HomeMy WebLinkAbout1943 SUNDANCE LN - Building Permits ' �t _ CITY OF COSTA MESA
�r/ �t BUILDING DIVISION
- i . - , PERMIT NUMBER
F DEVELOPMENT SERVICES DEPARTMENT /
X41; PERMIT V/
E99-00502
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 1943 SUNDANCE LN Status: ISSUED
Suite No Applied: 06/14/1999
Vicinity: MASTER BATHROOM Issued: 06/14/1999
Parcel Nunmber: 42253305 '&200/�
ISSUED BY:
Applicant: ABLES, DOROTHY E
Address: 1943 SUNDANCE LN
Phone: (949)466-8184
COSTA MESA, CA Zip: 92627
Owner: ABLES, DOROTHY E
Address 1943 SUNDANCE LN
Phone:
COSTA MESA,CA Zip: 92627
Contractor: UYvAJ
Address:
Phone:
Zip: .
License:
SCOPE OF PERMIT
INSTALL 20 AMP CIRCUIT FOR JACUZZI TUB IN MASTER BATHROOM.
FEE SUMMARY
Quantity Quantity
ISSUE FEE $22.00 Temp Dist System/Lighting $0.00 0
Temp service test $0.00 Busway/100 ft $0.00 0
Res. a/c package $0.00 Standing Section $0.00 0
New Res(1-2 units) $0.00 0 Misc Electrical Equipment $16.25 1
New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0
Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0
Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0
Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0
Switches $0.00 0 over 100 kva/kw $0.00 0
Non Res Appl , $0.00 0 Low Voltage Equipment $0.00 0
Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0
Service to 200a $0.00 0 Misc. Conduit $0.00 0
Service to 1000a $0.00 0 Misc. Conductor $0.00 0
Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0
Motors to 1 hp $0.00 0 Circus(mech ride or lights) $0.00 0. -
Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0
Motors to 50hp $0.00 0 Fireworks Stand $0.00 0
Motors to 100hp $0.00 0 Other Electrical Fee $0.00
Motors over 100hp $0.00 0
Communication drops $0.00 0 Investigation Fee $0.00
Sub panel to 200a $0.00 0 Plan Check Fee $0.00
Pole Light Pkg $0.00 0 Reinspection Fee $0.00
Sign Circuits $0.00 0
Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $38.25 '
Intermed Pole $0.00 0
1
COMMENTS/SPECIAL CONDITIO
DATE
Io z-71oED
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92.28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626 e.
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I1Sereby affirm under penalty of perjury one of the following declarations:
'❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit is valued et one hundred dollars($100)or less.)
❑ 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 Califomia,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.it Class it
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is Issued.(Sec.3097,Civil Cale).
Lenders Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is
Id within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
I, as owner of the properly, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt nder s Business and Professions Code for this reason:
Signature:- Date: ,< _4/-79
Owner ID verified by driver's license. 0 Yes 0 No Driver's License Expires:
Verification of Ownership by(type of document,i.e.-properly tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person Is required to descend,will be made In connection with work authorized by this
permit,end that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2.Sec.
341,Title 8,Catifomla Administrative Code).
❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
materiel? 0 Yes 0 No
(Section 25505 of the Califomia Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the Calif omia Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes 0 No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? ❑Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication appermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency'? IID Yes u No
(Section 65850.2 of the Califomia Govemment Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No
8 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the Information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Ma ' Is and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE RIZ N.,OFIENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct.I agree to comply with alt state laws and city'ordinences relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described propertyfoci mesels.I a dee not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signal Of Legal Owner(s) Date
And/Or Authorized Applicant Date
CODE t INSPECTION TYPE PATE INTRIALS CODE INSPECTION TYPE DAM 7ITQIAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
2446-46
•
__ .. Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 7051 1 /09/J5 1 7 7^oJ '...
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. 7 TRACT NO. LOT NO. UNIT NO.
