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Home My WebLink About1910 SWAN DR - Building Permits ., 4'��1:1,- CITY OF COSTA MESA IA ►:,., t) BUILDING DIVISION �' b. ' ' DEVELOPMENT SERVICES DEPARTMENT k 698-01055 PERMIT PERMIT NUMBER (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1910 SWAN DR Status: ISSUED C/6. Suite: Applied: 06/16/1998 Vicinity: Issued: 06/16/1998 Parcel Nunmber: 13948145 Zoning: R1 R1 Applicant: MCEUEN, DAVE Address: Phone: 949-722-8846 Owner: MOLLNER, LOREN-DAVID— i - Address MOLLNER,.MARY:ERIN;.=- J COSTA MESA',CA t t_-'-• ', i —Phone:, i); '/ / 1 "- ' .4,, 1910 SWAN DR \�- -) , -Zip - -92626 r r �� -. �\ Contractor�(( THE,ROOFING.SPECIALISTS ' /2� / / Address:'),%216`E 18TH,ST-.,,,,,,,,->,-/;.:-.2.,± ,'�� '/ /��,�.N . 1'^/ \N, AJ//4e-,,T,7Phone: 714-722-8846 -�*,`4 . �,\ )�� COSTA,MESA;CA 4,2 Zip: 92672 V'��VA �' ,. C� f,0 f.j' License: 734068 ;' . „---- , Arch!Eng:� '! f - r 'Address: `.J -///c7 rr,,- I'll .•.. �Y'4�. -l. j r _ '\ l r r r ' ' Phone r �� - ' , i Q4,._ ,�,y Zip e 1 1. r.r,e; / Licenser i / _ , '+ �' SCOPE OF PERMIT "j' - �; I •: vA .,,T/OAND REROOFW/40 YR COMP. �V N , • _ .. ... - - 'FEE SUMMARY Plan Check: ` ' $0.00 ,, At Calc Valuation: $6,435.00 ' \ Permit: '-$124.75 "'-'" '"..--",:.''. !:-.y.---7:_1- !'``- ' 4 - _,: 'Claimed Valuation: $6,435.00 ' SMIBRes $0.64 -- "f }. SMIP,Com x$0.00 1/ •� �A Other: x;';,$0.00 Inspection:' ;$0.00 Total, $125.39 -\k'• ;PLANNING& ZONING _ /' 'N SETBACKS;` /) ��-? i� MAIN STRUCTURE Front ,0=0'," 'Rear -'0-0 ‘ _ Left- 0.0 -- Right: .- 0-0 , , 2' • J . J. ACCESSORY Front' .0-0 '•r / 'Rear. , 0-0 - - Left -0-0 Right 0-0 r r _ PARKING Existing: -'0 - Required '0 ' , - ' Proposed:' '0 x - NOTES: ., - .... . . • 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)754-5628 DECLARATIONS WmiRKERS'COMPENSATION DECLARATION: • - e T hereby 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 J._'jock 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'coni uranc� mer ayolicy number are: "'`. Carder: T.LN/ PI Policy Number. 7/-5 " ///a 2 9 (This section need not be completed if the permit Is valued at one hundred dollars($100)or less.) - ❑ I certify that in a pe • ance oft ork for which this r s issued, I shall not employ any person In any manner so as to become subject to the workers' compensation -:ws of Cal •mia,an. :. t it I shou d be•• e .ubject to the workers'compensation provisions of Section 3700 of the Labor Code,� I shall forthwith comply with th tiW e pro .lon.. ! Applicant Signature: 40 Date: CO�`6 !91 V / WARNING:FAILURE TO SE••1•- •'- E•' •• PENSATION COVERA- IS U WFUL 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 COMPE • • ,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CO C S DECLARATION: t I hereby affirm that I am liven ed under p :• - • 1 - eater 9(comma ing 'th Section 7000)of Division 3 of the Business and Prof ions d and my license is in full force and effect.Lic.# 7 " VO EYClass# yContractors Slgnatur . /� — Date: e -1C.0-7>f ^ J CONSTRUCTION LENDING AGENCY: . ❑ I hereby affirm that there is a construction lending agency for the perfo of the work for which this permit is issued.(Sec.3097,Civil Code). 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 sold 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 under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby condi/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,and that no building structure,scaffolding,faisework,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,California 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: 1 Wit 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 material? 