sections 25505,25533,and /FR 5000 REROOF BY VALUE RESIDENTIAL N0Z0NE 1 . 00 1 5, 000 , 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a ,i END OF FEES /C'• permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisi0ns. H EXPIRED :� Date:_ Applicant: 1 I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county I Mete II ispectlons r ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes.pose /���s,'�'—� c. '/ A Date: I0—O— /f/ Signature. Se/n/ Sig AP_ .r/43• 011501:4'y.J5-2._i7 .=. ' — . ' rte` Driver's License or Social Security h: ( (WT.• 141'4-J6 1 1.11 -.0 r_ '�"'^ emltlin :Green—Code Enforcement:Canary—Aoolicant:Pink— 1� qRevenue:Gottlenrotl—Assessor • v l . CONSTRUCTION AND PLANNING - . POUL & SPA Date Inspector Date Inspector APPROVALS Permit # - - APPROVALS Permit # • •1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ''h- '; 2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement `7 3. Electrical Conduit Utility-Undrgrnd. ' i.^ 54. Forms , ''.:%;". j,'.1 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding - ' 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE r - 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation / 59. Gas Pipe, 0 Undrgrnd., Test ',%, 9. Water Pipe-Undrgrnd. .---).-t-- 60. Backwash Lines, P-Trap, OUndrgrnd. --V 10. Structural Floor System 4/ 61. APPROVAL TO DECK I 11 11. Property Sewer Line & House Connection /� 62. Backwash & Receptor-Final „-e'' :r 12. Sewer Cap - l 63. Heater & Vent-Final ? - 13. Roof Drains is\ 64. Plumbing System - Final. . �i 14. Rough Plumbing 65. Electrical-Final r'I ' . 15. Rough Electrical-Conduit 66. Solar System-Final I ' 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. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # ';y 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil - �'r :4 23. Gas Pipe-Rough & Test - 72. Underground Flush 24. Roof Framing • 73. Undergrnd.Storage Tank 0 Gas 0 Oil . - 25. Roof Sheathing Wii. /VP-- 74. Overhead Hydro /'26. T-Bar Ceiling (Structural) & Monocoat75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Sidingi 77. FIXED SYSTEM FINAL 29. Insulation , h I 78. FIRE PREY. FINAL ' 30. Drywall Nailing l HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat i 79. FINAL INSPECTION 32. Electrical Power Meter-Final i :� 80. FOOD CERTIFICATE ISSUED 33. Final Electric '/;, Notes: 34. Final Heating&Air Conditioningf- • 35. Final Gas Pipe-Test 1 ' i . 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing - , -, 39. Water Service-Final ill 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer . • 43. Backflow Irrigation 44. Landscape Irrigatio ystem ...r 45. Sound Attenuatiort j 46. Handicap Regulatio4. --L- -.47. FINAL STRUCTUf2EI&4BtIILDING p-(2,ca 64- �` 04 _a_u_ _ 48. FINAL PLANNING;^' --.' 49. Electric Release to!Edisop.,, '/, 50. Gas Release to Southern-California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PRDJECTADORESS: 2817 SHANTAR DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: IB 064855 OWNER'S NAME: NGUYEN, KHANH •• ADDRESS: NGUYEN, NGOC T PERMIT NO: IB 064855 PLAN CHECK NO: N GOVT: N SUPP : Y ' 2817 SHANTAR DR COSTA MESA, CA 92626 CONSTRUCTION TYPE: 5—N PERMIT TYPE: OTH STR PURPOSE: ALT M ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REROOF SFD & ATT GAR. ( "EAGLELITE TILE" ) SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC : R-3 /M-1 PERMITTEE: KHANH NGUYEN ( 714 ) 546-1543 ADDRESS: 2817 SHANTAR COMMENTS . FINALIZE EXPIRED PERMIT #859382 COSTA MESA CA 92626 ********- ***************************** _ . *aE+Fac;LacTE******aFacac**aF*****+C*; ******xxac LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section \--....„, .' v G R EQU IR EMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. S E T B ACK S CITY LIC.: STATE LIC.: CLASS: Date: signature: MAIN BUILDING ACCESSORY BUILDING Dale: S'COMPENSATIONOECU1RA710N: I Signature -insure olio certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN Compensation Insurance.or a certified copy thereof(Section 3800,Lab.Cl POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV; PARCEL: 13940238 ZNE: REF NO: • 0 Certified copy is hereby furnished. 10Certified copy is filed with the city Building Division. PLANNING N TES> > Date: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY • DATE; • Dale' ��— /C) 7 ' signature: rt c�' (2 BUILDING APPROVED BY NOTICE:If.after making this declaration,you should bec a subi to the or per(Im-provisions of the Labor DATE; �r Code.you must forthwith comply with such provisions or this permit shat a deemed revoked. \A\ CONSTRUCTION LENDING AGENCY: Ihereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y ; Q DATE: I I lie"(CI 1. which this permit is issued(Section 3097.Civ.C)- **'*'*'**'>F'x'**************************************1F**********************,***#****** LENDER: *********************************************************************-********** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES ' GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct.alter,improve,demolish,or PERMIT 30 . 00 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Codes or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID ,: . DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTAL S----> 30 . 00 0 , 0 0 0 . 00 30 . 0 0 30 . 0 0 0 0 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale. If.however the building or REVENUE DIVISION TOTALS--> COLLECTED: 30 , 00 OVER/SHORT: . 00 fortheepurpose sold satejhin one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/TOT GRADING PLAN—CHECK for the mentis of sale). 30 , 00 I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ******************************************************************************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN d I am exempt under Section: BP7044 B.BP.C. Lor this reason: ALL WORK BY OWNER FAMILY / TYPE QTY DESCRIPTIO N UNIT COST 'TOTAL COST .�.] Date: //'-'10-73 owner• eel( INS 1 BUILDING RE—INSPECTION FEE 30 , 00 'i o 30 , 00 ' I do hereby certify that I am aware of and understand the requirements of California Ith Safety C de Sectio 25505.25533,and END OF FEES • 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a r permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions...._ rovisioon_s. /�y—� '�' Date: /F Applicant: I hereby certify that I have read this application and state that the above infor tion is correct.I agree to comply with all city and county • ordinances and slate laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. 01 00150453-001504`3 TOT ,�7 Date. //` / /V —93 Signature: .EW -. .�_�_ DATE: 11/10/93 TIRE: 14:46 30.00 Drivers License or Social Security t64t-46 White—Building;Green—Code Enforcement Canary—Applicant:Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL & SPA "APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location 2. Soil Pipe'Undrgrnd. 53. Steel Reinforcement • t, 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6, Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit•Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test • 9. Water Pipe-Undrgrnd. " 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System • 61. APPROVAL TO DECK I • 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final ;i 13. Roof Drains 1 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 Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning - ` - FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace • APPROVALS Permit # 21. Ducts, in Structure 70. Undeirground Hydro 22. Ducts. Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe•Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation - 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 1r _ 38. Final Plumbing 'gyp 39. Water Service-Final } 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System I _ 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE& BUILDING 1«2,_Q7 a'wo_. otcV a / �ft e� 6 48. FINAL PLANNING 49. Electric Release to Edison C, 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: UNIT: rt NER'SNAM : E 2817 SHANTARKANDR CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05644: e -�' NGUYEN, KHANH ADDRESS: NGUYEN NGOC T PERMIT NO: B 056442 PLAN CHECK NO; 00803-92 S GOVT; N SUPP; N 2817 S3ANTAR DR �� � COSTA MESA,CA 92626 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT 546-1543 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : EXTEND EXISTING WALL SQ FT: 400 ADDRESS: UNIT: PERMITTEE. r CLAIM VALUE: 400 . 00 CALC—VALUE; 400 ,00 GROUP OCC: R-3 / ADDRESS: KHANH NGUYEN ( 714 ) 546-1543- 2817 SHANTAR COMMENTS: NO OTHER WORK PERMITTED C.M. CA 92626 ****+ ***4****** <**+c*"K**;6**** ¢*>r}t**>Ex* *x****>EaE*-roc*kpk *x;6* *>E#* * ****k******* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I ant licensed under provisions of Chapter 9(commencing with Section Z O N I N G R E Q U .I R E M ENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT; FT LN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING RE • PROV; PARCEL : 13940238 ZNE: R1 REF NO• ] Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING N TES> TI go AN EXISTING RES, TO EXTEND AN INTERIOR WALL 5 ' TO > ADD. A BEDROOM. Date: Applicant: ***3F****1F*****KTE**#***IF1t********k*?EiE**FE*M*****1F* ****,6*1E#****)/.**B6*3F**Ii-}**3iiy.}*k* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). D E V E L O P M E Id ,T SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become , / subject to the Workers'Compensation Laws of California. ZONING APPROVED BY ' DATE;'J I'+ 1 S.L_ Date: Signature: NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; 7 S� N- DATE; 3 (L (q '--- Mitch this permit isissued(Section 3097.Civ.C). ******************.****3k?+-ir ?,* i3t-ti-******it * ************************f* .*7-R. . LENDER: *******************Ic**** **************************i'i*******ii******Y.3F*********NF* ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT ic , OO 5 U pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/ —RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 9 . 75 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE I, as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Q structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS—---> 15 . 50 0 , 00 9 , 75 25. 25 25 , 25 .0 0 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale. If,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED: 25 . 25 OVER/SHORT• , 00 tor the purpose of sale). BLDG PMT PLUMBING ELECTRIC ,MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 15 . 00 . 50 9 . 75 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors)license pursuantto theContractors'State License Law).I am aware *.,c**.**.*..T(.*.7(.ee{(.i(.**.**********.*.7(****kih**if*1F***********>********ii**aF************1g**it,g. that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN 0 I am exempt under Section: B.S P C. for this reason://// TYPE QTY DESCRIPTION UN T C � OST TOTAL COST Date' -T�2i owner: ` / SFR 400 ALTER. BY VALUE RESIDENTIAL NOZONE 1 0 400 , 00 I do hereby certify that I am aware of and understand the requirements of California He ih an fey Code Sections 25505,25533.and it END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a !• ` permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from #, these provisions. Date: Applicant: Al P/ R i D �h {,1p 4 I hereby certify that t have read this application an tate that the above information is correct.I agree to comply with all city and county / fell i S 1 ���' slate lawsingmbuiltling con uclion and hereby authorize representatives of this city to enter upon the above-mentioned 19 // �.y_., property for inspection purposes. Ae�#iJpL //'' .•r. r.-. 1' 'o� ' aibtot,,A 01 0010^+93_— Date: 3��(���j Signature. _ A_ 9Q1()'/y3.. T#1`•. _.z Driver's License or Social Security a. 3 '1-.1 �� DATE: 03/r1,�/)'�' MC: 'I�;r3i a (to 1641-46 white—Building:Green—Code Enforcement;Canary—Applicant;Pink—geve�;Goldenrod—Assessor q4 11� f CONSTRUCTION AND-PLANNING - POl SPA tAPPROVALS Permit# ' Date - Inspector APPROVALS Permit # Date Inspector 1:Temporary Electrical Service or,Pole - -52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. .Steel Reinforcement - �} 3. Electrical Conduit Utility-Undrgrnd. 54. -Forms - • =� 1 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 5. Steel Reinforcement - - 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER:GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test - r 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK • ' 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ;71. 12. Sewer Cap 63. Heater & Vent-Final .17 13. Roof Drains 64. Plumbing System - Final. +1 - -•1 14. Rough Plumbing 65. Electrical-Final 2' 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 Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil C - - 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing --).O6Z �(�/�-76. Dry Standpipe ' 28. Lathing & Siding 2 77. FIXED SYSTEM FINAL •l 29. Insulation 78. FIRE PREV. FINAL • 30. Drywall Nailing 7/1 HEALTH HEALTH DEPT. REQUIREMENT • I 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED t • 33. Final Electric i Notes: 34. Final Heating& Air Conditioning -�- n 35. Final Gas Pipe-Test ' 36. Hood or Canopy - 37. Final Factory Fireplace • -` 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer • 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING - , 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - No. Date CITY OF-COSTA ME: 32. Electrical Power Final /'' BUILDING SAFETY DIVISION �• 33 final Electric 1//3/72 /4•1 POST IN CONSPICUOUS PLACE 34. Final Heating & Air Conditioning ON THE JOB 35. Final Gas Pipe-Test NOTICE 36. Hood or Canopy You must furnish PERMIT NUMBER and the JOB ADDRESS FOR EACH RESPECTIVE INSPECTION. CALL 754-5627. 37. Final Factory Fireplace APPROVED PLANS SHALL BE ON JOB AT ALL TIMES. 38. Final Plumbing 151 a ISSU o 39. Water Service-Final TYPE GROUP PLRM��`r `f Z 40. Gas Service-Final �-'7 y 1. l 1 41. Solar Domestic-Final BUILDING ADDRESS �Q 7-EM cAt'-61.,LL �� `'" 42. Backflow Preventer TRACT I LOT ��BLOCK 43. Backflow Irrigation NEW ADD ALTER REPAIR flOVINC, DEMOLISH 44. Landscape Irrigation System 45. Sound Attenuation OWNER 46. Handicap Regulations ( Cyd y.- �, FINAL STRUCTURE & BUILDING k-(y q2 6w1/ USE •T! i1;%l',' ` . "548\FINAL PLANNING \SS.Q �` v6`,a -SD > POOL&SPA SETBACKS \361j ApROVALS Permit# Front Yd. Side Yd. L R Rear -� \ (49. Pool & Equipment Location Side Yd. L R \\ Rear_ 50. Steel Reinforcement CONSTRUCTION AND PLANNING 51. Forms Date Spector APPROVALS Permit# 52. Electrical Bonding 1. Temporary Electrical Service or Pole 53. Rough Plumbing & Pressure Test 2. Soil Pipe-Undrgrnd. 54. APPROVAL TO COVER-GUNITE 3. Electrical Conduit Utility-Undrgrnd. 55. Electrical Conduit-Undrgrnd. 4. Electrical Conduit-Undrgrnd. 56. Gas Pipe, ❑ Undrgrnd.,Test 5. Steel Reinforcement 57. Backwash Lines, P-Trap, CJ Undrgrnd. 6. Electrical UFER Grnd. 58. APPROVAL TO DECK 7. Footings 59. Backwash & Receptor-Final 8. Foundation 60. Heater &Vent-Final 9. Water Pipe-Undrgrnd. 61. Plumbing System - Final 10. Structural Floor System 62. Electrical-Final 11. Property Sewer Line&House Connection 63. Solar System-Final 12. Sewer Cap 64. Fencing & Access Approval 13. Roof Drains 65. APPROVED FOR PLASTERING 14. Rough Plumbing 66. POOL/SPA SYSTEMS FINAL 15. Rough Electrical-Conduit FIRE DEPT. REQUIREMENT (/)--/c Rough Electric Wiring 3 /6ft-✓ l/.l a APPROVALS Permit# 17. Rough Wiring Sign !