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Home My WebLink About2828 SHANTAR DR - Building Permits PROJECT ADDRESS: 2828 SHANTAR DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 059319 OWNER'S NAME: JUSKA, LEONARD A- 2ND ADDRESS: JUSKA ELIZABETH A PERMIT NO: B 059319 PLAN CHECK NO: 03807-92 S GOVT; N SUPP: N 2828 SHANTAR DR Lf, COSTA MESA, CA 92626 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT ARCHIENGINEER: REG.ND.: JOB DESCRIPTION : ADD FOUR SKYLIGHTS (PER NER216 ) SQ FT: 2, 685 1' ADDRESS: UNIT: CLAIM VALUE: 2, 685 . 00 CALC—VALUE: 2, 685 . 00 GROUP OCC ; R-3 /M-1 PERMITTEE: SKYLIGHT SPECIALTIES ( 714 ) 645-8645 • ADDRESS: 3160 INCLINADO COMMENTS: SMOKE DETECTORS REQUIRED PER 1991 UBC, SAN CLEMENTE CA 92673 >r..*** *****�E***�E,**********�E** * ************ *x*Stu **+E****yE********* r.********** 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 anti Professions Code,and my license is in lull force and effect. SETBACKS CITY LIC.: 027519 STATE LIG.: 395554. . 'S B • Date: f0/-412, Signature' . / _ MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: Ihereb :ffirm that I have.certificate of consent to sel4insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation( sura0ce c amilt ie c py thereof(Section 3800 b LEFT; FT IN RGHT: FT IN LEFT; F T IN RGHT; FT IN 1LICY NO.: 063891. -92 EXP.DATE: v/4 /O1 /93 comma: STATE FUND PARKING REQ: PROV: PARCEL: 13940302 ZNE; R1 REF NO: ❑ Certified copy is hereby furnished. C11 Certified copy isfil hecdX ilding vision. PLANNING NOTES> INSTALL FOUR SKYLIGHTS IN CEILIING OF KITCHEN, BATHROOM AND ^� � > MASTER BEDROOM. a. ^ Date' ./C2-1�� V Applicant: *********3l*****9(**Ma*****************i(-********************************9r********* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not pleted if the permit is for one hundred(MOO)or less) DEVELO ailM E N T S E R V I C E S - R E Q U I R E M E N S I certify that in the performance of the work for which this permit is issued,I shall employ any person in any manner so as to become c q subject to the Workers'Compensation Laws of California. ZONING APPROVED BY 1 :_a__.. -- DATE; i!f��fy2.._ Date' signature: BUILDING APPROVED BY: : DATE: /bl, / 7Q NOTICE:It.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. 1"i77 j. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED O Y; r . . 41, 64.1.----1--se- DATE• ( �(//`1 which this permit is issued(Section 3097,Civ.C). *******************'Pa4•** * *.'* •** '• - • ', k' ' ' x '•************)chat'**'** LENDER: ******************************************* ************************k********* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL' SEGMENT; Y i' 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 • S,MIP/RES ,- GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 54 . 00 .i 50V repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed /8 SM I P/NON9 RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business c it and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PIAN 35 . 10 1 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—DI V—> PERMIT ISSUE PLAN—CHECK TOTAL "! PAID /0 DUE 1 structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTAL S---'—> 54 . 50 0 • 0 0 35. 10 8 9• 6 0 . 89 . 60 • 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 TOTAL S--> COLLECTED: 89. 60 OVER/SHORT• ,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 me purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/t,OT GRADING PLAN—CHECK •I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business j 4 • 0 0 j:5 0 35 , 10 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon .1 and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ****,K.********************it**X.********X.*******3(**X-************3(****Be********it*** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E B R E A K D' O W N 4 o I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNI3'f COST TOTAL COST 4 i1 Date: Owner: SFR 2685 ALTER BY VALUE RESIDENTIAL NOZONE 041 • 00 f 2, 685, 00 I do hereby certify that I am aware of and understand the requirements of California.Health and Safety Code Sections 25505.25533.and END OF FEES 7' //1 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 Quality Management District.Residential construction applications are exempt from • these provisions. Date: Applicant: et2, I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction a,tzereprhereby enI 'es of this city to enter upon the above-mentioned /4. P1 property for inspection ppurposes. /' Dnver�LL ns�r5ocial urityk Signature: 01 G911(1'(1'_i4312510- ,Te_ 4;7 -.0 10F1.0132 • 1641-46 White—Building:Green—Code Enforcement:Canary—A licant:Pink—Revenue:Goldenrod—Assessor • CONSTRUCTION AND PLANNING - - L & SPA Date Inspector • Date Inspector • APPROVALS Permit # - - _ APPROVALS Permit # _ 1. Temporary Electrical Service or Pate 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrnd. - 54. forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical 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, ❑ Undrgrnd. - 10. Structural Floor System ) 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap • 63. Heater & Vent-Final • 13. Roof Drains 64- Plumbing System - 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. 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 /6.7-12. 4w976. Dry Standpipe 28. Lathing& Siding I 77. FIXED SYSTEM FINAL 29. Insulation ,i %. `• 78. FIRE PREY. FINAL 30. Drywall Nailing ,� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ! - 79. FINAL INSPECTION 32. Electrical Power Meter-Final ; .t 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning ' I 35. Final Gas Pipe-Test I - 36. Hood Or Canopy 37. Final rectory Fireplace 38. Final Plumbing • • 39. Water Service-Final - • 40. Gas Service-Final 41. Solar Domestic-Final - 'I 42. Backf low Preventer 0 -6"11.- net es47- 43. Backflow Irrigation •f•! (II 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING /,4/2_ 6�44!" �4V4 caoc cote _ (�/Y/. ./SL 48. FINAL PLANNING ! 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51, CERTIFICATE OF OCCUPANCY No. Date •--....—St 11� lid jtA t; r�fi yf,`� v��(u� 5� �7 �?J /�c"C S h�trr// r� S P E C I A L T I E S ` rF f��0 1 CF` • . Ntie 24 4 ' _" II t V 5jT'H I II i: I j I i 9/5061 ; ; y t )frote) j 4 1 1 , _ fII �i s APPR 0 VIEVT : ) f i ' ! CITY OF COSTA MESA ! 1I J 1 PL ANN:,NG_4EP1__, : l — � -- _ —YbYh..-ID-BlD&-D.r�. YGp, . _ F V�I`� i_ • it nY 6e. ' i ; • Iii DATE �—! Z w I DIRECTOR OF PLANNING ', 1 TnS l�i�l 1 E ` ^f I {I C ' / • ) t; Imo( '_ ' y ��'rrn Ar s` ,. ED 'A 4,C '� , J 'E tios Bui I + 1 1 ; pt. ? = • - eY e•+ lid/ LDAT l0) 11- 'j 1 HE E PUNS MUST4BE DN J B A ALL IMdS M KE N D ANG1S INITH01i1T P 10 APP A ' –1t V 'L 0� D L `.l •N E O GRANTINr, P T . -- ,- PLANS AND SPECIE SAPPROVAL O� (CATIONS S �'LFj9�i OL TJj STRUED 10 BE 4f _cf,P FI - O NsOR APPCODNu AMY ITPRESU �Ic�.`f T: • °T^' ,'�+uGIS1G�NS OF THIS CODE.fJ:�PEITMIITP _OF ANY C; AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF TH 5 •• E CODE SHALL BE VALID EXCEPT IN SO FAR AS THE WORK OR USE, WH%Id ' HORIZES IS LAWFUL. r � � HE ISSUANpp O •ERMIT BASED UPON PLANS ANp • SPE'FIC ISS S $FALL No�;ppFIT N7 SED BUILDING OFFICIA. cict FRO THER� ETER,P WW-HE CO CTION OF ERRORS I • y SAID "LAN D IFICATIONS OR FROM PREVENTIN1,-- .---- ! ' BUILD ' ,�� h OlooM n BEING CARRIED ON THEREUNDER WHEN IN VIOL 'ION 0 CODE OR OF ANY OTHER ORDINANCE ON I ✓ ttt THE CIT ;, 7 i ,olit e) • /7/Xti L t 1, 3160Inc!inado • Son Clemente • CA 92673 • (71 A) '61 -9233 • (714) 645:8645 • Lie.= 3395551 Pt1dECT ADDRESS: 2828 SHANTAR DR UNIT` CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 05930C OWNER'S NAME: JUSKA, LEONARD A 2ND ADDRESS: JUSKA, ELIZABETH A PERMIT NO: B 059300 PLAN CHECK NO; N GOVT: N SUPP ; N 2828 SHANTAR DR COSTA MESA,CA 92626 CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: ALT 764-7666 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF RESHT, REROOF W/HARDI SHAKE SQ FT; 10, 400 ADDRESS: UNIT: CLAIM VALUE: 10, 400 . 00 CALC-VALUE: 10, 400. 