0 Yes 0 No (Section 25505 of the California 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 California 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 ❑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 California Health and Safety Cale 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 application a ppermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑Yes ❑No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California 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 0 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 Materials and Emissions. Signature: Date: CERTIFICATE OF COMPUANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is erect. I :. ee to comply with all, laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the (r,�/ above-descri•:••property for inspection pu o :_ :gree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Le • ner(s) ^ —(0. --4 �• •.:Or Authorized '•• :nt (� / Date CODE# INSPECTION TYPE DEE fr ' 2Oaf INSPECTION TYPE DATE . IHTIDALS 1616 Fixed System Final Fire Prevention - 206 Final Mechanical 1268 Pool Spa Final . /,., 208 Final Plumbing 200 Final Re-Roof 'II r� T• 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. a. , 1-WILISI) CI11Y OF COSTA MESA CONSTRUCTION PERMIT PERfy117 NO_ i 9 to TRACT NO. LOT NO. UNIT NO. ` Project Address . 1910 Swan Dr. 3 - PERM- 730 26 198$ Applicant's Mailin r 55 5457 Crenshaw Blvd TYPE OF CONSTRUCTION ❑ NEW U ADD H ALTERATION Li REPAIR 1 ,0 Swan" Dr 557-2590 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# �p @AF� Owner's Name U Phone DESCRIPTION OF WORK/USE OF BLDG. I00— Pl/A turn lh Address . - S Main Building: - Accessory Bgji Z Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION U STRUCTURAL T Front VV O Address - - . ❑ TENANT ❑ ELECTRICAL ❑ PLUMBINGX MECHANICALBA Rear N -Contractor's Name Adee Pig & Htg Inc CI ;OTHER Phone C Right K N Address(mailing) 5457 Crenshaw Blvd 213-759-91 1PROJECT DESCRIPTION SQ. FT. OCCUPANCY RECEIVED JAN 2 5 1988 G 030203 CONSTRUCTION TYPE VALUATION$ 7 2200. $ Left . R City License No. ZONE GRADING CU.YOS. ACRES Pl ng. Ref.# Par king Rpate�gJ./Provided E LICE-USED CONTRACTOR DECLARATION RECEIVED JAN — 6 1988 Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M W with section 7000) of Division 3 of the Business and Professions Code, and my license is in f H ce and effect. T to License Class '� � -, tin • 86 _ RECEIVED JAN 1 4 1988 $ "`f 38 Date —4flt Signature it 4!, ILII— PLUMBING FEES I WORKERS' COMPENSATION DECLARATIO C EIVED JA V P V# 19 r I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers ELECTRICAL RECEIVED E of Workers' Compensation' Insurance, or a certified copy thereof (Section Backflow Preventer Service-Sink Automatic Washer Transformer ❑ 15-50 KW I 3800, Lab. , IVn) Policy NO.6d6987 Company State Fund Backflow Irrigation Sewer Ca 0 50+ KW P Construction Pole Sub. Certified copy is hereby furnished. Cert'fd y itl d with the cit wilding �f- n�z/ e Bathtubs Sewer Connection Cooking Unit Meter Cup to 100 amps Date 1 I — � ant A //� fECLAR • EXEMPTION FROM WORKERS'COMPENSA ON DECLARATION Clarifiers Solar Collectors Dishwasher Meter ❑Over 100 amps (This section need not be completed if the permit is for one hundred ($100) or - — less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑1%-B 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 09-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks - Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes • I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name Range Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal !Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-5 KW ❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permit _ 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 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 Reinspection Fee $15 Issue Fee $ 3 • compensation, will do the work,and the structure is not intended or offeretlReinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own Hood or T DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler ype I ❑ sale. If, however, the building or improvement is sold within one year of corn- Canopy Type II 0 Zoning Approved By 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 the pope). — - Date--�_ _ ❑ I,as owner o the project t7 44, sinesscontracting witholicensedioncon- Duct-Structural Refrigeration System Application Issued By Dat jam( hetors construct the project (Section to and Professions t Cotle: ❑0.100,000 BTU ❑100,000-BTU The sContractor'smproLicense Law does notapplytrto ran such owner je propertyiwho Duct-Ventilating SUMMARVIOF FEES builtls or improves rhereo n,and who contracts for Protects with a con- tractor(s1 license pursuant to the Contractor's License Law). i am aware that Exhaust System 0 Multiple 0 Systrm Repair/Alteration BUILDING PERMIT $ $MIP $ proof of their Worker's Compensation insurance should be provided tome. _ PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers ISSUANCE $ trttCDC Date Owner Heating System& Ducting Regsters 11.00 PLAN CHECK 25% $ ENERGY P.C. $ 4� I hereby certify that I have read this application.and state that the above 1- ❑0-100,000 BTLD100,000 BTU 100-N F/A Furn ELECTRICAL PLUMBING $$ GRADING $ information is correct. I agree to comply with all 'ty and county ordinances ; and state laws relating to building construction, d hereby authorize repre- 1 PLAN CHECK 50°h $ MICROFILM •$ sen[atives of this city to ent- on h- ab•re-rntionetl property for 2€ .00 inspecti.• • ••ses. #,. / 12-21 -8 MECHANICAL $ G••00 TOTAL FEE $ '�'g1^�309C goers' ,.' Date Reinspection Fee I $15 Issue Fee C $ft PLAN CHECK 25% $ Drivers' License Or SS# S ' 5- "� CMF 086 - , . : : White . Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor 1 CONSTRUCTION AND PLANNING POOL& SPA APbROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1...Temporary Electrical Service or Pole •,i 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 UFER;Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8.,Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK • 11. Property Sewtr Line & House Connection 62. Backvaah. & Receptor-Final 12. Sewer Cap • 63. Heater & Vent-Final 13. Roof Drains -' 64. Plumbing System - Final •1 14. Rough Plumbing 1 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 O Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro _ _ - - 26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. -Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning z-w-&8 LEO 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 r. i.t, 42. Backflow Preventgl-t r• � �• 43. Backflow Irrigation; • 44. Landscape Irrigation System •- • • 45. Sound Attenuation; 46sHandicap Regulati^DTis "' �•,� 47.. FINAL'STRUCTOE & BOLDING 1''a 48: Special'Requirements Completed•:, I•-' 49. Electric Release ttgggdisonc -en a _ 50. Gas Release to Southern California Gat,Co .0 ..i .'1' ; - . 51. CERTIFICATE OF OCCUPANCY • No. Date ' _ + • - _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF'COSTA MESA CONSTRUCTION PERMIT tPE IT NO. TRACT NO. LOT NO. UNIT NO. • ;• 0 d/ ' 24.455' � �-.3 • Project Address / 9i Sk./A/{/ 49.4 ii„.",-, p- f • " .--.4 • ' A ..19 /� �. TYPE OF.CONSTRUCTION NEW' LJ ADD ALTERATION ❑ REPAIR R9r19 7/f17/RF1 4 nn TL Applicant's Mailing Address .43/6 G N v . /f. _ / • ❑ CONVERSION ❑ DEMOLISH ❑ OT Ra Owner's Name �i/•f7 y /.7,51144. Phone c37.25�� R C / A.P.AP # 169 .4/51—�-,5 • _ Zone �/ . DES RIPTION OF WORK/USE OF BLDG. f /.00 R - S. Main Building: Accessory Building: Address �// D .3..t/A/f2. s�( IS�.-.L+' E Z 4. Arch/Eng. License No. T TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T- Front ' O Address - ❑ TENANT Li ELECTRICAL ❑ PLUMBING ID MECHANICAL B Rear �� N • • //��` `, ' ❑ OTHER _ A Contractor's Name I / Phone - f-IN p C Right � � N" Address(mailing)• PROJECT DESCRIPTION 9Q. FT. 4 ( • OCCUPANC QQ q� � q''^I I CONSTRUCTION TYPE VALUATION$ rf(%O�,O(/ S Left n'#_ , / ou�c G City License No. ZONE ' GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION ' > I Ping. Ref. # Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: : " Planning Notes:"- 1 Le 1 �' (.