f(rojete Address 7943 - UN �r� --��.r�1 (/'rja23� { r-7,g
11 Applicant's Mailing Address t>iNyic 546 at.p`Q�1`l��sl C�, TYPE OF CONSTRUCTION NEW LJ ADD L ALTERATION ❑ REPAIR /
Owners Name' - At/el r44214--f• ,I� Phone&- ❑ CONVERSION ❑ D OLISH ❑ OTHER CD V s--+ •A,P,# ii5 — ,nvo — 9 I ZoneppD/.Z_l,�
•
DESCRIPTION OF WORK/USE OF BLDG. I�/ J JVa! /h
•
Address A%. G S Main Building: Accessory Building:
•Arch/Eng, l�prRR s.1/�1 �^t rJG . {)License No.�( J, TYPE COF PERMIT ❑ GRADING ❑yFOUNDATION STRUCTURAL E Front I / • O
Address (I� 3 ` I. r �•+ ���$•r\� ❑ TENANT ECTRIGAL 1.1 rLUMBING MECHANICAL B Rear ii-/ / N
Contractor's Nam- ' A. -- •hone •�� = ❑ 'OTHER AJ,l A • l
PROJECT DESCRIPTION SO. FT./#10 0 OCCUPAN Y,�—#1,-? �3 C Right t ! N
Address(mailing) AC _ !i / A! � K G
7/• 7 . CONSTRUCTION TYPE U.r--k VALUATION$ s Left e C�I R
City License No. ZONE GRADING CU.YDS. ACRES
• Ping. Ref.# •� Parking Req./Provided E
LICENSED CONTRACTOR DECLARATION / - jig
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: /J ♦J' c Z Planning Notes: _ Q
with section 7000) of Division 3 of the Business and Professions Code, and / r ` . ���'_ ��� Z D �� I togCLCIl �� ll ooAf••tt••�� M
my license is in f • ora and effect. /� !/ +s. swsu.+u.i111:111s7 T
( Ucen Class L^ is /OI y L'• 6O/_ K.-CZ- S
\ Date °^� - Signature ....e°2. / PLUMBING FEES y- - Car 1 WORKERS' OMPENSATION • /TION .
Bar Sink Showers ELECTRICAL FEES
('S "hereby affirm that I have a certificate of consent to self-insure or a certificate . .
�f Workers' Compensation Insurance, or a certified co thereof (Section Backflow Preventer Service Sink
600, Lab. CL/ /� Automatic Washer Transformer-0 15-50 KW
Policy NO. '//`' i6s A'/ Company ..5— ,4-7--e_ , Backflow Irrigation - Sewer Ca - / ❑ 50+ KW
131_ , 9 P Construction Pole Sub.
Ce f d copy is hereby furnished.
er ' d c is ith the city B 9g 1 n. //''� -Z Bathtubs // Sewer Connection j+ / Cooking Unit Meter Pup to 100 amps
Date_ Applicant /t'( +� ` �T y�� ` /
1
EXE PTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers, Solar Collectors / Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred($100)or
less). / Dishwasher / Solar Piping 2 r• / Dryers/Gas ❑Electric / Sub Panel
I certify that in the performance of the work for which this permit is issued, 1
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00.1 HP 01'A-B
Workers' Compensation Laws of California.
Date Signature Floor Drains - Swimming Pool w/Spa / F.A.U. Inc.Solar 09-15 HP 016-15+
NOTICE: If,after making this declaration, you should become subject to the J
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal 1G Fixtures,
comply with such provisions or this permit shall be deemed revoked. /� Microwave
CONSTRUCTION LENDING AGENCY Gas Service 3 Outlets Water Closet kf / Device Boxes
I hereby affirm that there is a construction lending agency for the performance / Pole Light
of the work for �ss�hich this ye it is issued (Section 3097 Civ.,.C.) Interceptors /, Water Heater Z /y� Outlets Range
Lender's Name- ]�.oe /d5.7 01�� _ q I{/
•
Lender's Address✓ `�� (f - / Kitchen Sink / Water Service /i. SwitchesSi yn
OWNER BUILDER DECLARATION [ _
I hereby affirm that I.am exempt from the Contractor's License Law for the 3 Lavatories Auto-Wash Garbage Disposal ;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
any structure, prior to its Issuance, also requires the applicant for such permit P-Trap Laundry Trays Generator 00-5 KW❑5-.15 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains •
the Contractor's License Law(Chapter 9(commencing with Section 7000)of -• - • ,
Division 3 of the Business and Professions Code) or that he/she is exempt - . -
`lerefrom 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 - • ,
penalty of not more than five hundred dollars($500). • $ 3
0 I, as 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 - Reinspection Fee J $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 •
thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I ❑ - DEVELOPMENT SERVICES REQUIREMENTS: (y
employees, provided that such improvements are not intended or offered foryP a �—
sale. If, however, the buildingOr improvement is sold within oneyear of com- Zoning Approved By —/ - Date
Canopy Type II 0
prove ;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).
❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By -,I _ Dat
tractors to construct the protect (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 -
builds or improves thereon, and who contracts forsuch projects with a con- SU A�, F FEES �A
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑ System-Repair/Alteration BUILDING PERMIT $ �d , SMIP $ 1V�'
proof of their Worker's Compensation insurance should be provided to me. -_f - PLAN CHECK $ PERMIT _
o I am exempt under Section — y
B.& P.P.C.C.for this reason / irepyf•�..B}t,,�- Fire Dampers PLUMBING $ -2, 7 -- ISSUANCE $
' Date Owner / Hefting System& Ducting Registers 4' PLAN CHECK 25% $ An ENERGY P.C. $
I hereby certify that I have read this application and state that the above / 0.100,000 BTU 0100,00067E U f GRADING 'S -
information is correct- I agree • co • " h all city and county ordinances- ELECTRICAL $
and state laws relating�sy•_•15 -cy--ion, and hereby authorize repre- _ - PLAN CHECK 50% $ i.9 MICROFILM $
sentatives of this to - the above-mentioned propertyp� for ��
Inspection pude f / / a6 MECHANICAL $ Mgr Signals Date O _ OTAL FEE $
Drivers' License or SS -��` • Reinspection Fee ' $15 Issue Fee $ 3 PLAN CHECK 25% $ I.0 s ----;-- i• /
CMF 0865-46,rev.10/84 White - Building; Canary - Applicant ; Pink - Accounting; Goldenrod - Assessor - 47 9' 5,2, i
ICONSTRUCTION.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. //7j/i` )171 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 UFER Grnd. I/ 57. APPROVAL TO COVER-GUNITE
7: Footings ? ' - g6' 58. Electrical Conduit-Undrgrnd.
8. ,Foundation' • ..9_a ( /Q49/hG 59. Gas Pipe, O 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 &‘1.-louse Connection 62. Backwash & RTptor-Finals
12. Sewer Cap 63. Heater & Vent-Final '.
13. Roof Drains 64. Plumbing System - Final ,
14. Rough Plumbing
rpm ,..0- 65. Electrical-Final . ,g` •
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring _gra cc ;67. Fencing & Access Approval
17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling i'L, 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 0,
20. Rough Factory Fireplace APPROVALS Permit#
ref
y •
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 i '
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil
25. Roof Sheathing 3r geo P 5 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ,
27. Frame and Flashing (XX# •i/v, 76. Dry Standpipe t.
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation : 78. FIRE PREV. FINAL ,
30. Drywall Nailing HEALTH DEPT. REQUIREMENT I - •+
31. Plaster Brown Coat , ( 79. FINAL INSPECTION •
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric jSt q) Notes:Sikkb 1(Si tetra I We ale, • :
34. Final I4ating & Air Conditioning Ci"zg-1((e (.4Q Mtn'F%YR SPEC(� IfCQUII�MENf$ 1I t
35. Final'Gas Pipe-Test cfleirkb Get -.
36. Hood or Canopy 1
37 Final Factory Fireplace cf.uy $C Loo j �
38. Final Plumbing ql-24-24 L.49 . - . ,
39.'Water Service-Final q-29'It 4.IE/1 ' • ,'
40. Gas Service-Final r,-
a
41. Solar Domestic-Final r
42. Backflow Preventer ', - i' • n• •
,43. Backflow Irrigation • -
44. .Landscape Irrigation System '
A'
45. Sound Attenuation - •
-46-•'Handicap Regulations f,. - v i,- ,
47. FINAL STRUCTURE uu a'
48. Special Requirements Completed �7} . 1
tlI/7(S/a nil
49. Electric Release to Edison ✓
50. Gas Release to Southern California Gas Co ,
51. CERTIFICATE OF OCCUPANCY .0 , "
No. Date .