00 GROUP OCC: R-3 / PERMITTEE: PREMIUM CONSTRUCTION ( 714 ) 998-6676 ADDRESS: 2600 N CANAL COMMENTS; SMOKE DETECTOR REQUIRED IN THE HOME TE ORANGE CA 92665 ******* **;E*x********* **** ****x****Tt******************** **** ************+:)r:* 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 full force and effect SE TB ACKS CITY LIC,: -31 STATE LIC.:492 Q 4 9 CLASS: �/ f� date: /7 3` 9°( signature IY-''"''C,—j MAIN BUILDING ACCESSORY HUILUING WORKERS'COMPENSATION DECLARATION: I hereby dl- at l have ce float of enc to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN Compensation lsy(apcgy2]cajtQedcopythereof(Section3800.Lab . LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN xv POLICY NO.: IDra J10 /`J1 EXP.DATE: 81/01 /93 COMPANY: STATE FUND PARKING REQ: PROV: PARCEL; 13940302 ZNE: REF NO: ❑ Cemfi9ed copy is hereby furnished. l i Certified copy is filed with the city Building rvsion. PLANNING NOTES* in _date; /73='If; Applicant: - z // *******N.*.*.***IE.Dr*****)4*******************-lEN***3v'•*********3f-**Df1F*********14*§k******* EXEMPTION FROM WORKERS'COMPENSATION DECLARATIONi his section�Cdh/lot be completed if t o permit is for one hundred 151001 or less). D E V E z2..„ L O P M E N T S E R V I C E S R E Q U I R E M E N�r`lti S I certify that in the performance of the work for which this permit is issued s all not employ any person In any manner so as to becomel subject to the Workers'Compensation Laws of California. ZONING APPROVED BY , DATE; .17-: Date: Signature: NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY ; O' DATE: /i, Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. C r CONSTRUCTION LENDING AGENCY; I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y• C DATE; y(.7.-7a _/ Z-• which this permit is issued(Section 3097.Civ.C1. **************,*€*********3(* '** '**************- * *******fe*********3(- **i}j*****3.**** UNDER: **************3f***:************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT; Y ' OWNER BUILDER DECLARATION: thereby affirm that l am exempt from the Contractors'Stale 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 126 . 00 I 1 . 04 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed .SM I P/11ON-RES pursuant to the provisions of the Contractors'Stale License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN l and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE - (' ^ I. as owner of the property or myemployees 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 ale(Section 7044,Business and Professional Code: The Contractors'Slate License Law TOTALS----> 127. 04 0 , 0 0 0 , 00 1 2 7, 0 9 T27. 04 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• 127. 04 OVER/SHORT: 00 improvement of sale). one year of completion,the owner will have the burden of proving he/she did not build or improve lorthepurpose 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 126. 00 1 . 04 ❑ 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 *************************************************************B!,*************BE*** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDO W44 ❑ I am exempt under Section: B.8 P.C. /41 for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date. Owner: SFR 10400 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 004 10, 400. 00 I do hereby certify that am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and END OF FEES 4n425534 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 n • permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from ' these provisions. ,.14,. Date: Applicant: .it 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 r: ordinances and state laws relating to building construction and hereby authorize representatives oft ' city to enter upon the above-mentioned 7 property Ion iiino nspet ion purpr ses. / ` lentre 3 !2 Signature._ 4,,—.4-t---/C--.4 ,7 . Driver's License or Social Security a: 7 Oi. 09125931-00125037 TL +1Y''.d'. DATE: 09130:92 T111:: 13:12 1641-46 White-Building:Green-Code Enforcement:Canary-Applicant;Pink-Revenue;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL & SPA , • �" Date Inspector Date Inspector APPROVALS Permit # - APPROVALS Permit# 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. 5• 3.'-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 UF 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. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final - - 15. Rough Electrical-Conduit - 66. SOlar System-Final r 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 ❑Gas ❑Oil • 23. Gas Pipe•Rough & Test • 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing /0-1- 1L itt-.6e 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat L 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding - 77. FIXED SYSTEM FINAL 29. Insulation I I 78. FIRE PREV. FINAL 30. Drywall Nailing I N �- HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat I 'I`-_,J 79. FINAL INSPECTION 32. Electrical Power Meter-Final � I I 80. FOOD CERTIFICATE ISSUED 33. Final Electric '-j - Notes: 34. Final Heating & Air Conditioning 1_ 1 ' •I 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 - (41 472- --# S n'eXt _Q .{ O 45, Sound Attenuation 4014-1-- " 46. Handicap Regulations ?�- 47. FINAL STRUCTURE & BUILDING /B`/y42 �v�L 4&. FINAL PLANNING (' t _ 491 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. ,CI. F COSTA MESA -- - - - - PERM I NO. TRACT ND:" LOT-NO. , BLDG.NO. -- ' ' -• - -' - - • - - . -- - t OTRUCTION PERMIT_ e•%;:- ��c�o�% • • •Project Address• ' . :nary4 it u�• • TYPE OF CONSTRUCTION ,❑,NEW Li ADD Li ALTERATION U REPAIR• - - - ' . . - s��y Applicant 5 Mailing Address • ��,s�� 1 /tom+��- ❑ CONVERSION '❑ DEMOLISH ❑ OTHER s • q'.p,#. ' • u I Zone- .i 1 `+ Owners Name1,41. /� S� r"' Phone- 1 - DESCRIPTION OF WORK - - - S Main Building: - Accessory Building • - ' ' Z i \ Address � + ,7 ' 1� - _ ❑-STRUCTURAL . T -Front t-• - N ' TV PE,OF PERMIT ❑ GRADING . ❑ FOUNDATION I Arch/Eng:: .�`^ -License No. • ❑ TENANT'$ELECTRICAL ❑ PLUMBING ❑ MECHANICAL - B Rear - N Address - /�� ID OTHER ‘ , - - - - - -• A . , I Contractor's Nam- • 4I. r •• 1-•,..9, Phone �7"O'I' 'PROJECT DESCRIPTION: SO: F7.' 1 OCCUPANCY'• C Right - - - t , . - R O7 NI t y 1�T/jJq 'CONSTRUCTION TYPE VALUATION$ ' _ s R Address(mailing) I i Ime - �Y Left ? _ E City-License No. ` - ZONE GRADING• CU.YDS. ,ACRES ping. Ref.4 Park,Fees $ Q LICENSED CONTRACTOR DECLARATION .276d) _ U Remarks: Parking Req./Provided hereby affirm that am licensed under provisions of Chartessi (commencing - - - . R - with section 7000) of Division 3 of the Business and Professions Code, and ' Use of Building: , - E •my license is in full foice anf�effeet. '1� +t�7[ • • 'License Cla - �- y `—w Lei ense No. �.�.d hr!' /+"+ ' PLUMBING .I FEES Planning Notes: - M Date • .3/;N - Signature --j/7� L - . 1 I • N Bar Sink S • howers - WORKER ' OMPENSATION DECLAR• ION I -^ T I hereby`aftirm that I have a certificate of on5ent to self-insure or a certificate I - , i of Workers' Compensation Insurance, or a certified,copy thereof (Section —Backflow Preventer Service Sink. r 1 • _S 3800, Lab. C.)'/// • xpp,{-� _ Backflow Irrigation Sewer Cap - 1 ELECTRICAL FEES , Policy No. •fb-n Company 4V d v - - [] Certified copy I hereby furnished. Bathtubs ' Sewer Connection - - Automatic Washer. 'Transformer 0 15-50 KW _ , ertified co T with the city u �s o / - � 0 50.+ KW • + Clarifiers Solar Collectors Construction_Pole Sub. . I Date Applicant , ,, , EXEMPTION WORKE RS'COMPENSAT ON DECLARATION.. - Dishwasher' - - - "'$Olay Pi in - - '- ' • - (This section need not be completed if the perm is for one hundred ($100)or P 9 CoOking'Unit . - - Meter Dup to 100 amps less). DrinkingFountains - I certify.that in the performance of the work for'whlo this permit isct tot I _ Solar Tank • i Dishwasher Meter Dover 100 amps shall'not employ any person in any manner so as to become subject the . -Workers' Compensation Compensation Laws of California.. I - Floor Drains, • ; ' : Swimming Pool w/Spa: - Dryers 0Ga5 DElectric 'Sub Panel .f , Date Signature ' -- NOTICE: fatter making this declaration, you should become subject to the Floor Sinks I Urinal . / Fan - ./ Motors 11�0-1'HP Di t4-8 --Workers'. Compensation provisions-of the Labor-Code;-you must-forthwith • — . • . - - comply .with such _provisions ,or his permit I shall be deemed revoked. . Gas Service ' -Outlets - Water Closet , - CONSTRUCTION LENDING this - ? • - - - F.A.U. 