� 67. Underground Hydro 18. Rough Electrical-T Bar Ceiling 68. Product Piping 0 Gas 0 Oil 19. Rough Heating & Air Conditioning 69. Underground Flush 20. Rough Factory Fireplace 70. Undergrnd. Storage Tank 0 Gas 0 Oil 21. Ducts, in Structure 71. Overhead Hydro 22. Ducts, Ventilating 72. Dry Chemical 23. Gas Pipe-Rough &Test 73. Dry Standpipe 24. Roof Framing 74. FIXED SYSTEM FINAL 25. Roof Sheathing 75. FIRE PREY. FINAL 26. T-Bar Ceiling (Structural) & Monocoat Notes: 3.--2e2.,_3-2v72_ l'-raLc 9 0/11- 27. Frame and Flashing 3-20-f-14 Gi / d',- R f--C iC/ _ - ecist 28. Lathing & Siding 29. Insulation (3� Drywall Nailing >3r-q.2„ 31. Plaster Brown Coat (see reverse for additional notes) CME 0559-46,rev. 12/82 PROJECT ADDRESS: 2817 SHANTAR DR UNIT: CITY OF COSTA MESA — BUILDIiNG PERMIT PERM NO; E - 05644? OWNER'S NAME: NGUYEN, KHANH ADDRESS: NGUYEN, NGOC T PERMIT NO: E 056443 PLAN CHECK NO: N GOVT; N SUPP: N 2817 SHANTAR DR COSTA MESA,CA 92626 CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: ALT ARCH/ENGINEER: 546-1543 REG.NO.: T ADDRESS: UNIT: JOB DESCRIPTION : EXTEND EXISTING WALL, RE; #B56442 SQ FT; PERMITTEE: CLAIM VALUE: CALL—VALUE: GROUP OCC : R-3 / ADDRESS: KHANH NGUYEN ( 714 ) 546-1543 2817 SHANTAR COMMENTS : NO OTHER WORK PERMITTED C.M. CA 92626 *>F**;FacaL> ***N*****SExx*n<t**v.>E**1(** 1E****x**a *** x)E* >E>E* !>E>F*>Fk*+E*>F>E"k>i >t**N** **** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FR NT: FT IN REAR : FT IN Compensation Insurance.or a cenifled copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY:to PARKING REQ. PROV: PARCEL: 13940238 ZNE: REF NO: Certified copy is hereby furnished. D Certified copy is filed with the city Building Division. PLANNING NOTES> l':• > ate. Applicant: **********It*****)F*** ********x.****.******#********** *****)i*3(****IE***kick****#}.k* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred($100)or less). DEVELOPMENT S EyR V I C E S REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. " - ZONING APPROVED BY .4 DATE: . Date: Signature: • . NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED B Y , t DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. Y n CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• i DATE: 7FF•'�t` ?<1" which this permit is issued(Section 3097.Civ.C). *.********************3E • 7. • . ' • / • ' ********** tt. x•ii *'N. LENDER: ************************)r******jiii•*iE*3E*********k****ii***k*******6***.******#*k*3Ek* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM IP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 7 5 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business . 50% SM I P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE 15,00 I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL, PAID DUE Q structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS--——> 0 . 75 15. 00 0 , 00 15 . 7 5 15 . 75 • 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale. If,however the building or It improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED• 15, 75 OVER/SHORT: 0 U • for the Purpose al sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 15 . 75 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to theContractors'State License Law).l am aware *****;f***********#**********************k************************************** that proof of their Worker's Compensation insurance should/be provided to me. INDIVIDUAL F E E BREAKDOWN o I am exempt under Section: B. 8 P for this reason: G//JL:. / TYPE QTY DESCRIPTI O N UNIT COST TOTAL COST Date 3'q'r'L OwnerELE 1 RECEPT/STWITCH 1 ST 20 EA, . 75 , 75 I do hereby certify that I am aware of and understand the requirements of California Heal and tremei sec(ons 2 ,25533,and ENDOF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a , permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and runty tpn ordinances and state laws relating to building struction and hereby authorize representatives of this city to enter upon the above-men one/ property for inspection purposes. Date: 3` qt--- Signature: . /Vy 01 00109933-00109933 1-07! 15.r` J DATE: 03/05/92 TIDE: 15.1:; - Driver's License or Social Security ii: Canary—Applicant:Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING a. - POGNA APPROVALS Permit#, Date Inspector APPROVALS Permit# _ Date Inspector 1. Temporary Electrical Service or Pole - -52. Pool & Equipment Location L4,1 - 2. Soil Pipe•Undrgrnd. - 53. Steel Reinforcement �. ' 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. . 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test . . 9. Water Pipe-Undrgrnd. 60.-Backwash Lines, P-Trap, 0 Undrgrnd. i t ) 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final y/ •! 12. Sewer Cap 63. Heater & Vent-Final `"/ 13. Roof Drains 64. Plumbing System - Final 1/ 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit n,, 66. Solar System-Final � Si1 16. Rough Electric Wiring 34.-5-42_ !!U"99g**`., 1 L 67. Fencing & Access Approval 17. Rough Wiring SignRRR( 68. APPROVED FOR PLASTERING 1r 18. Rough Electrical-I Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 76. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION - 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED {ll 33. Final Electric /3-2 43 Notes: 34. Final Heating& Air Conditioning """""''\ 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final ' 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ . FCOSTA MESA CONS/TR UCTION PERMIT PE MIT NO. TRACT NO. LOT NO.• UNIT NO. I , ddress 2 7 r I44NrAr l�h.� C��! q.'6�6 3Z" f`S� Lf3y� l'';v2� 841 I 4/08/88 15461 TI . plicant's Mailing Address S -C.A of J.,` Or, Ad • • " TYPE OF CONSTRUCTION ❑ NEW ADD FIVALTERATION ❑ REPAIR. '❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# � 39– �o a- 38 I Zone RI Owner's Name KHANX N�Dfi S4/ Phorte� D S RIPTION WOR K1USOF BLDG. CCQf7C 2 cls-OQmorfa - Address '��Y/7��S��JA//1�7 �rP , CDS/A SSA C4 il?.r. - , A-/ /Jr�-!CT O fi4iC4, __.C/ S Main Building: Accessory Building: Z Arch/Eng. L t- 4G(/•/d' License No. 'TY E OF PERMIT ,L GRADING �OUNDATIONSTRUCTURAL T Front / 0 r7 / • ❑ TENANT L'J ELECTRICAL PLUMBING lir-MECHANICAL B /#.J7 e ! O p T- /�T/O� N Address - A Rear F- C A L s ❑ OTHER Contractor's Name a�kPv 66i/ Q/e Phone C Right - N PROJECT DESCRIPTION SQ. FT._ OCCUPA V�•'�" 3 K / - /I G Address(mailing) •'. • 'CONSTRUCTION TYPE VALUATION$ /J .00 S Left R - City License No. -ZONE GRADING CU.YDS. ACRES E LICENSED CONTRACTOR DECLARATION .5- y I Ping. Ref.# Parking Req./Provided Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing . Remarks: I j� - Planningn .Notes: iM•7,,,t af �, /}� �L M withysection 7000) of a and effect.on 3 of the Business and Professions Cotle, and' •C• * 2/7-84 S v''"'� a z , o �X r S4 - c, S my license n In full force and /l 1C' �. License Class License No. Date Signature _ - - ' PLUMBING FEES / ira.) ' - ' 1RKERS' COMPENSATION DECLARATION • •IBar Sink Showers 2 so ELECTRICAL FEES . :reby affirm that I have a certificate of consent to self-insure or a certificate .. 1 ' Workers' Compensation Insurance, or a certified copy thereof (Section,. 