• ) 23c'7
INSULATION CERTIFICATION
This is to certify that, in conformance with the current energy regulations (California Adminis-
trative Code, Title 25, State of California•) and approved plans, insulation has been installed in
the building located at:
MISSION VIEJO ORANGE
city cons
190 /3 SUNDANCE DR. 1 #12067
• StrN1 No. (If ANIIeeM) abet W le Tat No.
DESCRIPTION OF INSTALLATION
ROOFSTpeyof Material fiberglass Manufacturer CERTAINTEED ThicMess_101_R Value". R-30
EXTERIOR W CERTAINTEED Thickness 3i" vaMa.. R-11
Type of Worn.be rlass Manufacturer
roc Tads ora
CEILINGS
BATTS:
Type of Material Manufacturer Thickness___R Value"_
(Or Tab Nowa
Sq. Ft Covered
BLOWN:
Type of Material Manufacturer Thickness No,Bags—
(er Trade rely
Wt/Bag Sq. Ft Covered_ R Value"_
FLOORS -
Type of Material Manufacturer Thickness__R Value"_
(Or Tab ren)
SLAB ON GRADE
Type of Material Manufacturer Thickness__R Value'•_
(or Tale NOM)
Width of Insulation Inches
FOUNDATION WALLS (If required)
Type of Material Manufacturer Thickness___R V:lue"_
for Tads Nona
REMARKS (If desired)
General Contractor (Builder) license Number
By T4U Date
SubContrartor (Insulation Applicator) QUINN INSULATION License Number. 311115
rlerll4nan. Yung. En.) / elan "MYC' a•cera N Omni hLoe.Nr) ..
1
ay C1 0 Tits► owner we 06/09/86
•Cel�fe•nl. Adwlnl..ell.e Cede. E... , Iteieew SlenM.d.. adores: Carr Few St. Ida7! el the Vele .V Way Cee M the Ulu
...welrw.e, ue.. ce..ltiw N M. Inr.eellee el Insole/len. . ew4 M Celllenle.
..lyre Met ne I.wlali.n Me pew Iwlelled le ashes.... .1M the
.*4.••••••••••• N Mt. rwel#lees Omit be cewoleted err enetud by "Me stlee.n el wnewry es Omar Mlae.lw IMI • sly cw•
n. irie.bM enflame/ eed by the Femme. TMe R:el.4w Oa.lienc. ~IS 1e..I. enI. .bele/ Sew. haw M ever aelewll.l
• .hull M ISMS es e weeteeee. untie, within the dw.11inp^) dwelee is h.►IIMI• shell be lamed by .ea • WWM deeeree.eel
— alest the eewel.re el lett WHIRS the MN..el eeersl I.wl.nw
•'e Y.be it It. wenn N the runt..,.. N • n..wde1 ee belIdlae rl.ed..ds e.w.11rhud eeremeel Seals deet."
.nr .o the rem.*et heel. TM rwi.Iwce Verse (II .1 e ar•yt
r.1bruin shell et Include en elms lee .eeeed.e lodes.)
. . - - - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ _
, CITY OF COSTA.MESA CONSTRUCTION PERMIT PERMI O. TRACT NO. , ' LOT NO UNIT NO. •
I
• 4Project Address 1�14.i sSl)•.KOANL� (�.1 aCV?40 t.2 Mom , 3515 9/22%86 : 12.D0 TL
.�U— TYPE OF CONSTRUCTION NEW J ADD ❑ ALTERATION ❑ REPAIR f '
Applicant's Mailing Address a• - ir e c •-- ❑ OTHER_
❑ CONVERSION ❑ DEMOLISHA•P, •�,E Zone •
Owner's Name (CIL F1 to Ft r.di Nl\taL _Phone (nil ce-3600 DESCRIPTION OF WORK/USE OF BLDG.