'Inc Solar109-15 HP 016-15+ . I hereby affirm that there is a'construction'lending agency for the performance' I • Intercejitors - Water Heater, i . Fixtures j , 'Microwave I �/ ' of the 'work ,for ,which- this permit. is issued (Section 3097- Civ. C.) _- - - - - - I I • Lender's Name- = Kitchen Sink i - • Water Service - , ' ' Device Boxes .Pole Light ' • Lender's Address • . - OWNER BUILDER DECLARATION - - .. Lavatories; - _� _ - �� Outlets + Range I I hereby,affirm'that I am exempt from the Contractor's License Law for the ' _ _ ,I i I. following reason (Section-]031.5,Business and Professional-Code: Any city or - I P-Trap' i • , . I ,_ , . n - '-5 Switches' Sign , . 7 county which requires a permit to construct,alter,Improve,demolish,or repair • v .- • 'any structure, prior to Itsissuance, also requires the applicant for such permit Roof Drains r ' `tl - Garbage Disposal • •Standing Sections , - . • -to file a signed statement that he/she is licensed pursuant to-the provisions of - '- - - - the Contractor's License Law(Chapter 9 (commencing with'Sectioo 7000)of - - - Generator 00:5 KW❑5-15 KW . Trash Compactor ! I • 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 - , I . 7031.5 by- any applicant for, a permit.subjects the_applicant to 'a civil '.Reins coon Fee $13 r0. - Nenalty of not more than five hundred dollars ($500). C. • rie I $25 Issue Fee - s I, as owner of the property or my employees with wages as their sole - Reinspection Fee ' $25 Issue Fee' . • $'3 compensation, will do the work, and the structure is not intended or offered • I I • . MECHANICAL - • . I FEES -1 - for sale.(Section 7044, Business and Professional Code: The Contractor's -- - ---- - -- - PUBLIC-SERVICES REQUIREMENTS: - License Law does not apply to an owner of a property who,builds or improves Boiler - Hood or Type I 0 , I ' ' + thereon,'and who;does such work,himself/herself or through his or her own Zoning Approved By Date employees, provided that such improvements are not intended or offered:for • - - Canopy Type Ili 0 , ' / . _ • sale. If, however, the building or improvement Is sold within one year of com- Duct:Under Ground , I • Application Approved By I Date pletion, the owner-will'have the burden of proving he/she did not build or im- - O , prove for the purpose of sale). ', + i i Duct-Structural i Refrigeration System 1 i r Application • Issued By - ✓1� Date /n-/3-rt 3 LJ I,as owner of the property, am exclusively contracting with licensed con- I. ) DO-100,000 BTU ❑100,000 BTU '' ' I I ? tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating _ I 'SUMMARY OF FEES The,Contractor's License Law does not apply to an owner of property_who .y - -_ . _. - - .- .- • _ ._• BUILDING PERMIT $ - SMTP, ; builds or improves thereon, and who contracts for such projects with aeon- Exhaust System 0 Multiple 0' System Repair/Alteration • tractor(s) license pursuant to.the Contractor's License Law): .1 I -• • PLAN CHECK $ PERMIT 1 ❑ am exempt under Section 'B.& P.C.for this reason ; Firepl/Fact.Bit. ICBO# _ _ • PLUMBING $ ISSUANCE - $ ' - Date Owners • - - t I Heating System& Ducting I i f I •I . t' PLAN CHECK $ I ENERGY P.C. $ I ' I hereby certify that I have read this application and state that Die above ' : Do-100,000 BTU 01y00,000 BTU - - -? I GRADING , $ I '. Information is correct.-I agree-to com I -- - - -- - -- - - - - . - _ . I- i ELECTRICAL $ I _ / comply-with all•cit here!countyo authorize repre- noes , - - i--- I ) and.state laws-this,city building construction, and hereby r - 1. I PLAN CHECK I $ p2 -� I MICROFILM { $ sentatives of this,city to ent:r. upon t-e above-mentioned •'prop.rty dor ' . I ! inspection pur.ose ' I - !, I MECHANICAL ' I Signature -. Alifia L -4//_ ' Date 13 • I I 4 _ I $ TOTAL FEE ) $ '9— Drivers' License or`SS - - ' / • '/ /� Reinspection Fee • $25 , Issue Fee : . ; $ 3 PLAN CHECK 1 $ • - - Pink-Accounting;Goldenrod -Assessor- - - - --t-- • CMF 0865-46 rev. 7/83 -White-Building;Canary-Applicant; • \' 1-1.91 CONSTRUCTION AND PLA ING POOL&SPA - •APPROVALS !404 'APPROVALS Permit# fa1'r• '._Date Inspector Permit# Date Inspector - '.1. Temporary Electrical Service or Pole; 52. Pool& Equipment Location ' _ - • 2. Soil Pipe;Undrgrnd. .• .. _• - , 53.,Steel Reinforcement • _ ! 3: Electrical Conduit Utility-Undrgrnd. - - , 54.,Forms, - . - •4. Electrical Conduit-Undrgrnd. - , ' ' - - 55. Electrical Bonding - w ' 5. Steel Reinforcement... - - 56. Rough Plumbing & Pressure Test 6. Electrical,UFER Grid. - ' ' 57. APPROVAL TO COVER-GUNITE . . 7.4Footings ' .7�. - _ - -^ 58.` Electrical Conduit-Undrgrnd. • ' 8.;Foundation ' - 59. Gas Pipe, 0 Undrgrnd.;Test - - ' 9. Water Pipe-Undrgrnd. -60: Backwash- Lines, P-Trap, O Undrgrnd. 10. Structural Floor System - • 61. APPROVAL TO DECK • 11. Property Sewer Line & House Connection 62; Backwash & Receptor-Final ' 12. Sewer Cap • ' 63. Heater & Vent-Final . 13. Roof Drains r - . • "� 64. Plumbing System - Final "- 14. Rough Plumbing ' • 65. Electrical-Final ' . J` ; 15. Rough Electrical-Conduit 66. Solar System-Final - 16: Rough Electric Wiring - _ nn/3[�. / �./71, 67. -Fencing & Access Approval ' - - . ' 17. Rough Wiring Sign C i, , 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 ❑Oil . 23. Gas Pipe-Rough & Test • 72. Underground Flush. 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑_Oil 25. Roof Sheathing J 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 PREY. FINAL . 30. Drywall Nailing HEALTH DEPT..REQUIREMENT • J 31: Plaster Brown Coat 79. FINAL'INSPECTION 32. Electrical Power Meter-Final . . 80. FOOD CERTIFICATE ISSUED . • 33. Final Electric Notes: I �a-�/�f3 C� /�//Y�3 pC lC.�n �r/N S PECTi 0.4.) 34. Final Heating & Air Conditioning ,v ' / ' - . QEF` '�l._C 0. t, _ 35. Final Gas Pipe-Test - - , 36. Hood or Canopy - ' t : . : ' ' •37. Final Factory Fireplace • - - - -, 38. Final Plumbing : . I 39. Water Service-Final - i - . . 40. Gas Service-Final - • - 41. Solar Domestic-Final • _ - _ _ . . . , 42. Backflow Preventer - '� -• - , 43. Backflow Irrigation - . • . 44. Landscape Irrigation System _ ' _ I . ' • - 45. Sound Attenuation - - 1 - . • 46. Handicap Regulations ` 47. FINAL STRUCTURE & BUILDING - I - - - - 48. Special Requirements Completed • ' . _ • ' I •, I. 49. Electric Release to Edison - - - - , - - -- I - ,' 50. Gas Release to Southern California Gas Co I ' I 51. CERTIFICATE OF OCCUPANCY _ _ _ __ ' No. " Date I • � ' I - - • I. I • Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERM T NO. " •' TRACT-NO. ' LOT NO. BLDG.NO. - 7646 _ ,9/ 482 �J•5O TL' CONSTRUCTION PERMIT 0-4 girl— - ., - r ' Project Address S� . . ` TYPE OF CONSTRUCTIONS ' '_' ,f : �r' - - OWner ;re; ry Qa% T� - Phone %�,► 0 NEW L'J"ADD - ❑ ALTERATION ' - - - • • • . Address r!•82s 5(4-4J'*4-e. - ❑-REPAIR 0 CONVERSION ❑DEMOLISH • % ❑ OTHER ZONING REGULATIONS Arch/Eng. -4A- . . License No. ?WA-. - • A.P. - .S.