'Backflow Preventer Service Sink - Automatic Washer Transformer ❑ 15-50 KW 5800, Lab- C.) r - Policy No. Company [/L' Backflow lrlrigation Sewer Cap Construction Pole Sub. 0 50+ KW - - 8 Certified copy is hereby furnished. • Certified copy Is filed with the city Building Division. - + ,• ^ Bathtubs I / Sewer Connection . S n0 Cooking Unit Meter Dup to 100 amps ; Date Applicant - • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION' s Clarifiers I Solar CollectorsDishwasher Meter Dover 100 amps , (This section need not be completed if the permit Is for one hundred ($100)or, ' '- Wash r Solar Piping Dryers ❑Gas ❑Electric less). - ejP g Y Sub Panel I certify that in the performance of the work for which this permit is issued,-i D�� shall not employ any person in any manner so as to become subject-to the Drinking Fountains Solar Tank. ! Fan Motors❑O-1 HP ❑1''A-8 • Workers' C mq ensation Laws of California., A ' - _ 'Date•/f-�`/ Signature J�/� ' - Floor Dra ns Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP ❑16-15+ ' NOTICE:If,after making this declaration,Nor, outrbecom subject to the — - - - 75— comply f- Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal .Fixtures Microwave 0 7S comply with such provisions or this permit shall be deemed revoked. - ve • CONSTRUCTION LENDING AGENCY Gas Servide Outlets / Water Closet /-v 2 !:J Device Boxes Pole Light - • I hereby affirm that there is a construction lending agency for the performance - • - G g ^. • of the work for which this permit is issued (Section 3097'Civ. C.) s' - - ^r Lender's Name - ,�.. yyC Interceptors - Water Heater 4Y. sr Range .3-` 7S Lender's Address /�.-E Kitchen ink Water Service a Switches Sign / SD OWNER BUILDER DECLARATION �— - - - I hereby affirm that am exempt from the Contractor's License Law for the CavatOfi¢s . Auto-Wash i> 2 QD i, .Garbage Disposal r Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or - -� ' ' county which requires a permit to construct,alter,improve,demolish or repair P-Trap ' l:5 Generator ❑0-5 KW❑5-15 KW Trash Compactor -.• any structure, prior to its issuance, also requires the applicant for such permit ,. . to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains ?;7e Contractor's License Law(Chapter 0 (commencing with Section 7000) of _v tLvision a of the Business and Professions Code) of that he/she is exempt • " "erefrom and the basis for the alleged-exemption. Any violation of Section ''' 031.5 by-any applicant for a permit subjects the applicant to a civil comalty of not more than five hundred dollars($500). I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 i Issue Fee . mpensation, will do the work,and the structure is not intended or offered - Reinspection Fee $15 Issue Fee $'a- for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own Hood or DEVELOPMENT SERVICES REQUIREMENT / • employees, provided that such improvements are not intended or offered for Boiler Type I ❑ S/R0 sale: If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By •` Date pietion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date prove for the purpose of sale). 7 . O I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who : Duct-Ventilating ❑0-100,000 BTU 0100,000 BTU SUMMARY OF FEES �^ builds or improves thereon, and who contracts for such projects with a con- SUM!../kr '��'"r Ce SMIP - $ • O•A O • tractor(s) license pursuant to the Contractor's License Law). I am aware that f Exhaust System 0 Multiple 0 System Repair/Alteration 6 SO BUILDING PERMIT $ •p proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ S•'`0 PERMIT 0 I am exempt under Section B.& P. C.for this reason Firepl/Fact.Blt. ICBO# Fire Dampers • PLUMBING $ •oa ISSUANCE $ Date -#PP Owner r Heating System& Ducting. Registers . PLAN CHECK 25% $ r7f ENERGY P.C. $ - • I hereby certify that I have read this pp atrEN-and state that the above ❑0-100,000 BTU 0100,000 BTL 2� 7s GRADING $ information is correct. I agree to comp y lh all city and county ordinances ELECTRICAL $ r and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ S.3,cp MICROFILM $ sentatives of this city to enter upon the above-mentioned property for ' inspection purpo.- �w MECHANICAL $ 2// SO TOTAL FEE $ /� 6/ X Signature 1 Date /r X Drivers' License/•r - 1---- '. Reinspection Fee $15 Issue Fee $.8� PLAN CHECK 25% $ x•63 • / CMF 0865-46,rev. 10/84 white - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor - - CONSTRUCTION AND'PLANNING 1 I ,1 ' POOL&SPA A �' , , - Date• 1 npector. Date Inspector •APPROVALS .Permit'# 1 i, APPROVALS . Permit# 1:'Temporary Electilcal Service'or Pole 52. Pool & Equipment Location . Y/eW,s . 2. Soil Pipe-Undrgrnd. - .1 i rrJ° 53. Steel Reinforcement , 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding I° ,;. 5. Steel Reinforcement.-1', _ 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd- 57. APPROVAL TO COVER-GUNITE 7. Footing` , 1/4-. 58. Electrical Conduit-Untlnd rgr - . c.8. Foundation ,I.{; 59. Gas Pipe, D Undrgrrid.,Tesf• d i . 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, g Undrgrnd. . ' • 10. Structural Floor System 61. APPROVAL TO DECK r• 11. Property Sewer Line & House Connection yfo.'Y. Leto 62. Backwash & Receptor-Final;•. `_' f•• Y 12. Sewer Cap 63. Heater & Vent-Final , p > I- 13. Roof Drains 64. Plumbing System - Fjnal :t 14. Rough Plumbing t1/, : L� 65. Electrical-Final _ -! 15. Rough Electrical-Conduit `'`7I 66. Solar System-Final " •' V 16. Rough Electric Wiring y,743/ DX , 67.;Fencing & Access Approval 17. Rough Wiring.Sign n /�u, 68. APPROVED FOR PLASTERING 18/ Rough Electrical-T Bar Ceiling 1.-1 r/' 69. POOL/SPA SYSTEMS FINAL t . 19. Rough Heating & Air Conditioning 1/.44/61 t ) FIRE DEPT. REQUIREMENT ). , I 1 20. Rough Factory Fireplace APPROVALS Permit# - • 21. Ducts, in Structure 70. Underground Hydro - 22. Ducts, Ventilating 71. Product Piping Deas 0 Oil / 1 23. Gas Pipe-Rough & Test 72. Underground Flush " U u 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro ' L 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing Sl/c. /6:8 , 76. Dry Standpipe �, 1 a .0 ') i •'1 28. Lathing & Siding 77. FIXED SYSTEM FINAL. - 'C- 1 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing .�(� � HEALTH DEPTkIREQUIREMENT 31. Plaster Brown Coat _J - 79. FINAL INSPECTION 1l- 32. Electrical Power Meter=Final A 80. FOOD CERTIFICATE ISSUED'. _I ,, 33. Final Electric o /� ©dZ t� Y�r'�,�.h/�"Q.��j Notes: s��/� �.G�'»7Pe eye �•itl6OnlG. 34. Final Heating & Air Conditioning $f z--r Lira i LI L 35. Final Gas Pipe=Test ll. f7:449-L ©`RiL �r,UL, - 36. Hood or Canopy = /1Y FoicC - G �C'!!W. Q. y' �-. l 37. Final Factory Fireplace remor_'. W+r-£ en" ____ , _., j: !' '• tl,. F 1 'R '.' 38: Final Plumbing 49-2.-2:t tea L- 9- nut-1.11" NA tvr'r{in.t N I , - 1 • 39. Water Service-Final • S _ � 40. Gas Service-Final - Zi 1:, . •'41. Solar Dornestic-Final '� •142. Backflow Preventer • t43. Backflow Irrigation I • - • �� • ,/ ,,. { 44.Landscape Irrigation System _ ,� :.,�r ;i ; ' ,- • 45. Sound Attenuation / ;;, ,. '. 46. Handicap Regulations • r is � •v '47. FINAL STRUCTURE & BUILDING 8749 C22-3 • 1, - i• I • 48:•Specia l'Requirements Completed - , -, • 49. Electric:Release to Edison - 50. Gas Release to Southern California Gas Com 51. CERTIFICATE OF OCCUPANCY r No. Date PROJECT ADDRESS: 2817 SHANTAR DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 060365 OWNERS NAME: NGUYEN, KHANH ADDRESS: NGUYEN NGOC T PERMIT NO: B 060365 PLAN CHECK NO: N GOVT: N SUPP: N 2817 S{1ANTAR DR • COSTA MESA CA 92626 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT ( 714 ) 546-1543 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : APPLY EXTERIOR LATH & STUCCO OVER SIDING SQ FT: 800 ADDRESS: UNIT: CLAIM VALUE: 800. 00 CALC—VALUE: 800 . 00 GROUP OCC: R-3 /M-1 PERMITTEE: KHANH NGUYEN ( 714 ) 546-1543 • ADDRESS: 2817 SHANTAR DR COMMENTS: EXISTING SIDING TO REMAIN! STUCCO SYSTEM APPLIED OVER SIDING! COSTA MESA CA 92626 ****RERr+ERE4RERERr****REErRE***************Rr************xRETE*****RrRr*r*RERE***+E****+E*+r****RE* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance,or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV: PARCEL: 13940238 ZNE: REF NO: J Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> ..