�boa M with section 7000) of Division 3 of the Business and Professions Code, and • • /' ;/_IJy''� /1. my license is in full force and effect. (,yy (1-y)/) n/ hn.r/�- LSa/,t '�,f / t T License Class License No. - - /]Y�{'''`)/`^-�. ' htAU dill / ��"^^ 1lN S Date Signature : PLUMBING FEES i err fit b LAI- • WORKERS'COMPENSATION DECLARATION •Bar Sink ' Showers - ELECTRICAL FEES ' I hereby affirm that I have a certificate of consent to self-insure or a certificate - of Workers' Compensation Insurance, or.a certified copy thereof (Section- Backflow Preventer' - Service Sink 3800, Lab. C.) - - . Automatic Washer Transformer ❑ 15-50 KW Policy No. Company Backflow Irrigation • Sewer Cap Construction Pole Sub. • ' . El50+ KW ❑ Certified copy is hereby furnished. - - _ ❑ Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter Oup to 100 amps EateXE KERS'COMPENSATION - Clarifiers Solar Collectors ' Dishwasher Meter Dover 100 ann k EXEMPTION FROM WORKERS' DECLARATION P - (This section need not be completed if the permit is for one hundred ($100)or' - ' less). ' Dishwasher - Solar Piping Dryers,❑Gas ❑Electric - Sub Panel - ' I certify that in the performance of the work for which thiy.:0-1-mit is iss d; I shall not employ any person in any manner so s to j e subject o the Drinking Fountains Solar Tank Fan Motor 0-1 HP ❑i%;8 Worker o en�yy Laws of California �� _ ✓Date. X4 Signature _ _. �_ ..�. Floor Drains Swimmi t 'dol w/Spa F.A.U. • NOTICE: If,after making this declaration,you ou • become subject to the 6.Solar ❑9-15 HP 016-15+ Workers' Compensation provisions of the La•/•r Code, you must forthwith ' Floor Sinks • Uri . • Fixtures comply with such provisions or this permit shall be deemed revoked. - Microwave - CONSTRUCTION LENDING AGENCY Gas'Service - Outlets , ater Closet Device Boxes • I hereby affirm that there is a construction lending agency for the performance POIe Light of the work for 'which this permit' is issued (Section 3097 Civ. C.) Interceptors Water Heater OutletsRan e Lender's Name - g Lender's Address -. - - Kitchen Sink - Water Service - Switches • Sign I OWNER BUILDER DECLARATION - I hereby affirm that I.am exemptf rom the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or — county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays any structure, prior to its issuance, also requires the applicant for such permit • Gen¢ratOr ❑0-5 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 't 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 , ' - R ' 7031.5 by any applicant for a permit subjects the applicant to- a civil ks den of not more than five hundred dollars($500). VI; as owner of the property Reinspection Fee $15 Issue Fee $ 3 ^- will do the work,and the structure is not intended or'offered - Reinspection Fee • I $15 Issue Fee ' . $ 3 for sale (Section 7044,. Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves • thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 . DEVELOPMENT SERVICES REQ M T �-9` • employees,le. If, ho ever,.thded that such improvements are not tor ofyear redof c forZoning Approved By Date_-� a sale. If, however„the.builtling or improvement is sold within one year of com- Canopy Type I ❑ 7. ['/ .pletion, the.owner will have the burden of proving he/she did not build or im- . Duct-Under Ground Building Approved By Date d[a prove for the purpose bf sale). 7 p 0 I;as owner of-the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System] Application Issued By • /o • / Date 4 ' E.