-.. _ O . • . _ DESCRIPTION OF'WORK _ - - - - - Address H- -' ZONE PLNG.TppREF: -Contractor D(L 50/46 - ItJ L Ph6n�/�`(/�p - BUILDING - - PROPERTY LINE_' �j s' e9f-52JUU5Q TYPE OF PERMIT BUILDING F:* p ��ll u _ 'SETBACK C/L ST. 6 Address f O I MA-1� .H-. /a7O7 ❑ GRADING�,�❑ FOV NDATION ❑ STR U_C/TU RAL r�SIDE 7YARD•J 'LICENSED CONTRACTOR DECLARATION. _ ❑ TENANT IJ ELECTRICAL ❑PLUMBING GMECHANICA pE YARD I hereby affirm thtt I am licensed under provisions of Charter 9(com- - RIGHT • mencing with sectlon^,7000) of Division 3 of-the Business and GATHER _ , Professions Cotle, n y license is In full force an. effect. '- REAR YARD (TO P/L) ' rd;- - PROJECT DESCRIPTION' License C ss ` - ense N•. "� -" - - - PKG.SPACE REQ. PROVIDED - Date q Z • Signature ��_�a- -r .P _• SQ. FT. WORKS SSATION DECLARATION OCCUPANCY_CONSTRUCTION TYPE STREET WIDTH Pq RK FEE$ •I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION • ZONE ZONING APPROVED BY DATE ' certificate of Workers' Compensation Insurance, or a certified copy. • - thereof(Sec on 3/800, Lab. C.). �-CiN� GRADING CU.YDS. • ACRES • 'SPECIAL CONDITIONS: Policy No. ZZ -Company n • . - D Certified copy Is hereby furnished. ,. REMARKS: Ain&CC_ Cti_1 ix �.2. . . Certified copy is filed with the city,Building Division. q e'A •-y� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION el2A 17704- IG ''v L)C/S7 Ai 4. . . . (This section need not be completed if the permit is for one_hundretl /a.re,4 Ait ger, /Z - • ($100) or less). K/KC_L-u 17yAJ/[N rifts - - I Certify that In the performance ofhe work for which this permit Is Issued, I shall not employ ar5pq In any manner so as to become PLUMBING , PLAN CHECK • ELECTRICAL PLAN CHECK subject to the Workers'Com t' ws of California. UWtLLING - 0KRA4E BATHTUBS - _ • SHOWERS ' Date • Signature SQ FT SO FT A _ NOTICE: If after making this declaration, you should become-subject TOILETS URINALS - - GENERATOR - 0-1 KW_1-10 KW T�p' to the-Workers' Compensation provisions of the Labor Code,-you must TRANSFORMER •- 2, a+sq forthwith comply with such provisions or this.permit shall be deemed LAVATORIES DOUBLE LAVS • - ---- - APPLIANCE 10-50 KW_50+KW W revoked. CONSTRUCTION LENDING AGENCY - 'KIT.SINKS - DISHWASHERS ^ - MOTORS 0-1 HP 1-10 HP - I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS , SUMPS - '(INC.SOLAR) 10-50 HP 50 + HP formance of the work for which (.his-pernfit is issued (Section 3097 Civ. CJ: •- -• /N1 FLOOR SINKS `- FLOOR DRAINS FIXTURES ' OUTLETS SWITCHES i Lender's Name - Lender's Address DRINKING FOUNTAINS ' • - • •^ GAS TUBE SIGNS • - OWNERBUILDERDECLARATION INTERCEPTORS CLARIFIERS '- ,POLE,LIGHTS • - • - I hereby affirm that 1 am exempt from.the Contractor's License Law for the following reason (Section 7031.5 Business and Professions-Code: •SWIMMING POOL P TRAP _ LUNS I NUL I IUN Any city or county which requires a permit to construct, alter, - POLES METERED SUB improve,demolish or repair any structure, prior to-its Issuance,also re- WATER SERVICE ALTERATION - ;PANELS MAIN SUB quires the apt licant for such permit to file a signed statement that he - ' is licensed pursuant-to the provisions of the Contractor's License Law- GAS SERVICE - - OUTLETS • SERVICE - • AMP - - (Chapter' 9 (commencing with Section 7000) of Division 3 of the - Business and-Professions Code) or that he is exempt therefrom-and the WATER HEATERS BTU OUTPUT,,,\ • f -. basis for the alleged exemption. Any violation of Section 7031.5 by - - • any applicant,for a-permit-subjects the applicant to a civil-penalty SEWER CONNECTIONS - ' - ' - - of not more than five hundred dollars ($500). - ❑ Las owner of the'property,or my employees with'wagesas their SOLAR TANK COLLECTORS sole compensation, will do the work, and the structure is not Intended !/,/� or offered for sale. (Section 7044, Business and Professions Code: The 'SOLAR PIPING SYS. - - ' ISSUE FEE - !pp() Contractor's License Law does not apply to an owner of a property _ -- who builds or improves'thereon, and who does'such work-himself or - ISSUE FEE -- ' - -- ;APPLICATION APPROVED BY - DATE - - through his own employees, provided that Such improvements are not - __ intended-or offered for sale. If, however,-the'building or Improvement MECHANICAL PLAN CHECK - . is sold within one year of completion, the owner will have the burden SUMMARY OF FEES of 'proving he did not build or .improve for the purpose-of sale). - - BUILDING - - HEATING SYSTEM 0-100,000 BTU • ,PERMIT $ - SMIP• ' $ ❑ I, as_owner of the .property, am exclusively contracting with. AND DUCTING - .. - - - - - • 1 licensed contractors to construct the project (Section 7044, Business 100,000 + BTU ;PLAN CHECK $ PERMIT 'L•GPJ° and Professions Code: The Contractor's License Law does not apply to M�s.vyl1 . ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTUfJCt• :PLUMBING $ tracts.from-such projects with a contractor(s) licesned pursuant.to - SYSTEM -. [// -�j C� ._ _ GRADING - $ "• the Contractor's License Law). -100,0001+BTU ( so PLAN CHECK -$ I ' • . ; ❑ I am exempt under Sectiori ---"-' 13,-& P.Cr for this - - •-'- •-^ - - - - $•- • BOILERS BTU AtECECTRICAL- $ reason - �� - - . . _ - MICROFILM $ • / SYSTEM REPAIR,ALTERATION •,PLAN'CHECK- $ Date Owner - - MECHANICAL $ it, 50- . TOTAL'FEE$ ( I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD. information is' correct.-I agree to comply with 'all 'city and county .PLAN CHECK -$ - - - VANCE PC $_ - - - ordinances and state laws relating to con tion and hereby authorize - , • • representatives- of this icy to-enter ' poo the-above m cloned - ' So property for i o r oses �1 q �{ C .JJ • Signature /psoy�'/�'/7iJ� pDa[ { - ' • - ISSUE FEE . _ . . _ _ .$ 00 _: . _ - CMF 0865-46 White.Building;Canary-ApPlicant; Pink-Accounting;Goldenrod-Assessor - t-, -. , . . _ - . . . CONSTRUCTION AND PLANNING POOL&SPA _ _ •, � g� Date Inspector - ' ' - 'Date' , Inspector APPROVALS Permit # E' !U APPROVALS• • r'+, Permit# • 1. _Temporary Electrical Service or Pole ; , 43. Pool & Equipment I:ocation ' . -` . ' -• - L. 2. Soil Pipe-Undrgrn; + ' 44. Steel Reinforcement - .. '- - ' - .• - ' _ 3. .-Electrical Conduit Utility-Undrgrn_ _ _. _• _ - __ _. 45: Forms - - - , _ 4. .-- -Electrical.Conduit.undrgr.n . - _ - - , - . . - 46.-. Electrical Bonding .: - -- -- - -'- - - __5. . Steel Reinforce -._ - _ __ - . . - . , ,i 47. RoughPlumbing.& Pressure Test - . - . - - ' , - _6. _Electrical_UFERGrn_-.-_ ______ ' a _ - `48. APPROVAL TO COVER=GUNITE :,-;' -: . - - r ,_.7,.... Footings_ _ __--_ - _ _ 49. Electrical Conduit-Undrgrn '-. - "° ' • • ' ' ' ' 4- -8...-Foundation... - _. ---- _ _- _ _ 50. Gas Pipe,-..0 Undrgin,Test " , '' ' - ' ` _9._ . . _ --.- .-- --WaterPipe . - ._ .-- -- __ 5 - 51. Backwash Lines.P-Trap: D-Undrgrn. - --""_ :\ + ' ` -.10.._- ructurai_Eloor,SYstem. - . _ , - •a:'.• ..52. .APPROVAL TO DECK - , '_1.1..-_P.roperty,.Sewer.Line& House Connection - _1. _-. . . - •• - .53. Backwash & Receptor-Final' . . .' ' ' '_." ' . :-_1.2._. Street Sewer Connection _.' ..- "' . _ _-_ - - -. - - 54. Heater &Vent-Final , ' __1.3... Rough Plumbing ._ _ _...-__ ._ I " 55. PlumbingSvsfem•-Final 14. Rough Electric-Conduit - - '- - - -56.- Electrical=Final._ ---1 • - -• ' '= e 15. Rough Electric-Wiring- ! "'� ` "' '-.-57: Solar System-Final ,; t -16.---Rduglt Heating &Air Conditioning-- - -. - •- ' . -. . - ''d _Wt. Fencing&Access-Approval • „ i -17,--Ducts; in Structure • - . _ _. • 59. APPROVED FOR PLASTERING ---18:- Ducts;.-Ventilating-- • f- •-- - -_ _ ._. r i 19: .Gas Pipe=Rough &Test- "' ` ` •. it' .4--._- _ _ _.60. .POOL/SPA SYSTEMS FINAL' „ :I.,' . ' i- 20: Roof,Framing- -. _ ___ - , . •n. .. , �,. , .., 21; Roof Sheathing -.. _.,- - - -- - _ - . .Y -22. Frame and Flashing - - - _ 'NOTES .. _ .. • l i' / `- -232. -Insulation - - -- -. _ "s. r-'- r. _. _ _. . '_ � " ' . _ _ ._, ' , Q4. L+thirty & Siding-- - - . . . • _ - ._._ _..; _ _ -- _ . . ri ___ _._. . _ _ - _. _ -25 Dryw'all Nailing-_- - .- . _ . . , - I. _4_._ -' -- . : - _ , 26: Plaster Brown Coat -- _ j - . .. • - . _ - . . -- . - ' - - 27! Electrical Powei'Meter-Final- - - - - - ' t_. ;_ _ .. . _ . ._ . __.._ . .. _ _ a ,• • .. ' 28i--FinalElectric ' .• --- - - - - -. . 4 - ..;_. . l . . - _ . ._.._ . _ 29.'--Final'Heating & Air Conditioning - - ,C�4y/PI- ,F� - - - u' 30:- Final.Gas Pipe-Test- - . . _ _ . _. . __ - (\ - 31 , Final Plumbing - - - - - - - r - - - - w' _ . . _ • __ - .: .- . .. . . 1 -32. Water Service-Final - _ - - - - _ • „ - �� r 1-33.-- Gas Service-Final: -- - _ .. - _.: : . . ' ._ _ • . - _ r .,m,� , ,v , 34. Solar Domestic-rinal 'f • " • .-, ' ' 35. Landscape Sprinkling System 1 - --- - • ' c ..,. . . - _ - - _ .. 36. --Sound Attenuation . . . ,. , 37. Handicap Regulations .E.•t' • • ,., • ••• • ,:,-i • . , ,� _.. 38. FI NALSTRUCTURE &-BUILDING "' ' - . - ' 35. Special Requirements Completed - - _ , - _ _. _ - ---- --� .. ' 40. '€iectric,Release to Edison -j - �' . i 41. Gas Release to Southern California Gas Co. - ' - 42. CERTIFICATE OF OCCUPANCY . __ ° ' No_ Date C - _. - - - _ - - _ ,. • • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. F COSTA•MESA: - PE IT - -TRACT'NO. LOT NO. BLDG.NO. - - - • - n .7-160_ 10/,12/83- -- .I GReOO • TI. ONSTRUCTION PERMIT 7 • (y� Project Address, -- 'ate/11S >ITIt4 TYPE OF CONSTRUCTION ❑ NEW ADD U ALTERATION ❑ REPAIR,. • ) Applicant's Mailing Addre/�is,Q -• - S/9-rnb fr t ' ' ❑ CONVERSION ;❑ DEMOLISH ❑ OTHER„ I. q;p;#. Zona - , � Owner's:Name WART - Phone v%7/r, ' 'DESCR I PT ION OF WORK ' ., - Z _ S Main Building:' 'Accessory Building (°O ' Address' �}��'��}};;;•- f TYPE OF PERMIT ❑ GRADING; I• `� FOUNDATION' U STRUCTURAL T Front ^ . - c N t.