-- > > I Date: Applicant: **************************** ****************************************F********** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not he completed if the permit is for one hundred(Si®)or less). DEVELO 13- KENT :::. _ S E R V I C E $ R E Q U I R E M E N �T S I certdy that in the performance of the work for which this permit is issued, shall not employ any person in any manner so as to become Cl:' subject to�theheQWorkers'Co enation Laws of California. ZONING APPROVED BY '. _ DATE: _ �� Date: g—/� 2/ Signature: " - . NOTICE:IL after making this declaration.you should become lec or ers ompensation provisions of the Labor BUILDING APPROVED BY : _ DATE: Code.you must forthwith comply with such provisions or this perm shall be deemed revoked. '//[7 �//�/,/ [�[� s ft-- CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY:'t �) �^ fi / jF [9 —sc- DATE• 4E2i1-iFb �f 2� which This permit is issued(Section 3097.Civ.C). C*PLIC******ISSUE***EP***U 1E**** ** **** *************** L * ***** LENDER: • ***I****E*LLL****************************L** LUL*LLLLEE**PILI*C*I* EIPI*****L ADDRESS: LEGALIZATION:N - F E E S U M MARY STRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES? GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 21 . 0 0 . 501 _ repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON:—RES pursuant to the provisions of the Contractors'Stale License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN / .1 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 'rt I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> . 21 . 50 0 , 00 0.0 0 21 . 50 21 . 50 . 00 does not apply to an owner of a property who builds or improves thereon.and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale.If, however the building or REVENUE DIVISION TOTALS--> COLLECTED: 21 . 50 OVER/SHORT• J 00 improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve for the purposeol sale). BLDGPMTT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK • 2I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business '"} ❑ and Professions Code: The Contractors'State License Law does not apply loan owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ****I*******L****PLIPLUL*L*LUPI****L*******LEL***EI*PPUEE**CC*P******j** *C***** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN pl I am exempt under Section:B P 70 4 4 B.B P.C. rel for this reason: ALL WORK BY OWNER TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST /2-/6-?2 Date: Owner: SFR 800 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 800 . 00 I do hereby certify that I am aware of and understand the requirements of California Health aalesLode Sections 25505,25533,and ,( END OF FEES A 25534 and that I or any future building occupant will/will not(circle one)need to comply with said stale codes and the requirements for a i 1 permit for construction or modification from the Air Duably Management District.Residential construction applications are exempt from P,.• these provisions. 11.. ,^, -- \ /+ Date: Applicant: ! el.P ! VW� / ' I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ) L•'41A, /' ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned r 0--n-c. t-Y SAvwl property for inspection purposes. � '/ �� r/�,, (� ,, �] _ 4111///"'. .`. T-` 1 Ln:,�t� Date'. /Z `/6—Q2 Signature: --)411-4=4112.-LJ �`___ 0 �x 'i r1- - - Driver's License or Social Security a: r 1'\�`�� C�(L 164146 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor FO i " CONSTRUCTION AND PLANNING - POL S SPA Date Inspector Date Inspector APPROVALS Permit# APPROVALS Permit # 1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location 'ti 2. Soil Pipe•Undrgrnd . 53. Steel Reinforcement • . •, 3.; ElecUical Condtiii_1itility-UndrgEnd. C - 54. Forms ,r- 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding _ -..- --• 4. 5. Steel Reinforcdme it - 56. Rough Plumbing & Pressure-Test ' 6. Electrical UFER Grnd. . 57. APPROVAL TO COVER-GUNiTE .. 7. Fbtitings n'-, 58. Electrical Conduit-Undrgrnd. . 8. Foundation \ / 59. Gas Pipe, 0 Undrgrnd., Test tj 9. Water Pipe-Undrgrnd. '- , 60. Backwash Lines, P-Trap, 0 Undr'rnd. ' f . •X 10. Structural Floor System "' 61. _APPROVAL TO DECK 11. Property Sewer Line,& House Connection 62. Backwash & Receptor-Final ',y ' • 12. Sewer Cap - JI 63. Heater & Vent-Final '.4 •• t • 6 I 13. Roof Drains - 64. Plumbing System -Final -' t _ 1 14. Rough Plumbic Tc 65. Electrical-Final 2'. 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 Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT . -, Un-4W." :3 20:•Rough Factory Faltlace I ' -`Y -. th_0L4'' '- •APPRQVAES,C, •' Permit # * . r - 21. -Ducts,in,Structui•e c 1 - -. •:S ., - :2,7;, -; •y, -' r. A4. Ii. J r- 0. Undergrourdf Hydro x 22. Ducts, Ventiteting v •7•S -> c::.' r` ,_71. Product Pip. g O'Gas O'Oil - - '/D 23. Gas Pip 2Rough & Test . t 4 pA Y. .-•72doupd Fluehrj,.- _ , I . Unergr - � - . ' e. 24. Roof Framing .` I I- - -• .. -' k-' '7 ` ' > ' • t--175 _ x > x , `•• =Undergrnil'Stora�rfTahk _©Gas•O Oil 1- ..1 ;y 25. Roof Skeathin X "' r, 'r' L3 - - -z-) . �.' 9 t-.x <L v .. -74:=,Overhead Hydro:-' 26.--T-Bar Ceiling (Structural) & Monocoat t C". i. -J" n 75.7pry Chemical_ -; } •- c • _27. -Frame and Flashing; _, x ,: nr j r r :: 76:-Dry StandPiPe c Y '1 _ - % _ .1; 28. Lathing$ Siding rn 4= f• )/lj v� x '< 77_� FIXED Sl^WTEM)FVNAL `� L "39. Insulation CI i; q .. ,. c x 78..y1RE PREY. FINAL ; ;> .q > ,' if 30. DrywalINailing r- - � HEALTH DEPT-REQUIREMENT t . 31. Plaster Brown,Coat" S FC7 5g r ' 79''FINAL INSPECTION x ., r r*: , „ 32:-.Electrical c Power Meter-Final. < - ? ,F , :rSOFOOD CERTISSUED CER-TIF -' r. . 33.:Final Electric s r 4 r_ > Ngtgs: _ _ ,J r .34- Final Heating& Air.Conditioning.. C j ; C' 4 ---- '-r- 35._Final Gas_ Pipe-Tes'tr _ :1 " ,T > " :r e= „ • • A , -36. Hood or, Canopy - n - - ^ i V 1 _ .a .'.o -r r ? - L 37. Final.Factory Fireplace., i ;S °. • r I I III x �• t. , - .` - _, 38. Final Plumbing o. n _ - ` _. : .- r, s y 39. Water Service-Fina hr '` s : .. . , r 40. GasServ_ice-Final-� , , r - •. ' r _y 41. Solar Domestic-Final'. - - K.• 42. Backflow Preventer, • Is . 43. Backflow Irrrigation'. - -•S`� - co r- < C• 44. Landscape Irrigation System:.Vit. .. -., C. y • - .C. s .45. Sound Attenuation' - ' '- _ " ' 46. Handicap,Regulatio"ns '� .- - -s w 47. -FINAL STRUCTURE & BUILDING `(-1 --�t7 tFl"*H = at t }(9_ / / _ 48. FINAL PLANNING :-f y Lc- -t�.Gclt� 49. Electric Release to Edison - 1- ' - p . • i :l ' . C. -.I: 4 :1-.. - 50. Gas Release to Southern CaVifornia Gas Co I x ,; 51. CERTIFICATEOFjOCCUPANCY 'i 5 v-1 v - No. Date - , Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. - UNIT NO. Project Address 21/7s'6,a.d/Ar Derr, C/ g2CPp '� - ,32 `SSS _ 8410 4/08/88 35. 15 TL Applicant's Mailing Address 21/7 ShANTAr Ar.. Crtq g7it TYPE OF CONSTRUCTION L`] NEW Li ADD -U ALTERATION U REPAIR KI-MAJN Ntra yrN Phone 7/9 c<i6-/r ❑ CONVERSION CI-DEMOLISH El OTHER Owner's Name A.P..# [Zone Address 2,/? NAwITAr Or.� Ciel (2,4 7a 6.