�ri 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 BT "0 100,000 BTU - - SUM RY F 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 0 Multiple 0 System R air/Alteration - BUILDING PERMIT $ • SMTP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ • _ PERMIT' 0 I am exempt under Section `- & P.C.for this'.son Firepl/Fact.Blt. ICBG# Fir ampere PLUMBING . - $ ISSUANCE $ • ✓Date 1 Owner .�/ /__. Heating System& Ducting Registers ENERGY P.C. -$ ` •�', P - PLAN CHECK 25% $ I hereby certify that I have read this ..plication and state that the above ❑0-100,000 BTU 0100,0006 ELECTRICAL $ GRADING $ information is correct. I agree to com• with all city and county ordinances • and state laws relating to building ••structio and -reby authorize repre- PLAN CHECK 50% $ - MICROFILM $ l sentatives of this city • entern-..n the abbve- •-ntioned property for ' Q' Q inspection purpo -s. 7 - MECHANICAL $ TOTAL FEE $ 2 (.•••+ rfp. t•-"-Signature __, _ :4 _....e.,:. Datr� • "*.4” .y , piOrivers' License or # - -- - Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865.46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL &SPA is APPROVALS Permit# Date Inspector APPROVALS Permit# - Date Inspector 1. Temporary Electric& Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. .54. Forms v 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding ' n 5, Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE i 7. Footings dSa� 71/4.Jg,, sit, 58. Electrical Conduit-Undrgrnd. r 8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test p9. 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. Rbof 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 'Lag - 7� �� 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 O Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL • 29. Insulation 78. FIRE PREV. FINAL i ' • 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION - 32. Electrical Power Meter-Final 80. FOOD CERTIFICATES^IISSSSUUE-D.�r� , 33. Final_Electric Notes:4. 7/'$fg'6 =� / 7't .-_ 34: Final Heating & Air Conditioning 0/e •-- � �+ I 371 '2 Kl 1� 1 • 35. Final Gas Pipe-Test 36. Hood or Canopy 7A{ J _C�. wg�, OA_ � ) 2;9 nW 37. Final Factory Fireplace iso M 38. Final Plumbing 39. Water Service-Final i : • 40. Gas Service-Final - • ' • . 41. Solar Domestic-Final % 1 42. Backflow Preventer ) • 43. Backflow Irrigation - , 44. Landscape Irrigation System 45.%Sound .Attenuation r' 1. : ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 3I748.'Special Requirements Completed • /LY'�y r 49. Electric Release to Edison 1 50. Gas Release to Southern California Gas Co • • 51. CERTIFICATE OF OCCUPANCY No. Date a - •, r TYPICAL 6" CONCRETE BLOCK , FENCE �, , , I . a • • • • • • �CementCopingOptianal -� GENERAL- NOTES Channel Block With One 3/849 !.19. I I I c ' . I E I I •Horizontal Top of ell • Fences s I r_ I MORTAR; One Part Plastic Cement, and 1 J Three Ports Sand ' ForFenees6'orLen �� - 2 �I -I I dII GROUT: One Port Cement Three and One Half Ports fond -Vert.Bars 3/8'6 at 4'•0"O.C. e t o _ COPING: a } One Part Cement, Three Fo`rFences Higher Than 5 ��3 , I_ ICONCRETE: WellSand Mixed I: 2Ih : 3%2 Vert.Ban 3/81b.at 32" 0.C. W Fill Cells Solid With Grout ' • j • ; ,3 Max. of 7172 Gallons of II��, z I Water Per Sack of Cement Where Steel Occurs aI— _ Reinforcing Steelf$hall ,ll I _ _ - OFGROUTTHE MAFEVNCE BE POURED FROM THE TOP I --- Conform to Sec.A•15.39 W o A.S.T.M. IAI Z I CELLS AND AREAS OF HORIZONTAL REIN s.��I W A I 1 I FORCEMEN4 SHALL:E CLEAR,CLEAN All Steel to be Lapped , I' • FREE OF ALL MORTAR DEBRIS,ETC. 1.1"or to Code �, Jth .'! : INATURALGRADEI 1 BONDSSHALL BE PROVIDED BV LAVING 111III-. BLOCKS IN STRETCHER COURSES SO THAT VERTICAL JOINTS ALTERNATE IN EACH • ,e `O . .a` . . Th. • COURSE. TWO 3/8" BARS . .. . . . . CONTINUOUS TOPx .0 D' &BOTTOM b WIDTH TO 16' 0 C. MAX. • t. • SEE CHART p�6- O O • p BELOW aL ^ , OE PTH OF EARTHTCOTH a � by 1/3 THE HEIGTH OF FENCE • BELOW BOTTOM OF FOOTING. O . . 