`� 4-'" rF/l5 - P�I /�^7 'License No,,C-�(C �3/]fJ'/� 1�' . N Afch/Eng: // ❑'TENANT ❑,ELECTRICAL�CLPLUMBING, ❑•MECHANICAL : B r • - ., :. 'Rear Address. - ' - :❑BOTHER : 4 - 1 - A - I E'✓•r /�Uait t` / 6 '' - ) C Right - ,. - I - 1 1 r , G Contractors Name _ :Phone' 1 -, PROJECT DESCRIPTION• SO. FT OCCUPANCY G z^s..sAo^ d 1 CONSTRUCTION TYPE VALUATION$ . g 'Left' r '' R Addresslmailingl �S3 / (r•w+� � /l - _ E City License No. - r ZONE 1 _ GRADING CU.YDS. ;ACRES - D Ping. Ref,# t Park Fees $; LICENSED CONTRACTOR DECLARATION Remarks:2 , - ii N 9 7/; g - Parking Reg/Provided t - - I ' ' I hereby,affirm that I am licensed under provisions of Charter.9 (commencing III��' t!/ f`�J - • R I with-section 7000) of Division 3 of the Business and Professions Code, and Use of Building: ,• ' - _ - E my-license is in full fo e a • effect, : ' Q / ff•/� License ass ` a ' Licens- No. �' �f i PLUMBING ' - FEES Planning Notes: - `• - ' i- E • Date L ': Signature /� ' /` H. N WOR ER- COMPENSATION D '� •ORATION Bar Sink Showers • - t T I hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink 1 ' S ' of-Workers' Compensation -Insurance,.or a certified:copy-thereof (Section ' ♦, 3800, Lab, C) `-9 �` l , Q ^ .` Backflow Irr ation Sewer CapI �- Policy No. Ci) `.:-9 QD I -O Company JVD`-� i 9 ELECTRICAL 'FEES Certified copy,is hereby furnished. • I /1 Bathtubs - ' Sewer Connection Automatic Washer' Transformer D 15.50 KW ' I J❑Q�Certified copy is flied with the city Buil tuts' f: 'Date /D,/g-�,�3 � r.9. Clarifiers 1 • - 0 50+KW Applicant 1 Solar Collectors 'Construction Pole Sub. .EXEMPTION FROM WORKERS'•COM SATION DECLARATION. - -1. . Dishwasher ' -- Solar Piping- - ----- Cooking Unit r-' - - -Meter Dup[0 100 amps section need not be completed if permit is for one hundred ($100)or k 9 ✓ P " ' -- - } less) •° '•, I erti ft'that lo•th'e performance of the work for which this permit is issued, I/' Drinking FOunta105 Solar Tank ' • . Dishwasher 1 Meter Dover 100 amps : . shall:not employ,any person in any manner so'as to become subject to the.,, "y • - Dates''Compensation:Laws of California- a . Floor Drains- I Swimming Pool w/Spa , f .Dryers DGas ❑Electric Sub Panel Date - :y Signature I I. i • NOTICE:If,'afterjmaking this declaration, you should become subject to the; - Floor Sinks ' Urinal i . - Fan f�, Motors❑0.1 HP ❑1%-8 Workers', Compensation provisions-of'the Labor Code; you must forthwith' • - �_ comply with such -provisions or this permit shall -be deemed revoked, Gas Service Outlets. Water Closet F.A.U, - Inc.Solar ❑9-15 HP 016-15+ CONSTRUCTION•LENDING:,AGENCY • ' • - I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater r I Fixtures Microwave of the work .for, ,which, this, permit is issued,'(Secdom' 3097 Civ. CJ, , • - - _ i Lend'er's Name - '- -- _ 1 ' = Kitchen Sink = _ .Water Service 1 Device Boxes ' 'Pole Light ' Lender's Address: _• - " '' - 1, , OWNER BUILDER DECLARATION Z-Lavatories r " - Outlets ',Range 1 r I hereby affirm-that I am exempt from the'Contractor's'License Law for the. ' following reason (Section-70315 Business and Professional Code: Any city or P—Trap: ) _ ' ', Switches' ' Sign I county which requires a permit to construct,alter,improve,demolish'.or repair I - 1 ' I any structure, prior to Its'Issuance, also requires the applicant for such permit ' • Roof' Drains' - Garbage Disposal , - Standing Sections I to file a.signed statement that he/she is licensed pursuant to the provisions of _ - - the Contractor'the Bnse law(Chapter 9 (commencing with/Section 7000)of _ ,• Generator 00.5 KW❑5-15 KW ITrash Compactor. i -Division 3 of the•Basiness and Professions Code) or that he/she is exempt F _ - p • 7031.5 by the basis for:the alleged exemption. Any violation of Section - - ' " ' , by- any'applicant for.a' permit:subjects the^applicant to a civil _Reins ctlon Fee $ 3 • penalty of not more than five hundred dollars($500). Pe I $25: , Issue Fee, 'DI,.as owner of thel property'or my employees•v,ith wages as their sole Reinspection Fee $25 Issue Fee, • $ 3 ' compensation, will do the work,and the structure is not Intended or offered ' ' MECHANICAL I FEES - - - , for sale'(Section 7044, Business and Professional Code:,The Contractor's - --- PUBLIC SER VICES REQUIREMENTS: • ' License Law does not apply to an•owner of a property who builds or improves ' Boiler : ' ' Hood or Type I ' ❑ ' - - ' thereon, and who does such work himself/herself or through his or her own 'Zoning Approved By ' - ' Date ' ' employees, provided that such improvements are not intended or offered,for - Canopy Type II ❑ sale, if, however, the building or improvement is sold within one year of com- ' , Duct-Under Ground ,I i • - Application Approved By Date • pletion, the owner will have,the burden of proving he/she did not build or im- : v / rove for the purpose of sale). ; Duct-Structural • Refrigeration System. _,. Application Issued By LS Date—/a7:77 U i, as owner of the property,am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: • Duct-Ventilating I ,SUMMARY OF FEES The Contractor's License.Law,does not apply to an.owner of property who - BUILDING PERMIT $ SMIP $ builds or improves thereon,.and who contracts for such projects with a con- Exhaust System El Multiple D. System Repair/Alteration ' tractor(s) license pursuant to:the Contractor's License Law). PLAN CHECK I $ - PERMIT 1 ❑sham exempt under Section - B.& P.C.for this reason ' Firepl/Fact.Bit. ICBO;# 1 - p ISSUANCE $ - PLUMBING $ ' Date Owner: Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ _ • I hereby certify that I have read this application and state that the above . ❑4100,000 BTU ❑100,000 BTU ELECTRICAL $ GRADING $ information is correct. I-agree to comply with-all city and county-ordinances - - • - •- - - -- - - - - -- - . .- and-state laws relating to building construction, and hereby authorize repre- I PLAN CHECK $ - MICROFILM $ ' ' ' sentatives of this;cit to'enter upon the above-mentioned proper[ for ' , • Inspection purposes - z�,.��9� ` MECHANICAL • $ TOTAL FEE " $ : /* Signature ' �� Reinspection Fee $25. 1 Issue Fee • $ 3 PLAN CHECK • , $ 1 - - 'CMF 0865-46 rev-7/831 -White•Building; Canary-Applicant;Pink-Accounting;Goldenrod-'Assessor ... _ - .. CONSTRUCTION AND PLA �G POOL &SPA _- APPROVALS Permit# � Date Inspector APPROVALS Permit# Date Inspector 1. • 1. Temporary Electrical-Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Gndrgrnd. ' • • /�%�,,,�.Ja 4 53. Steel Reinforcement ..3. Electrical Conduit'•Utility-Undrgrnd. �'. - 54. Forms 4. Electrical Conduit-Undrgrnd. - - 55. Electrical Bonding - • ' 5. Steel Reinfo`rcenient - '' 56. Rough Plumbing & Pressure Test• , 2- • • 6':r•Electrical UFER Bernd. 57_. APPROVAL TO COVER'-GUNITE 7. Footings ', ' - - ,58.- Electrical Conduit-Undrgrnd. 8. Foundation tir. ... . - 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 . lit Property Sewer Line & House Connection 62. Backwash & Receptor-Final • 12. Sewer'Cap• " 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final • 14-, Rough Plumbing`, ID-71420 65. Electrical-Final .- 15. Rough Electrical-Conduit '-. - -66. Solar System-Final 18. 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 '23. Gas Pipe-Rough & Test ./ 72. Underground Flush 24.•Roof Framing - • , 73. Undergrnd.Storage Tank 0 Gas D'Oil 25. Roof Sheathing n 74. Overhead Hydro 26. T-Bar Ceiling (Structurally& 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 di 80. FOOD-CERTIFICATE ISSUED 33. Final Electric I • Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test . • 36. Hood or Canopy 37. Final Factory Fireplace ' 38. Final Plumbing . : /(-34-111,395011 39. Water Service-Final - 40. Gas Service-Final ' 41. Solar Domestic-Final . •. 