-26 �3 DESCRIPTIONON — .,irc 5'1' E� Sire- 5 S Main Building: • Accessory Building: Arch/Eng. olds¢/' (.3w/tier License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front O AddressII ✓pJ�� El TENANT ❑ ELECTRICAL CI PLUMBING CI MECHANICAL B Rear - • N Contractor's Name UIIW/lvr t".4/tdw0- Phone El OTHER C Right N Address(mailing) PROJECT DESCRIPTION SQ. FT. OCCUPANc,y 2-3K G CONSTRUCTION TYPE - VALUATION$ 4.1400 $ LeftR City License No. ZONE GRADING CU.YDS. ACRESE LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided O I affirm that am licensedunder provisions of Charter 9(commencing Remarks: Planning Notes: M withith section 7000) of Division 33 of the Business'and Professions Code, and T my license is in full force and effect. Q �' , 2i D9 ` S License Class License No. P. Vim! V . Date Signature PLUMBING FEES ' 'ORKERS'COMPENSATION DECLARATION • Bar Sink Showers ELECTRICAL FEES ereby affirm that I have a certificate of consent to self-insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) Automatic Washer Transformer ❑ 15-50 KW Policy • No. Company Backflow Irrigation Sewer Cap - Construction Pole Sub. 1050+KW 8 Certified copy is hereby furnished. _ Certified copy is filed with the city Building Division. Bathtubs Sewer'Connection Cooking Unit Meter Duo to 100 amps Date Applicant - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors • Dishwasher Meter Clover 100 amps (This section need not be completed if the permit is for one hundred ($100) or less). Dishwasher Solar Piping . Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is issued, I - shall not employ any personin any manner so as to become subject to the Drinking Fountains Solar Tank • Fan Motors 00-1 HP 101'/::-8 Workers' "in:Nation Laws of Californi _ Date ^R t�(!! - Signature �a - rs- ' Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ ' NOTICE: If,after making this declaration,yo{'"FMrfd becomeTubject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal • Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. , CONSTRUCTION LENDING AGENCY Gas Service Outlets 'Water Closet Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097'/Civ. C.) Interceptors " Water.Heater Outlets Range Lender's Name ,t, � ' Lender's Address /"� � Kitchen Sink Water Service - - Switches Sign- OWNER BUILDER DECLARATION ,4 I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal --- Standing Sections following reason (Section 7031.5 Business and Professional Code:.Any city or ( � countywhich requires a permit to construct,alter,improve,demolish or repair ' any sructure, prior to itissuance, also requires the applicant for such permit P—Trap Laundry Trays Generator 00-5 KW E5-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains - 'he Contractor's License Law(Chapter 9(commencing with section 7000)of • ivision 3 of the Business and Professions Code) or that he/she is exempt r i erefrom and the basis for the alleged exemption. Any violation of Section 1031.5 by any applicant for a permit subjects the applicant to a civil `penalty of not more than five hundred dollars($500). $ 3 U'I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee mpensation, will do the work, and the structure is not intended or offered Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves , DEVELOPMENT SERVICES REQUIREMENTS: thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type ❑ employees, provided that such improvements are not intended or offered for - Zoning Approved By Date sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ �.¢7 Motion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground I Building Approved By Date / o prove for the purpose of sale). - VVVV `it eAPt7 ❑ I, as owner of the property, em exclusively contracting with licensed con- Duct-Structural ' Refrigeration System Application Issued By Date tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct- Ventilating . 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- - tractor(s) license pursuant to the Contractor's License Law). I am aware that --1 BUILDING PERMIT $ 2%r0� SMTP $ _ �• M. proof of their Worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple 0 System Repair/Alteration: /3.6S— al � PERMIT PLAN CHECK $. _ ❑:l am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $- ISSUANCE $ Dateur.,P-0 Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this ap i'c Tmr and state that the above 0o-100,000 BTU 0100,000 BT •• ELECTRICAL $ GRADING $ information is correct. I agree to comply ith all city and county ordinances and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ _ sentatives of.this city to enter upon the above-mentioned property for inspection purposes. _/ � 'i O �� MECHANICAL $ TOTAL FEE $ J,5 fr Signature /.t.(/ Reinspection Fee I $15 - Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor ' CONSTRUCTION AND PLANNING POOL&SPA APPROVALS Ptermit# Date Inspector APPROVALS Permit# Date Inspector 1'. Temporary Electiical,Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd'., -54.' Forms I 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ' 5. Steel Reinforcement I. 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. ' 57. APPROVAL TO COVER-GUNITE 7. Footings r if 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test I 9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection y/.,_/8g tea 62. Backwash & Receptor-Final . 12. Sewer Cap `W 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing d 65. Electrical-Final 15. Rough Electrical-Conduit %1' 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 i " 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ,, y J 20. Rough Factory Fireplace APPROVALS Permit# 1' r la 21. Ducts, in Structure - 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd:Storage Tank 0 Gas 0 Oil f 25. Roof Sheathing 74.'Overhead H(ydro •f . 26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 1. 2- 27. Frame and Flashing 76. Dry Standpipe -`� 28. Lathing & Siding 77. FIXED SYSTEM FINAL1 •= 29. Insulation 78. FIRE PREV. FINAL I - . 30. Drywall Nailing • HEALTH DEPTt REQUIREMENT ``• r ' 31. Plaster Brown Coat , . 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: _ 34. Final Heating & Air Conditioning ' 35. Final Gas Pipe-Test ' 36. Hood or Canopy • 37,r Final Factory Fireplace - 38! Final Plumbing ti//4' C.a9 , r 39: Water Service-Final - - - • . ,. - 40. Gas Service-FinalI ' •.41. Solar Domestic-Final' i/ v 42. Backfitw Preventer I' .: ,r '43. Back4low Irrigation - ;:f r �, --..44.i.Landseape Irrigation System '•� 45. Sound Attenuation - - . '416. Handicap Regulations . = _ ., • '47."FINALSTRUCTURE &'BUILDING I 48. Speci4Requirements Completed ; • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co y . ' 51. CERTIFICATE OF OCCUPANCY - . .. II No. Date " ,• Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. TRACT NO. LOT NO. UNIT NO: CITY..��OFCOSTAMESA CONSTRUCTION PERMIT A.P. Zone P i1 Addra D// rAn %�1 r o C c M,e g 3�1� 1 2 - 6 /s (2 rras/(/ /- kt`Z�� - r ' S Main Building: Accessory Building: Apple, nts Mailing Addressssd'A.ye- TYPE OF CONSTRUCTION ❑ NEW LI ADD U ALTERATION LJ REPAIR Owner's Name ,(��j./1�('i 1��sa��/��Phone� "/S"3 El CONVERSION El DEMOLISH El OTHER B Front - N /l """']p _ DESCRIPTION OF WORK/USE OF BLDG. Rear Address _ ../4. rg. / . • . -. t Y..' A - I L. C Right N Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL K- G Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL I S • Left ll'''' ❑ OTHER E Contractor's NameS` 4Per (31//164- Phone Ping. Ref.# Parking Req./Provided E PROJECT DESCRIPTION SQ. FT. - OCCUPANCY Q Address(mailing) - Planning Notes: M CONSTRUCTION TYPE VALUATION$ ln(� T I City License No. ZONE GRADING CU.YDS. ACRES S. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: I p$jA O�1 Ti.with section 7000) of Division 3 of the Business and Professions Code, and VS..sus �� my license is in full force and effect. ELECTRICAL FEES Date Signature License Class License No. PLUMBING FEES Automatic Washer Transformer 0 15-50 KW KERS' COMPENSATION DECLARATION - Construction Pole Sub. 0 50+KW • oy affirm that I have a certificate of consent to self-Insure or a certificate Bar Sink Showars I orkers' compensation Insurance, or a certified copy thereof (Section Cooking Unit Meter Cup to 100 adios 3ouO, Lab. C.) Backflow Preventer Service Sink - Policy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 10.0 amps Certified copy is hereby furnished. Dryers Ekes ❑Electric r e Certifie co is filed with the cityBuildingDivision. BathtubsY Sub Panel �-�c, Y Sewer Connection t:' Date 17--,-- !' Applicant Fan L. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Motors ❑41 HP ❑1 h-B h (This section need not be completed if the permit is for one hundred ($100) or less). Dishwasher Solar Piping F.A.U. Inc Solar 09-15 HP'016-15+ II I certify that in the performance of the work for which this permit is issued, I Fixtures ,Microwave shall'not employ any person in any manner so of to become subject to the Drinking Fountains Solar Tank '/' Workers' Cm cation Laws of Californ"a,/ n Date /2-/-3-- � Signature +%, tecom Device Boxes Pole Light'4 Floor Drains Swimming Pool w/Spa g j.-- NOTICE: `.' NOTICE:If,after making this declaration, u s Code, fsecome lett to the Outlets Workers' Compensation provisions of the b Code, you must forthwith Floor Sinks Urinal - Range comply with such provisions or this perm t shall be deemed revoked. , CONSTRUCTION LENDING AGENCY • - Gas Service • Outlets Switches Sign I hereby affirm that there is a construction lending agency for the performance - Water Closet of the work for which this permit is Issued (Section 3097 Clv. C.) • Garbage-Disposal Standing Sections - kInterceptorsHeater Water Lender's Name / _ - - Lender's Address `J�N� Kitchen Sink . Water Service Generator 00-5 KW 05.15 KW Trash Compactor OWNER BUILDER DECLARATION - I hereby affirm that I am-exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays any structure, prior to its issuance, also requires the applicant for such permit - - - I . to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains ,,,Contractor's License Law (Chapter 9(commencing with Section 7000) of '1ti t!cion 3 of the Business and Professions Code).or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3 efrom and the basis for the alleged exemption. Any violation of Section 5 malt by any applicant for pa permit subjects the applicant to a civil • penalty of not more than five hundred dollars($500). I 3 DEVELOPMENT SERVICES REQUIREMENTS: I,'las owner of the property or my employees with wages as their sole Reinspection Fee ! $15 Issue Fee $ compensation, will do the work,and the structure is not intended or-offered Zoning Approved By Date for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By - Date License Law does not apply to an owner of a property who builds or improves _ F� ,.p thereon, and who does such work himself/herself or through his or her own I .Application Issued By - ' Date 1 !.- O emplok-ees, provided that such improvements are riot intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 I SUMMARY OF FEES pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground L • prove for the purpose of sale). - BUILDING PERMIT $ ZC _ SMIP $ D 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct- Ventilating 00.100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $ - builds or improves thereon, and who contracts for such oroiects with a con- _ • tractor(s) license pursuant to me Contractor's License Law). I am aware thatPLAN CHECK 25% $ • ENERGY P.C. $ proof oftheir Worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple 0 System Repair/Alteration GRADING $ 0 am exempt under Section - B.& P.C.for this reason - Firepl/Fact.BI t. ICBO# Fire Dampers ELECTRICAL $r. PLAN CHECK 50% $ MICROFILM $ ,�1-� Date -1�R,,ii owner Heating System& Ducting Registers MECHANICAL $ TOTAL FEE $ �\ I hereby certify that I have read this applic Imr-arr�etat t the above 0o-100,000 BTU 0100,000 BTL Information Is correct. I agree to comply with all City and county ordinances • _ PLAN CHECK 25% $ and state laws relating to building construction,and hereby authorize repre- • • sentatives of this city to enter upon the above-mentioned property for , Inspection pure n Signature tic � i�s.L Date 121-ft� Drivers' License or 55'# 1 `� Reinspection Fee $15 Issue Fee $ 3 _ 01 00021531-00021532 TOT 25.50 1 - DATE: 12/08/38 TI1E: 11:47 • 0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor PO' SPA CONSTRUCTION AND PLANNING Date Inspector Date Inspector &OVALS Permit# APPROVALS Permit.,# .71 1. TSmporary Electrical Service or Pole ..' 52. Pool & Equipment Location I x 2'SSoil Pipe-Undrgrnd. 53. Steel Reinforcement _ 3: Electrical'ConduitiUtility-Undrgrnd. - 54. Forms • - � 111' 4.. lectr,ibal'Conduit-Undrgrnd. 55. Electrical Bonding • r • I 5. Steel_Feififorcement 56. Rough Plumbing & Pressure Test -.6. Electrical UFER drnd. 57. APPROVAL TO COVER-GUNITE 7.,Footirigs > 58. Electrical Conduit-Undrgrnd. . 8. Foundation ,_-jj .59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. ; 60. Backwash Lines, P-Trap, ❑ Undrgrnd. IU l: 10. Structura! Floor System - ../1i 61. APPROVAL TO DECK � ' b• 11.,Property,Sewer Line & House Connection -•I 62. Backwash & Receptor-Final 12iSewer,Ca5 �; 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 Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 201 Rough Factory Fireplace , APPROVALS Permit# 21. Ducts, in Structure r 70. Underground Hydro 22. Ducts, Ventilating - 71. Product Piping 0 Gas 0 Oil - 23. Gas Pipe-Rough & Test -- 72. Underground Flush 24. Roof Framing 73- Undergrnd.Storage Tank 0 Gas 0 Oil • 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing _ HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat , 79. FINAL INSPECTION 32. Electrical Power Meteri-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer L I 43. Backflow Irrigation 44. ,Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations F/ 47. FINAL STRUCTURE& BUILDING &AQ 48. Special Requirements Completed WWWVVV!!! 49. Electric Release to Edison • • 50. Gas Release to Southern California Gas Co 11 51. CERTIFICATE OF OCCUPANCY No. Date • n 1 OWNER PACESETTER WEST JOT - VEN`URE D. OCT 2 a 619;52 JOB ADDRESS 2817 Shantar L_ BUaDING PERMIT NO. 17938 GENERAL CONTRACTOR Andros Land CO. VALUE $ 20,112.00 AP No. 139-4-02-38 LOT 86 TRACT 43119 FIRE ZONE DESCRIPTION OF WORK Res.w/att.gar. INSPECTIONS Signature DATE GROUP I&J TYPE V ZONE R-1 Soil //-7-ea- SUBCONTRACTOR PERMITS ISSUED Gas W -AsP6 , DATE NUMBER Water A (.!/ Il..1-/&..- Rough Corn. Refrig. ❑ Air Cond. ❑ Rough Heating __,.g. -__/ � i. /o,�/ ,A. - /a-a7-4A /n 9.3 — Rough Plumbing r+ /.Z-.Z97-1 i s • 77/. - _ -/ 4 _ 7p12 — Miscellaneous / / / NOV-2 8 Prop.Swr.Line [pause Con. t-Swr. ❑ t itlAh_Z4-19663 FLtN E C Q.N-Tn 19r1-1- -TC— Sprinkling 9P2 T G Sprinkling System Construction Pole t u tEte-/. / ,;2X-67- /oar '!- Underground 0 Power 0 _ , Rough Wiring fVP/5 /.L/�? y r�j� �,de /a7Z /.79/02-/7-‘,,z /7,9 trenches 0 Forms 0 Steel Reinf. 0 nilll J1 /1/4-1-2— Floor System _ _a_( f iii - 4-.,. Bond Beam 0 Steel Reinforce 0 Sheathing /: .qj.(L.- Frame and Flashing_ "SM /- -C Lathing — In ®/Out m/ F-711 (-/ (>'S_"�.iV_1-1-(7-c=s Plaster, brown coat ,YM -,-Areg C3 Refrig. ❑ Air Cond. 0 Final Heating, Final n) Plumbing Fixtures, Final Final Gas Test /*' r/ i'/3 Electric Fixtures, Final /Peru 3./?,G._3/ /� !' C Building, Final c 3 OCCUPANCY FORM 8U4.5M — 7-61 17938 FEE RECEIVED • 17938 OCT 1 1962 COSTA- MESA BUILDING-SAFETY DEPARTMENT fNjCE DEPT. 1'. O. BOX 917 COSTA MESA. CALIFORNIA ti' i ,of COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING 'I7 4 NA-�17-AfZ A BUILDING 2 ADDRESS COSTA MESA. CALIFORNIA �f/ FF For Office Use Only OvJF '- 77'Y/f� �.E r Jr;- ` ��ATlS �r I RECEIPT NO. @ERpyTljl(?.3 MAIL ��� - �/� w/ , A/�e1 /j �+�� RECEIV D BY OA RECEIVED DATE ISSUED ADDRESS /L��/� ////y��/'✓� T Ay 0 /J OE®:✓� . 