' Address frt8WE . S Main Building: Accessory Building: ,
Arch/Eng.dr ' OAU(oNEne License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL • T Front - Z
Address I1 a'C1 ^(�s P� L1} 1-4(-.a)c - e`L'�\4 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL Rear • ' N
Contractor's Name &Acs C C Or-NT. Phone S'LI`CS b'EZ ❑ OTHER . - :CBK
_ _ _ I
PROJECT DESCRIPTION SO..FT. OCCUPANCY Right N
•
Address(mailing) PJ - \Q(..\V C r e�la Yl1-axYa ' G
C O N ST RUCTION TYPE VALUATION$ Left ; ' •
City License NO. 1 Ea? 1'l ZONE GRADING CU.YDS. I ACRES R
LICENSED CONTRACTOR DECLARATION PIOg.,Ref.# Parking Req./PfOvided E
1 hereby affirth that I am licensed under provisions of Charter 9 (commencing Remarks: Z - Planning Notes: M
with section 7000).of Division 3 of the Business and Professions Code,and (a- a O7 - .
my license is in full force and effect. T
.CN- License Class '1?.-1 - License No, 3n Feb I .
dir Date CO\9t YL' Signa PLUMBING ' ' FEES
•
WORKERS'COMPENSATI RATION Bar Sink • Showers -
I hereby affirm that I have a certifid to of consent to self-insure or a certificate - ELECTRICAL 1 FEES
Cr f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
800, Lab. C.) Automatic Washer Transformer ❑ 15-50 KW
Policy No. 1\L'akL.5 €cS� Company Backflow Irrigation Sewer Cap ' - 0 50+KW
,Fy-I Certified copy is hereby furnished. Construction Pole Sub.
Of� Cert ifi tl c py is filed with the city/i •:ing Division. Bathtubs - Sewer Connection
-
5 ss.... r Cooking Unit •
Meter ❑up o 100 amps
Date �1`e1 1. APPlicar II=_, -
EXEMPTION FROM WORKER •
/ • NSA _ - Clarifiers - • SOlar'Collectors_ Dishwasher • -. Meter ❑Over 100 amps
(Thissection need not be comp! e permit is for one hundred ($100) or - '
less). I Dishwasher Solar Piping •_ - Dryers ❑Gas ❑Electric . Sub Panel - '
I certify that in the performan e of e work for which this permit is issued, I _ - _ -
shan not employ any person in any manner so as to'become subject to the Drinking Fountains • Solar Tank - - Fan Motors DO-1 HP ❑1'/:-8
Workers' Compensation Laws of California. - .- .
Date Signature - Floor Drains Swimming Pool w/Spa - F,A.U.
NOTICE: If,after making this declaration,you should become subject to the • Inc.Solar ❑9-15 HP ❑16-15+
• Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixt Wes '
comply with such- provisions or this permit shall be deemed revoked. • Microwave
CONSTRUCTION LENDING AGENCY •r:
• Gas Service Outlets Water Closet Device Boxes Pole Li
I hereby affirm that there is a construction lending agency for the performance - Light'
of the work for which this permit is issued (Section 3097 Chi. C.) Interceptors Water Heater Outlets
Lender's Name Range
• Lender's Address Kitchen Sink ' Water Service • . - - - •
OWNER BUILDER DECLARATION • Switches •Sign ,
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal '
following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections I
county which requires a permit to construct,alter,improve,demolish or repair P--Trap Laundr •
any structure, prior to its issuance, also requires the applicant for such•permit y Trays Generator 00-5 KW 05-15 KW Trash Compactor -
to file a signed statement that he/she is licensed pursuant to the provisions of '
Roof Drains - -
the Contractor's License Law (Chapter 9 (commencing with Section 7000)of
-Division 3 of the Business and Professions Code) or that he/she is exempt - - -- - - -
•
`terefrom and the basis for the alleged exehiption. Any violation of Section .