42. Backflow Preventer . I ' • fes'•" 43. Backflow Irrigation . -- - • 44. ,Landscape Irrigation System - - - 45. Sound Attenuation 46. Handicap Regulations •• 47. FINAL STRUCTURE & BUILDING - - 48. Special Requirements Completed , ' 49. Electric Release to Edison • ' - - 50. Gas Release to Southern'California Gas Co - !: • 51. CERTIFICATE OF OCCUPANCY . ' 1 No. ' Date • - - - , < _ _. - _ Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations, - CITY OF COSTA MESA PERMIT NO. TRACT'NO. ' LOT NO. :BLDG'.NO." a --' " ' - ' "' - -' -' - CONSTRUCTION PERMIT P .5-907 7 1'. 2278 .12/29/82.12/29/82 6.00 , TL Project Address s�/��/./ TYPE OF CONSTRUCTION: - Owner Na w Phone'/.7Y'/6 ❑ NEW . ❑ ADD - ❑ ALTERATION - l�j�/1�f= - 1 ' Address " - " '- '`- - - V.• REPAIR ❑CONVERSION-❑DEMOLISH -ZONING REGULATIONS Arch/Eng. - ' License No.- - - 0-OTHER _, - A.P. — „ r_ - '. _ .. Address "- "` DESCRIPTION OF WORK - - /�,� ��-t.y� �s ZONE 'PLNG. REF: Contractor YT IG )A 1J//7/j Phan!lc 77C : TYPE OF PERMIT - • - - •. _ BUILDING - - - TO BUILDING - S� v SETBACK C/LST. PROPERTV,LINE Address 151 �iJ �5 . .. ❑ GRADING -0--FOUNDATION -❑ STRUCTURAL - - SIDE YARD- - -LEF _ • LICENSED CO TRACTOR DECLARATION - -- -- '- 0 TENANT- 0 ELECTRICAL- ZPLUMBING OMECHANICAL • SIDE YARD - - --- -- - -- I-hereby affirm that I am licensed under provisions of Charter.9(com+ •• ' +" RIGHT 'rnencing with section 7000) of Division -3 of the Business 'and- ❑,OTHER - - • - - - - - - .. -, _ Professions Code an my license is in full force nc�a tett: • - •+ - REAR YARD (TO P/L) r • .J aj I( -1a- PROJECT DESCRIPTION _ License 55 Liresen a oI n ! v D - • - - Ps(G.SPACERECt. PROVIDED ' Date Signature �h'vl �4AC- __ _ .WORKERS'COMPENSATION'DECLARATION • • - - . .- OCCUPANCY_CONSTRUCTION TYPE _ STREET WIDTH •PARK'FEE$ •. I hereby affirm that I have a certificate of consent to self-Insure or a -VALUATION 'ZONE ZONING APPROVED BV' - _ - '" I DATE '- - Certificate -of Workers"Compensation' Insurance, or-a certified-copy - - - - _ - .. - - - • - - - --- - - . - -- - SPECIAL CONDITIONS: thereof(Se I �sa b.C.). • rh,I,L� GRADING CU.YDS. ACRES ' ..Policy No. �V 1•4'.' Company '""`�' � - _ _ -. _ __ ._ _ r. ❑ ertified copy is-hereby furnished.- • - .. . - '• -REMARKS - -- .- _ . Certified copy is filed with the city Building Division. I / , EXEMPTION FROM WORKERS'. COMPENSATION DECLARATION - - ke d for- •14l Q; ,ffn . ' " " - ' - -($100) tion need-not.be-completed if the permd.ls,for one hundred ... __ , J , � ($100) or less'.. - , ... .. __ ._ ... . I certify that in.the performance of th¢_work.fonner sh this permit is - _ _ _ _ K - ubjeissued, I shall not employ any person in any manner so as to'become PLUMBING, ;.,. • PLAN CHECK --" -"' _ 'ELECTRICAL -- PL:AN CHECK - '' - - Date Subject.to the Workers'Compensation.Laws of California,_:. ". 'DWELLING --- - -- OA RRfaE ' Date Signature ' BATHTUBS SHOWERS { - SO FT NOTICE: If after making this declaration, you should become subject TOILETS . URINALS 'GENERATOR 0.1 KW_1-10 KW, to the Workers' Compensation provisions of the Labor Code,you must _ .. TRANSFORMER - forthwith comply with such provisions or.this permit shall be deemed LAVATORIES DOUBLE LAYS' - APPLIANCE - 10-50 KW_50-+'KW - - - revoked.-- .= _ -. -_ .__ _ - _ _ _ .._- CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS ' MOTORS - - 0=1 HP_I-10:HP a 1 hereby affirm that there is a construction lending agency for the per- SINKS' •" - -- - ( NC.-SOLAR - _- SERVICE -'y, SUMPS I - I 1 '•10-50 HP_SO +HP-- formance of the work for which this permit is issued (Section 3097. • _ - ' Lenders "' - ,`_ FLOOR SINKS` • FLOOR DRAINS ' r - -FIXTURES —OUTLETS "'SWITCHES' - "- -` - -" _ .• ,;. ,.•i, _ .. _Lend Lender's Address ‘ DRINKING FOUNTAINS ' ' - GASTUBE SIGNS -- ' - " - - - -OWNER BUILDER DECLARATION `--- " '- " "'" ' "' - -I- ' ' - " ' - 'POLE LIGHTS - ' ' --- " ' -" -' I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS_ _ 'the following reason (Section'7031'.5'Business and Professions-Code: SWIMMING POOL - P TRAP— •-- - LurvSI.HU(.i-iUN- _ • _ -. Any city or county which-requires a permit to construct, alter, r POLES METERED SUB• . improve, demolish or repair any structure, prior to Its Issuance,also re-' -WATER SERVICE ... 'ALTERATION- ' - j ' PANELS"`- -- MAIN' - ",SUB - quires the applicant for such permit to file a signed statement that he - i5Clicensed pursuant to the'provisions of the'Contractor's License"Law GAS SERVICE OUTLETS "SERV (Chapter, 9 (commencing with Section 7000) of Division 3 of the - . //�� - - 'Busihesi and Professions Code) of violatione pt therefrom-and-the WATER HEATERS • ' BTU OUTPUT-t L)_ • - ' "' basis app the allegedfa exemption. Any pofaSection it pen by _ V-- ". - - • 'any oppliwn[ "for five hun 'subjects the'($500)li applicant to a civil"penalty- "SEWER CONNECTIONS - - - -'- - - -" '- "-- V "'--- -- of not more_than five hundred dollars ($500). - - - - ❑ I, as owner of the property,or my employees with wages as their SOLAR T1iNK COLLECTORS,• :�y?� 1\ '" ' sole compensation, wilctio-the work,and the structure is not intended _ _ .v.,-: _ - -, - _,_ - , or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE'- whotbuilds or- improves doeo not applywto ansuch owner a_ms lfrty or -3 - -APPLICATION APPROVED BY' • who builds or improves thereon, and who does such work himself or ISSUE FEE I ._ -, -through his own employees,-provided that.such.improvements.are.not. _ intended or offered for sale. It, however, the building or improvement MECHANICAL PLAN CHECK . .SUMMARY OF.FEES-- _ - T is sold within-one year of completion, for the purposeimprove of sale). - ' -0-l,"-as"owner of the- property,-am-exclusively-contracting-with HEATING SYSTEM_ 0-100,000 BTU _ _ _ _ PERMIT • _$_ • - ,.1'`.s'$N11 P,; -.•; --AND DUCTING8. 'and contractors to construct cproject e(Section 7044,does-not-apply 100,000 +BTU - s T PLAN CHECK $ -•t• PERMIT• -moi .r 'antl owner ersof nr t h ldsContractor'sor License Law , who to an owner of property who builds improves thereon, and who Con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts Contractor's projects with'a contractor(s)-licesned -pursuant-to- -SYSTEM "- - " ' " ' -" "^ ^ -- - ^- HEC ""'-' 4-GRADING:. $ ' ' the Contractor's License Law). 100,000+BTU PLAN CHECK,'$- _ '1t {;, ", ❑ 1 am exempt under Section •B.& P.C.for this "ELECTRICAL •$ r § " _ - BOILERS . BTU - i � �� '.,°'MICROFILM $ 'Ir . . - __ - _ '_ ._ _ .. SYSTEM REPAIR,ALTERATION -- - 'PLAN-CHECK` $ ' - - "Date-- - - - Owner - - - - - - .. • ' "TOTAL FEE$' 0- •, • ' MECHANICAL" $'�' I hereby certif that I have.regre this9applicationpand state athe above ._ ... - . . VLTI PLE - --• • .� K- LESS AD r y. EXHA VST SYSTEM __ M _ --- - PLAN CHECK"-E "' ' _` " 'VANCE PC informationrdinasis correct. agree to comply with all cityand count •- representatives ansstale.l r- yti t ,t gcorst upon endboreb oed - , repr¢se ntatives ,Of his y to enter upon the above mentioned , - property for .in •-• 1• - - • - Signature _ �! ••• -s. Date • _. _ .-. . FINAL FEE � , , !_� - - ' CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor • C__ . - - - CONSTRUCTION AND PLANNIN POOL&SPA- - -- . .,' ' - . - - . s APPROVALS Permit 4 '6 a Date Inspector APPROVALS r - Date _•. Inspector Permit 4 ti 1. Temporary Electrical_Servic_e or Pole 43. Pool & Equipment'Location -- - - - - --- - ` 2. Soil Pipe_Undrgrn• 44. Steel Reinforcement . . --- - • - - . - - . •' 3. Electrical Conduit Utility-Undrgrn _. ,-, " . - - _ 45. Forms. . - . .. - . . . . . . . - ' . _ 4. .Electrical Conduit-Undrgrn, _ _ _ _-, . . 46.. Electrical Bonding - . . .. - - - - ' 5. Steel Reinforce 47, Rough Plumbing&'Pressure-Test- . --- - ' • 6. " Electrical UFER Grn _,-_ . . 48- APPROVAL TO COVER-GUNITE ' 7. Footings_. __ _ _ - - 49. Electrical Conduit-Undrgrn - • 8. _ Foundation -_.�:,-_ . -_ .`_" 50. Gas Pipe, ❑Undrgrn,Test - - ` _ 9.. Water.Pipe'Undrgrn. - . _. __.' ' '_ ' 51. Backwash Lines P-Trap: a'Undrorn - - - - -- - . - ' 52, APPROVAL TO DECK --_- ._ __..--,._- . ... _ _ . . . 