3/19{J�6'� CITYRa % /��fi� -Pi�� ,G//'� ,1 `/si Tate (43�'��DDRESS �(J// '-c�„^•" (��'V OV -rENEER/�Cf,{/�27E(.4.3AAc-/7' Ho. COSTA MESA. CALIFORNIA` D ,SII/ ADDRESS "/V/Y'N&/��'1 FIRE ZONE TYPE V GROUP \1� V 4! CONTRACTOR 1�,V'i�S LA-440 a / APPROVED DATE (/// ADDRESS /6 6-3 M/-w9ros4- • ZONING ZON NO.OF USE OF NEW-544-7.3..,ye,., CITY // �(�7 p-1 IPLANS 2 I BUUIILDING�AW/Ca/ ^4�/^_ E LSTC.TNO. L l0. NO. �V J�S \ LEGAL ® - 1 D at J�f ll3f T 9 (/ DESCRIPTION (T'� �- OF LOT 70 .0 /� INOW OF OTB2 --- 3 A.P.NO. /39— /V° USE OF iesl/0�J/�s YARDS EVES OF BLDG. I�� (/�/ APPROVED ALLOWED SETBACK LINE FROM (CENTER LINE ST.) CENTER OP STREET �GJ REAR YARD FRONT SSV FT. -- IN. SIDE YARD iLEFT IRIGHT 40 R.SIDE C FT. IN. DESCRIPTION OF WORK L.SIDE S FT. N. NSA,.. . I 'X\ 9 II ALTERATION I H ADDITION I REAR y FT. q' INN.. REPAIR II MOVING I INO. OFI DEMOLISH BYPROVEO ♦_. /n�m� DATE //P/ `Z SIZE Ly^jpy/ ROOMS a .SfT-OORIEES�2� ('��fY Y EXTERIOR COVERING /j V�v�•, �COF BUILDING AND WORIOfVEERRI,NPG§���/3•/4)t- ems .Sc• S ,c /e7d Qc./_ sea 6 �', //f9 I HERESYACKNOWLEDGETHAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATIHN IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE WE REGU TING BUILDING CONSTRUCTION., // /) r VALUATION 4 OO SIGNATURE `K.C-•"L•/ (Y/�}' PERMIT FEE $ C. H a /� to �” P MI / $ O, 4� PLAN CHECK $ 3 3 . R / F AUTHORIZED A=al SI, -41.1. e/4,--t Cy 0-19p ` TOTAL FEE $ / 4OWNER RTXRY, RFXDATE 4-4-68 JOB ADDRESS 2817 Shantar Drive BUILF PERMIT NO. 28386 GENERAL CONTRACTOR Owner-Bui.1,-:r DESCRIPTION of WORK J. Living Room to Res. AP No. 139-1f02-38 LOT 86 TRACT 449 FIRE ZONE VALUE $3,850.00 INSPECTIONS Signature Date GROUP I TYPE V ZONE R-1 SOIL SUBCONTRACTOR PERMITS ISSUED GAS Date Number ' Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. 0 _ SPRINKLING SYSTEM _ MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING ^ ry`/jf.`.e Heating and Vent. TRENCHES ' FORMS Q STEEL REINF. LTJ 6'-r FLOOR SYSTtM f •.''-d-6e BOND BEAM rl STEEL REINFORCE 7 SHEATHING NM 4/-i3-6,S; FRAME AND FLASHINGrE0� R.A 4-e"-ab V LATHING — IN OUT ® _An,OJwg[ 5/_21 Wino - PLASTER, BROWN COAT S-'1-ag' HEATING, VE, FINAL E -Ct/FI -,//4cc ".1.5< :1:1; g 1, HEATING, VENT., REFRIG. AND A.C., FINAL I�PX_/) (A/./L'!i/T•// yr/ PLUMBING, FINAL AND GAS TEST I ELECTRIC, FINAL fri-) 4-'2. BUILDING, FINAL /I7jP 4-7- fl 28386 RAR 28-6 ,t]OO =818• ****2250 • COSTA MESA BUILDING-SAFETY DEPARTMENT • P.O. BOX 1200 - COSTA MESA,CALIFORNIA 92620 For Applicant to HU In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING For Office Use Only BUILDoZ�lf7 Sid,Q/.i-AR Bk. /� T.[��/ ADDRESSING J R[curt NO. % RSC/ V� COSTA MESA, CALIFORNIA Reg (� p mew( p�`zzenof ..,#w IsSitre OWNER /\ell Rix !tel :gar: �1/V-(/ aV,Lllfl4/li{'G/Y/llL//�/��',L]1/ AS' ry r� ,1 N BUILD�ItN�G ADDRESS 0�0/- / ��/i/✓%�R� D�, FIRE #-� r a TEL ZONE TYPE GROUP ' CITY COS •, /"t�A NO. S APPROVED !�///��/NI WINE TEL BY //' /d DATE 31._,9,.._6(-- Ii ITECT R Q wl-��'/Z NO. ZONING ��'///yyy ADDRESS [ I NO.OP t�) USI OFNEW O .. " �" �, " X5../d../1 q/PCO.O / BUILDING. Oe`IA...Q./ CONTRACTOR_ LAL iw u - . 1 LV V V'� 1 VV LEGAL iRs, 11 3 if fff DESCRIPTION ADDRESS /3 /9 -VOL - 1 1 CITY NOTE: NO RAVE OVERHANG SHALL BE LESS THAN STATE TEL - EO'TO SIDE B REAR P.L LIC.NO. NO. /T EAVES OSIZE F LOT 70 X I O0 I NOW FOLDGLOT F ALLOWED (U.B.G.REOUIRBMENTI - YARDS APPROVED YARDS APPROVED USE OF (7�C/neNc MAIN BUILDING ACCESSORY BUILDING ' EXISTING BLDG. K { (FROM C/L STET ( SETBACK LIN[FROM / FRONT i' I / ..• • CENTER OF STREET CO REAR YARD FT '`- SIDE YARD I LEFT J I I RIGHTi �" R.SID[ !T. FT. DESCRIPTION OF WORK s .51 .70 FT. ALTERATION _ ADDITION REAR I FT. r DISTANCE SET. BET.MAIN& REPAIR MOVING DEMOLISH MAIN BLDQS, ACCESS.BLDOS. E'. BUILDING p NO.OF VAR.# DATE SIZE / ROOMS / STORIES / C.U.P.# APPROVED EXTERIOR WALLsru .co ROOF /� APPROVED `,COVERING J/yC,W I COVERING OGo RM ED BY ktipthwes�/}USE OF BUILDING AND WORK TO BE PERFORMED V w Liu/furl RonM N I O .Fr. 1 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j AND STATE THAT THE ABOVE IS CORRECTANDAGREE TO COM• PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. it PLY WITH ALL CITY ORD NCI'AND LAWS REGULATING VALUATION D BUILDING CONSTRU /� SIGNATURE OP� PERMIT FEE $ IS'all E PERMITTEB L"'7� w "^C 54 PLAN CHECK 8 7.J ll AUTHORIZED AGENT $- 20/7\59 TOTAL FEE (J OWNER ntAni, REQ V., ..1N. DATE 1/0_9_1...J_19164.5 -- n JOB ADDRESS 2817 Shantar Drive . BUH.nING PERMIT NO. . 2302 . LJ GENERAL CONTRACTOR Owner-F der VA $ 8,580.00 Add 'Den & AP No. 139-402-38 LOT ...ACT FIRE ZONE 3 DESCIUYTION OF WORKFe7Il. Room to ReE INSPECTIONS Signature DATE GROUP I TYPE V ZONE Rl Soil PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water Rough Corn. Refrig. {] Air Cond. 0 Rough Heating ' # A4-1-S 1->9--6 - 3/4 41/-..},�-',/,4 - -/- -/(17r—Th7C 3 Rough Plumbing .a.2.17.a.2.1.a.2.17-2 �(Qc -”,,,/ 21/4j%X �CuLe_27 Miscellaneous Prop. Swr. Line 0 House Con. 0 St. Swr. ❑ Sprinkling System Construction Pole Underground .0 Power 0 ,.,. 0.I /J11`� Rough Wiring_ tZ"1d 2,,,(5%57 1r�-li -, /.else-- ;a//o/ W r .1 Seo •L-9 - Trenches Eel,. Forms ❑ Steel Reid. ® Jj /:•)9/6-s- !/ Floor System Bond Beam ❑ Steel Reinforce 0 Sheathing , i� of,59 z/2�`- Frame and Fla inn I pp"'-.e/+'i"'` �f 9104 iJJ" Lathing— In M7"•ut irg 4 ,//c 2 /4 Plaster, brown coat 3//z. G}- Refrig. fl Air Con. 0 Final Heating, Final dit5 3-/716 Plumbing Fixtures, Final Final Gas Test/.�_//oa-1.teci-ricaege ^ Z/(�-!S' • Electric Fixtures, Final --------- !% . L7-4r- - 23402 FEE RECEIVED . COSTA MESA BUILDING-SAFETY DEPARTMENT • FINANCE 3DE �PT. P .O.BOX 317 COSTA MESA,CALIFORNIA (r���TTyy (n� (; 77pp N�.� . For Applicant to Fill In Completely APPLICA71bN"cSal- MIIES TYPE OR PRINT BUILDING �^J For Office Use Only ADDRESS /L�J 8/7 �f/ASVTJF<Q (//P. RECEIPT NO. PERMIT NO. COSTA MESA, CALIFORNIA {/ 0" 3 gcnt.-/// OWNER j/�—4I I . ZI X43/ V . RECEIVE BY ,p {'L RECEIVED___ /p_TEf Eq p V . BUILDING ...Jr /S / J� (�J ADDRESS 2p 1 7 SiOr VT.qg i*r . ADDRESS .` P 7 J %4/+ Lb TEL. X7 ZONE • TYPE.\( GROU £' CIN �ST/9 /IIS-`YA NO. 666 Y9 2 J3 APPROVED / /4/ AR�'MITECT TEL 2 BY TE J U' J C GINE6R L/I �UZOR/OGc NO. d2/ 8647 r ADDRESS 3Y3c4RrErin , TR/i9ASCE ZONING ZONt NO.OF ^ USE OF NEW '���LI/ j �/ `_� /�• I I PLANS L BUIL y� CONTRACTOR �/ v OOO Q 1, to., c(/'r/'•` LEGAL ADDRESS/22/7 Alai a. DESCRIPTION c� ��/�' / I P. . 7� YI CITY (_,✓xr/c / lai J C�j C ; A.P.NO. 13 / �' �j �- STATE /J TEL. J✓• NOTTO SI E: NO E VE R OVERHANG SHALL BE LESS THAN LIC.NO.�,t,Wc�a reins NQ. �T/ 6 e6 rY EAVES SIZE �X lO U i /I NO.OF BLDGS. / ALLOWED (U.B.C.REQUIREMENT) OF LOT 70 V NOW ON LOT USE OF //�/ YARDS APPROVED YARDS APPROVED EXISTING BLDG. NIC MAIN BUILDING ACCESSORY BUILDING - (FROM C/L ST E ) SETBACK LINE FROM 9 e / FRONT .JC/P • FT. CENTER OF STREET 7 Q REAR YARD 32 . SIDE YARD I LEFT 'Vf / 'I RIGHT S R.SIDE SFT. Fi. DESCRIPTION OF WORK L.SIDE 6 FT. FT. I ALTERATION ADDITION �� REAR O FT. FT. DISTANCE BET. BET.MAIN& REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS. V SRIF DING/SIX 37 F ROOMS STORIES CAU.P.# APPROVED EXTERIOR WALL ROOF APPRRQQ,�V �^� / COVERING STUCCO COVERING SHiN6� 4Y bV' 0, ll'. n. DATE / --I >-4 USE OF BUILDING AND WORK TO BE PERFORMED I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE ANDSTATETHAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. E O_ PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING13 VALUATION m BUILDING CONSTRUCT ? // e G N SIGNATURE O PERMIT FEE 5 �O PERM ITTEE • (� S/�B $ 7L S� /� PLAN CHECK $ ,3 AUTHORIZED AGENT :/�••/ (J e /+� H TOTAL FEE $ 7•j