)31.5 by any applicant for a permit subjects the applicant to a civil _ I '
enalty of not more than fivehundred dollars($500). t
0 I, as owner of the property or my employeesiwith wages as their sole Reinspection Fee $15 Issue Fee $ 3 - '
compensation, will do the work,and the structure s not intended or offered - Reinspection Fee .,$ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES p I $15 Issue Fee
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 DEVELOPMENT SERVICES REQUIREMENTS: '
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I -❑ -
sale, if, however,.the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By - 4 Date
' pletion;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). - p
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By _
Date (9-14-J�
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 ❑100,000 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 Exhaust System ❑ Multiple ❑ System-Repair/Alteration ' BUILDING PERMIT $ SMIP $
proof of their, Worker's Compensation insurance should be provided to me. PLAN CHECK $ • PERMIT'
0 am exempt under Section - B. & P.C.for this reason ' Firepl/Fact.BIL ICBG# �I/ Fire Dampers T _ U� PLUMBING $ -
ISSUANCE $
Date - Owner • Heating System& Ducting - - Registers PLAN CHECK 25% $ ENERGY,P.C. $-.
hereby certify th t'I.have-reatl this'application and state that the above ❑0.100,000 BTU 0100,000BM ELECTRICAL GRADING $ I
information,is corr ct.j a•ree to comply with all city and county ordinances _ $
and state law re Al y; •building construction, and hereby authorize repre- N CHECK 50% MICROFILM $
•
sentatives o o enter upon the.above-mentioned-property for $- - ,
inspect'.. s:! / TOTAL FEE $ /.2.Ob
/
. Signa ure /,a s - Date /Aii'L • _ - - ANICAL I $ \\• 0�
Drivel ' .1 nse or S r, Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ t.('Ot3
CMF 0865-46,rev.10/84 White - Building; Canary -APplicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL &SPA •
Date Inspector Date Inspectors
APPROVALS Permit# APPROVALS Permit# •.7 \
1. Temporary Electrical 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 • 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
• 7. Footings - 58. Electrical Conduit-Undrgrnd. 4-
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 ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush • •
24. Roof Framing • 73. Undergrnd.Storage Tank ❑Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. 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
33. Final Electric Notes:
34. Final Heating & Air Conditioning ,/I /1/7/y •
35. Final Gas Pipe-Test ( JY •
36. Hood.or Canopy •
37. Final Factory Fireplace y/y,4` i/e
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. Special Requirements Completed
49. Electric Release to Edison .
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. - Date
444,5tams, CITY OF COSTA MESA
a1 CALIFORNIA 92626 P.O. BOX 1200
ti
O .A'q .,,.; : ..�• FROM THE OFFICE OF THE DEVELOPMENT SERVICES DEPARTMENT/
C44:1;;;;;°° PLANNING DIVISION
October 28, 1985
•
Po: /
Building Safety Division J Pacific Bell (2)
Business License Division Police Department - Ping. & %search
Oanmunications Santa Ana Heights Water Qxnpany
County Administration Office Sanitary District Engineer
County Clerk/Board of Supervisors Southern California Edison Co.
County Registrar of Voters Southern California Gas Co.
County Tax Assessor State Board of Equalization
Engineering Division (2) Street Division
Finance, Revenue Division United States Post Office, Adams Avenue
Fire Prevention United States Post Office, Santa Ana
Manager, MID Zip 4 - Santa Ana
Mesa Consolidated Water District File (2)
Newport-Mesa Unified School District (2)
The City of Costa Mesa wishes to advise you that in revising street addresses,
the following addresses have been changed:
OLD ADDRESS NEW ADDRESS A.P. NO.
None 1930 Sundance Lane 115-502-29
1931 Sundance Lane.
1932 Sundance Lane.
1933 Sundance Lane ! .
1935 Sundance Lane
1937 Sundance Lane,
1939 Sundance Lane,
1941 Sundance Lane
1943 Sundance Lane-
1945 Sundance Lane
1946 Sundance Lane
1947 Sundance Lane
1948 Sundance Lane
1949 Sundance Lane
1950 Sundance Lane
1951 Sundance Lane
77 FAIR DRIVE (714) 754-5245
19191
1949 195v
194' I q40
.L.,
1952 I q30
1945 IUI
1943 N41 1939 19 37 1935 1 1933 Iq 31
klpireasii
SU kilDA
LiebNEN
ao--i C.sN C E. d tz..1\/E-