10.. . Structural Floor System - • _ - _ , _11 Property Sewer Line & HouseConnection " __ 53. Backwash & Receptor-Final ' - _ - 12.. Street. Sewer Connection__ - ' . .. - _. _ 54. • Heater &Vent-Final • - � - ,, - - • • j3. .Rough Plumbing " . _ ` -`"-- 55 Plumbing System -Final "- .. -. . ' --. . . ._. _ __ . , 14. Rough Electric-Conduit ---• • . . - - -- •56.• Electrical-Final . 15. Rough-Electric=Wiling - - -- - - -- --- - 57r-•SolarSYstem-Final;;;'` " ' - ""'' •' • ' -- -16.- Rough Heating& Air'Conditioning -� -- - -- -- _ - .- . b8-._Fencing&Access Approval . I 17.-•Ducts,-in.Strucfure .. __ . _.. _ _ .' _ ._' ... . . _ _. _ ' 59. APPROVED FOR PLASTERING - , ' - --18.--Ducts, Ventilating_.- '. -- -- - l . . _ - - 19- Gas Pipe-Rough &Test i . - _ . - . ' - - ' " 60._ POO L/SPA SYSTEM FINAL • v' ' ' 20.. .Roof Framing:' -- ' • +v n 1 ki 21. Roof Sheathing - -- . , - - ' _ .- - ---' - - - - -- - ,a ..i ' • ,�. � n•, . - 22.---Frameland Flashing- NOTES - 23--Insulation : �_ . ,__ ,,•- �- ._ - _../ -��i - .H.-24.- lathing.& Siding_ .- _ " " - -. -l.. - _ - -_- ^AC'• V , -25•. Drywall Nailing - . , ' • - ' --.26. Plaster Brown'Coat. ,. ,P- , _ - . _ . -. _ _ , 27. --Electrical Power.Meter-Final. _ • " _--28-Final•Electric-' _. . . . . . . - ... . , r -- 29.- Final Heating &.Air Conditioning. _ _ . _ . _ . _- J _ _ , .. . ' _ _ __ . .. . . •' 30.. Final Gas Pipe-.Test . _ 31_ .-Final Plumbing - . - - _.-/flit/8r,9' 2 / e • . .. . . - ••.__32'"�'Water Service-Final. - - -. _ . - - -. _ - - , . . ' . ' - - ' . ' , ' - 33- - Gas Ser.vice"Final ..__ `-: _ -. . ' ` - -. 34. Solar DomesticFinal' -• '.. • " .. . ' . . 35. Landscape Sprinkling System - _ • e• r " 36. Sound Attenuation .. .. _ . - - - - - 37. Handicap,Regulations t - - . , •• - - . 38. FINAL STRUCTURE&BUILDING I - • 39. Special Requirements Completed ` - 'r„ • "" - ' - "" - ' 40. Electric Release,to Edison . ' . ' - •,-r '-"" - - _ . ' - " _ - 2 41. Gas Release to Southern California Gas Co. ! • ' 42- 'CERTIFICATE OF OCCUPANCY _ . - •- - -` -No Date _ " _'_ . _- - - ------'-- c 1 4 1 Applicant to fill in all spaces except those within heavy border lines.and sign all appropriate declarations. - C17Y'OFCOSTA MESA: ' -• � - 9'/20/83 93.72 TL ♦:O PE IT NOp TRACT NO: - -LOT NO. • BLDG.NO. 5936 • :CONSTRUCTION PERMIT = 876 /✓r'�}�/�GJ 2y 1 Project Address' ' a - • ' �- • .- i - TYPE OF CONSTRUCTION , L I NEW• L I ADD 1WALTERATION. ❑'REPAIR-, - } I• Applicant's Mailiinn9�s,Addre-e s ra•-.•ir•Co 4 '. ..„4.,n, a; ; ❑ CONVERSION ❑ DEM LISH OTH• ER - - �1 jN ri✓s.- 1-R / AiW.QiR/` /hong 7S?--v c- 6 'DESCRIPTION OF WORK (�Lvufic - A.P.Wair# '�4— n3—O2 �ssdry lam,^ . Owneds,Name _ S Main Building:, - - • . -Accessory BuildingAddress 2:g 2: 8 • r7y • ' �J 0- TYPE OF PERMIT ; O__ • - , - 'CONSTRUCTION AND PLAN NING _ : ; - POOL •&SPA -• , `I APPROVALS Permit#!hk"� cg . • r Date- Inspector- ,APPROVALS Permit# Date• Inspector , :1. Temporary Electrical Service or Pole.• c - 52.. Pool & Equipment,Location'• • , r2. Soil Pipe-Undrgrnd. : ' - 53. Steel Reinforcement- . -' - r3. ElectricalConduit.Utility-Undrgrnd. ; _' ;4,Electrical Conduit-Undrgrnd.; . 55.. EI ctrical_Bonding- . . ' 5: Steel Reinforcement I o -- - - 56. Rough•Plumbing.& Pressure Test - - ,`- ' `6.' Electrical UFER Gild. ' - ` . 57.-APPROVAL TO-COVER-GUNITE - - 7! Footings ' - 58. Electrical Conduit-Undrgrnd. _ • 8.' Foundation _ " • 59."GasiPipe, 0 Undrgrnd.,Test - ' 9. Water Pipe-Undrgrnd. 60.- Backwash,Lines, P-Trap, 0 Undrgrnd. - - ? ' 10. Structural,FloorSystem ' -. ,61. APP.ROVAL-TODECK - 11.1 Property Sewer Line & House Connection • 62. Backwash & Receptor-Final • 12!Sewer,Cap 63._Heater & Vent-Final (-' 13. Roof Drains • . ' - 64_Plumbing System - Final ! • 14. Rough Plumbing 65. Electrical-Final -- • ' 15.` Rough Electrical-Conduit ; ' ' 'r,,- . ' T- 'I- ' 66: Solar System-Final - . • t - 1G• Rough Electric Wiring ' v , l-_ • z • - -"� r'r .67.- Fencing & Access Approval . I 17. Rough Wiring Sign 1 = ; - , 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 , , ' . 1 70. Underground Hydro , 22. Ducts; Ventilating • ( , 71. Product Piping 0 Gas LI Oil 23: Gas Pipe-Rough & Test Wr i 72. Underground Flush -,:2.4::.Roof Framing ; 1 - 73. Undergrnd:Storage Tank 0 Gas Von. ' • 25. Roof Sheathing ' ' - ' 74. Overhead Hydro - ' 26. T-Bar Ceiling (Structural)'& Monocoat ' , - 75. 'Dry'Chemical i , 27. Frame and Flashing • 7/_7_83. 4n 76. Dry Standpipe - 28: Lathing& Siding - 77. FIXED SYSTEM FINAL _ • 29. Insulation I 78. FIRE PREV. FINAL 30. Drywall'Nailing p." ' �,,y.�T-Wb,.o ,171,1 ) '1371 HEALTH DEPT. REQUIREMENT 1 I . 31. Plaster Brown Coat - 79. FINAL INSPECTION • 32. Electrical Power.Meter -Final ' ' 80. FOOD CERTIFICATE'ISSUED , Li .33. Final Electric . - , 1 I . Notes: /o/'Y183 ,72710"7 .- lad (/ 34. Final'Heating & Air Conditioning - Z4JD_ d k _ /, 11 35. Final Gas PI e Test ' - W L. 36. Hood or,Canopy , _ . ' , [7.-', Cw.wc3 'r�i�/ - 4h0QX- -r - 37. Final Factory Fireplace I , i ! - 38. Fina Plumbing j • ' 39. Water Sery ci a-Fina_I ) I A 40. Gas Service-Final)r , ; . • 41. Solir, Domestic-Final" I _ - _ _ _ _ V. 42. Backflow Preventer - , 1 ; : ' �? ,_ ' '� 43. Backflow Irrigation I + _ T { 44. Landscape Irrigation System ` - I r 45. Sound Attenuation f i . _ . 46. Handicap Regulations I 1 - 't •' . .. 47. FINAL STRUCTURE & BUILDING r7/21ii 6iti I ' 48. Special Requirements Completed 1 t 1 ' .. ' - 49. Electric,Release to Edison ' ' -• - - - - - -- - ; -=- ''-- 50. Gas Release`to Southern California Gas Co I -, ,' , ( .• `% '�' ' • 51. CERfTIFICATE OF.000UPQNCY,I ._ , . L. . _ .•_, • _ . . --- N ' ; N 'I: .. . . . Date -h• . .• - I , , , :I No. I � I • PROJECT ADDRESS: 2828 SHANTAR DR UNIT' CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 062086 I "OWNER'S NAME:JUSKA, LEONARD A 2ND • - ADDRESS:JUSKA ELIZABETH A PERMIT NO: E 062086 PLAN CHECK NO; N GOVT: N SUPP : N 2828 §HANTAR DR COSTA MESA, CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH 7547666 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : POWER FOR OUTSIDE SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: LEONARD JUSKA ( 714 ) 754-7666 ADDRESS: 2828 SHANTAR COMMENTS : OUTLETS FOR OUTSIDE CM CA 92626-3539 **TFx*******************.**>E#x**xx*x**xx******* ***x***>E>ExOc*********x*****OE**r:*** 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 full 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' FRN T: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.CI. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ- PROV: PARCEL: 13940302 ZNE; REF NO; 0 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANN ING NSTES> Date: Applicant: *****1E***1E*********lE*-IF**3E**3F3E***************!f*****#3EiF*************lE***********1F EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need n. ompleted if the pe^ rt one hundred(51W)or less). DEVELOPMENT S E R V I C E SS REQUIREMENTS I certify that in the per orma•c•of the work for which this permit is issued , e�� y manner so as to became /subject lob,:, irk,s'C. , rsation Laws of California. ZONING APPROVED BY DATE; ✓ Date: Signature: NOT E:It. Ater m.king this declaration,you should become subject to the Workers' . pensation provisions of the Labor BUILDING APPROVED BY . DATE: 4 Code,you ust 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 APPL I CATION ISSUED B Y: �-��' DATE: OS O—71:0 which this Derma isrssued(Section 3097,Civ.Cl. ****************************' -- : -dent c* - *'.** - * * ********************** LENDER: **************************************: **************************************** ADDRESS: LEGALIZATION: N F E E ` UMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: l hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECT.'(IC 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 35. 0% 0 0 repair any structure,prior to its issuance.also requires the applicant for such permit 10 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 5 0% SMIP/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($500). 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 ❑ structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS——--> 3. 00 15 . 00 0 . 00 18 . 00 18 . 00 . 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 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- 18 . 00 OVER/SHORT: . 00 forme 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 18 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon and who contracts for such projects with acontractor(s)license pursuant to the Contractors'State License Law). l am aware ******************************************************************************* Mat proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN •❑ I am exempt under Section:B P 704 4 B.a P.C. • bj ronnisreasoo:�P7LiSYO K BY OWNER i/� ;� �a TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST ate [�f / owner: 8 ELE 1 FIXTURES LIGHTING 1 ST 20 EA. . 75 . 75 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ELE 2 REC EP T/OG TL ET 1 ST 20 EA. . 75 1 . 50 25534 and that I or any future building occupant wilVwill not(circle one)need to comply with said state codes and the requirements for a LE i R EC tP T/SW 1'TCH 1 ST 2 D _ permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from Er EA. . 7 5 , 7 9 these provisions. END OF FEES : r Date: Applicant: EXPIRED I hereby certify that I have read this application and state that the above information is correct I agree to •••• with all city and county Ineom fete Inspections ordinances and state law relating to building construction and hereby authorize re. e atives of this city enter up.n the above-mentioned property Ion inspection mrposf' �� ,% Dale.ate: Signature: ' /" Date 4 01 00138774-00138774 TOT 18.00 Driver's License or Social Security DATE: 05/10/93 TIME: 15:32 1641-46 Assessor afi Whire—Building,Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor OWNER PACESE''n' R WEST JOINT VENTURE DATE OCT 2 3 1962 JOB ADDRESS }; 2828 Shantar Dr. BUILDING PERMIT NO. 17901 GENERAL CONTRACTOR .Andros Land. Co. VALUE $ 18,177.00 AP No. 139_1403-02 LOT 2 TRACT 4349 FIRE ZONE DESCRIPTION OF WORKRES.Watt.gar. INSPECTIONS Signature DATE GROUP I&J TYPE V ZONE R-1 Soil 4'7S C 1/4.74--e,v PERMITS ISSUED Gas Ehi /z7�. ... SUBCONTRACTOR DATE NUMBER Water W //e'G? Rough Corn. Rettig. ❑ Air Cond. ❑ _ Rough Heating - - / 2te. �.__ r ., /2-.27-G.z //274‘Rough Plumbing ,C/9' /L /$ _ . '-di .:,� y_. W //1-/ -6 a _5-692 3 - Miscellaneous SIC ' Prop.Swr.Line 12-House Con.EI-St.Swr. 0 [I( l-7264'3 t*.. ,&-/C te,.,,,,"— //7w-fa t 3 9 9.17 Sprinkling System option Pole Underground ❑ Power C Rough Wiring - j'y7 /A_?s_I, ,T7 /S. -- .77-/7-4a f 9.n- 'Frenches 0 Forms 0 Steel lteinf. 0lc-TVA //-3tj.i - Floor System 'JI24fy. Bond Beam 0 . Steel Reinforce 0 Sheathing W /], 3`-G.f7-_' Frame and Flashing' N I (3 Lathing — In G1/ Out Lpl_y r31'✓t0-C __ -kt_H (>3 Plaster, brown coat f --V�-)-4-% Ref rig. 0 Air Cond. 0 Final Heating, Final -;.-r/4/-17-/c1," Plumbing Fixtures, Final / 770:„..7 Final Gas Test S"' ,/- Electric Fixtures, Final r G Building, Final r=ne �V 3- .2 OCCUPANCY . FORM BU4 5M — 7-61 17C)01_ vw • FEE RECEIVED 17901 OCT 1 1962 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. Applicant • to Fill In Completely CITY APPLICATIONOF COSTAORMESA For P Y FOR PERMIT TYPE OR PRINT �/^� /f� ,�/-J��/J BUILDING ADDRESS ?i�1�1$ 77�U11//1 r\ AC. ' /CyO�STA MESA. CALIFORNIA (��(.� For Office Use Only OWNEFfel-Z J 7 S hJ� Jr VG/1!/ rs I RECEIPT NO. I ram. . MAIL j A' '-/f /— RECEIVED BY DATE RECKIVED �ygfsyTE, ISSUED ADDRESS /6;��I�S �/�044�i,udrA /' ��] 4 //y) n�{�(1:.2/-/$/KK-d f�¢ Ui JTv J W,jC//�. CITY 1647/4- A a/et NO'S/fD->4PcABDDRESSG !•T v !X U �'4y/(rL♦'///"/,/.J/P/Cj/'l HITECT OAR ENGINE ge4L f- A/43 G!/ TEL. COSTA MESA. CALIFORNIA ADDRESS /'T%U'�1 T/•EJI/�!M / �- ,1 /� FIRE ZONE TYPE V GROUP J. / CONTRACTOR AL'n I?GS Z14.- ® L(J I APPROVED DATE V ADDRESS /b4-- -M/41DEt'A ZONING y ZONFy.-' I NO.OF '-y I USE OF NEVF-3/ tt/•"r�cp CITY '1! PLANS c BUILDINGu STATE /2 1 / / /• TEL. LEGAL L39 4,0 3 - Q y LIC.NO. L-76 C [ ([a (,� NO. DESCRIPTION /J SIZE OF LOT X/O Q I NO. OF BLDGS. Ce f ) �f i y �� NOW ON LOT A.P.NO. {l/Y`./A'/ t:7• • - j USE OF / -` ./--/� ,/� y/��. EVES EXISTING BLDG.�JI/V b� Y�f�'lUl • TC.'S. APPROVED ALLOWED SETBACK LINE FROM f� ICENTER LINE ST.1 / • �� CENTER OF STREET �J(//�� REAR YARD 3Z- FRONT IA/6 FT. IN. SIDE YARD I LEFT 61 I RIGHT 6 R.SIDE (p FT. IN. DESCRIPTION OF WORK L.SIDE 6 FT. - IN. NEW I A II ALTERATION I II ADDITION I REAR 3 Z FT. o IN. REPAIR I MOVING II DEMOLISH /I APPROVED. "R77 , DATE 9/28/6 Z. SIZEBUDING/!/LLLyyy��/J� ROOMS NO. OF 4.7 STTOO�RI�E/S�/ COVERING W1-7 0(�TA! I CONGER I NG /[/4-4-i USE OF BUILDING AND WORK I• BE pERFORMED is • /6S6 "),- S0cz ) -d A. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION . _/` ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNT SHOWN UNDE ALPERMIT IS OR THE PURPOSE OF ESTABLISHIN A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINAN S AND STATE : .5 REG TING • BUILDING CONS ION. /1 VALUATION / B-O SIGNATURE // ' - e. a PERMIT FEE $ EJO- PERMITTEF `moo / r /T� E-0 u Id /j 4. $ ./if: / 7• PLAN CHECK $ 30. . AUTHORIZED AGENT p1 o-0 E / .. TOTAL FEE $ 70- D C(/ u J "OWNER WARD, ROBERT F. DATE 7-5-C8 JOB ADDRESS 2828 Shan-tar-Drive BUILDING PERMIT NO. 28812 GENERAL CONTRACTOR Owner-1Wlder DESCRIPTION of WORK Add Bedroom and Bath to Res. AP No.13q_1�03_Op LOT 2 TRACT ti./49.. FIRE ZONE VALUEf 4700.00 INSPECTIONS Signyrara Date GROUP 1 TYPE V ZONE R-1 GASsoiL �'n He— 717 PERMITS ISS ED 1 �u� { ' "t" SUBCONTRACTOR Dare Number Signature WATER fr-'Z'G8 (jeern,Plumbing n ROUGH PLUMBING 16.'2--"‘S' / .ttW,V - dJett tg -fle,43. PROP. SWR. LINE USE CON. ' �� O SPRINKLING SYSTEM MISCELLANEOUS �/ �G"�' ROUGH HEATING AND AIR CONDITIONING Zcf' Y *.er TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING fin t 43'Cr Heating andVet TRENCHES FORMS STEEL REINF. 0 Id 7.-(6-&K 4L�li-,.0 h} 7 ® )� 8-S=61 a_cc�f �s�/- FLOOR SYSTEM HMI- 'L-i(,-F& ` BOND BEAM n STEEL REINFORCE n aGL� SHEATHING at 9-2C-69/ FRAME AND FLASHING .y,� t 3 -g^Cr LATHING — INtrq OUT IT /we ,c"-/q/-6tf PLASTER, BROWN COAT f/% . .51-23,-(PS STRUCTURAL, FINAL �„ / �� /,Sif� }rJ�."*t/• Jitc- -I.V/7itc / HEATING, VENT., AND G. AND A.C., FINAL 7/� PLUMBING, FINAL AND GAS TESTJjL ELECTRIC, FINAL A" ? (-i;.ZL.L BUILDING, FINAL /ER /`L7-4 I4 ......P 288 $ 2it�-848 SA0O 414* * *27. 00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 02628 Y For Applicant to Fill In Completely APPLICATION FOR PERMIT .u...!; TYPE OR PRINT BUILDING ' For Office Use Only ADDRESO 2g 2S .SH4A/TA i2 D/ _ ADDRESS �C D U RECEIPT NO. PERMIT r42_ COSTA MESA. CALIFORNIA ��1yA(/ NEC tY� DATE RECEI D� 1R MSUm OWNER RoaE 1" t 141A/21.1 11// 77 LL// .7- bo MAIL -�1 C p/ Bu ILDNG ADDRESS 2 A �S Si:Mx/TAR DP• A��86 Lj FIRE /^• P` TE �� ZONE TYPF GROUP CITY Co �kl MESA_ r4tin NO. 94 ya �•-�/ ARCHITECT TEL APPROVED ARCHITECT /-6 ATEI/J (O� OR ENGINEER ryi.-9J!:R NO. ` !ll��///��- Z INCA Lr ADDRESS Z/p)BE I NO.OP�I / I UOEOF NEW I/ CONTRACTOR « W Il 4 If /l PNNt// BYIL1- R .1/40q , DDINOn O /� DESCRIPTION J L) 1 a / /\ . 3 q i ADDRESS • A.P.NO. / 3q — Lfo3 - U '- CITY NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE • TEL SO'TO SIDE a REAR p.L LIC.NO. NO. EAVES SIZE y /1 / No.OF SLOGS. ALLOWED (U.B.C.REQUIREMENT) OF LOT 70 JL /06 V NOWONLOT YARDS APPROVED YARDS APPROVED EXISTING BLDG. RE,to F-ti/C"e MAIN BUILDING ACCESSORY BUILDING (FROM C/LST ) CEU NE FROM REAR YARD / FRONT /9 m PT. CENTERNTER OP STREET I �j PT. FT.% I SIDE YARD Lan ..c. .' I R.SIDE 7 RIGHT S l �/ DESCRIPTION OF WORK � L.SIDE J PT. PT. /+ NEW ALTERATION ADDITION / REAR PT. FT. — DISTANCE BET. BET.MAIN& REPAIR MOVING,.�NDEMOLISH MAIN BLDGS. ACCESS.SLOGS. _ V 6ZEDING sq SQ:f /R� OOMS STORIES CAU.P••}� APPROVED EXTERIOR WALL V• II ROOF t � p APPROVED tail I''7/// 1/ COVERING SrL C.i1 COVERING LIAM SSli1c ST V ' ATE // ) /(i.1 USE OF BUILDING AND WORK TO BE PERFORMED � / ! y. CTCtlt? I si i;i4rii Anfimod m 1-oR S;hiCpL6- Pymit.y T SI 7 376 SQ.Fr. I HERESY ACKNOWLEDGE THAT.I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ASOVE.IS CORR CT AND AGREE TO PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. clb PLY WITH ALL CITY ORDINANCES AND ATE LAWS REOULA INS VALUATION BUILDING CONSTRU F/ p a..., E DO PERMIT FEB 5 �/J SIGNATURE OFT' R // PERMITTER $ 7,/ PLAN CHECK $ �� w° AUTHORIZED AGENT �7 11 , , .4.4 TOTAL FEE $ O`-/ --- • ;