3' b lo" '2- LJ,' SCALE: 1/2" : I' _ •FOOTING REQUIREMENTS -- WALL HEIGHT_ _ 6 ' 5' 4' _ 3' • WIDTH OF FOOTING 14" 14" 12" 12" THICKNESS OF FOOTING 10" 10" 8 " 8 " DEPTH OF EARTHTOOTH 24" 20" 16" 12" SPACING OF EARTHTOOTH 12' 14' 16' 16' -- OWNERS NAME: • City of Costa Mesa, California JOB ADDRESS: . Building Department 7-G _ AA. • z " I APPROVED .% 1 Cr THESE PLANS MUST BE ON JOB AT TIMESr TIT 46' 23 DA I s E9No Ch1ANGES WITHOUT PRIOR APPROVAE MR ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL 9 1336115 OF PUSS AND SPECIFICATIONS SHALL NOT BE CONSTRUED — TO BE A PERMIT FOR, OR AN APPROVAL OF. ANY VIOLATION ' OF ANY OF THE-PROVJZJONS OF THIS CODE. NO'PERMIT PREF SLIMING TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE + ' .‘y4 \ PROVISIONS OF THIS CODE SHALL BE VALID, EXCEPT IN SO - I F71. Y: FAR AS THE WORK OR USE WHICH ITAUT 10_12E S UwFUL, THE ISSUANCE OF A PERMIT BASED UPON PLAN; ANL • u SPECIFICATIONS SHALL NOT PREVENT THE BUILDING OF:1CC_ ,+. FROM THEREAFTER REQUIRING THE CORRECTION Cr E.14,..; Si IN SAID PLANS AND SPECIFICATIONS'OR FROM PRET— • a BUILDING OPERATIONS BEING CARRIED ON THEREUNGE.. _ ` !N VIOLATION OF THIS CODE OR OF ANY Or( - • - 1F THE CITY, STRUCTURAL APPROVAL ONLY SEPARATE PERMITS ARE REQUIRED C FOR ELECTRICAL. PLUMBING, e HEATING, VENTILATING AND a a REFRIGERATION WORK - ` Permit ra &j • UMBERMUSTACQ ~' ALL INSPECTION REQu h v r S• ----" a 1.1 FOR BUILDINGS WHERE PERSONS ARE TO BE THAT THE STAT _ s CALIFORNIA DIV SIONEMPLOYED, WE SEST OF INDUSTRIAL SAFETY Cr," BE CONSULTED FOR ADDITIONAL REQUIREMENTS. 0 w a is a JOO / 1lc: M w Q O G Z 0 u 1... _ Oz3 U Z mo -9 .133211S •FW .. o ... r ae r, G a ii0 OWNER PEMBA SUBDIVIDERS, INC. DATE 2_4-66 JOB ADDRESS 1910 Swan Drive BUILDING PERMIT NO. 25200 GENERAL CONTRACTOR Same DESCRIPTION OF WORK Res. w/att. garge AP No. LOT 30 TRACT 5493 FIRE ZONE VALUE $ 31,456.00 INSPECTIONS Signa - Date GROUP I&J TYPE ZONE ;— Soil [ r - PERMITS ISSUED Gas SUBCONTRACTOR Date I Number I Signature Waters flaw . " Plumb'.. Rough P umbing rj'�- . ��i r 1Aj) afred.ur/ if,� Prop. Swr. Line ID House Con. in-' y'r • ---/ "gra:/ �� 0 it Sprinkling System Miscellaneous • _ Rough Heating and Air Conditioning "Wane Temporary Service or Pole Underground • Power 0 I ' Roush Wirin;-- /'_J 35- Heating and Vent. Trenches if Forms '4'• Steel Reinf. a f,'ar �!� TMEIM,/ _ Floor Systeminnei a c—A e. :JrG C Bond Beam ❑ Steel Reinforce ❑ —_ Sheathing FRAM ff _ Frame and Flashin; 05 g/ssr/re Lathing—In 9 Out{3 he / Plaster Brown Coat b 'L ,c (G Structural, Final Electric Heating, Vent., Refrig. and A.C., Final :/fr �L.� e--.7.2.a ,2570` Plumbing, Final and Gas Test rie-rse— Electric, Final ifr 5;/A. CC Building, Final411:4114-k44-7-"a_ Lot5303 25200 ' CITY OF COSTA MESA COSTA MESA BUILDING-SAFETY DEPARTMENT FEB 2 1966 P.O.BOX 317 COSTA MESA,CALIFORNIA For Applicant to Fill In Completely PPLIC itiiP`tiff TYPE OR PRINT I tar O ice Use Only BUILDING .,, ADDRESS 1910 Swan LT�l 1Ve RECEIPT NO. Sp1/LT�tl�-. COSTA MESA. CALIFORNIA 2.52TcJU Pr BY DAT�LEIVVI. DATE ISSUED OWNER Pemba Subdividers, Inc. /L/�/ /- 6 FE/B�4 1966 MAIL BUILDING /9/0 N J ' / ), _ ADDRESS 2850 Mesa Verde Drive ADDRESS �W[�!L/ Q(/(„(.VCJ 549- FIRE �J TEL. ppZONE TYPE Jr GROUP , e �`%1 CITY Costa Mesa, NO. O,a./ JJ'qpp.�- APPROVED ARCHOR ENGINEERIKaltenbach T No'O. BY DATE ZONING ADDRESS 1823 E, 17th Street . SAA . ZONE NO.OP USE OP NEWf4t/Y�, CONTRACTOR Pemba Subdividers, Inc. ie- PLANE 1 BUILDINGA . LEGAL 91 ADDRESS 2850 Mesa Verde Drive DEECRIPTION�,D--t C3-O )// CITY Costa Mesa, Calif. A.P.NO. O NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LTC.TNO. 187318 0' 549-0395 90'TO SIDE 8 REAR P.L. EAVES SIZE OF LOT C�75 X 100 I NO.OF NOW ON LOTS O ALLOWED (U.B.C.REQUIREMENT) USE OF Single familyresidence YARDS APPROVED ACCESSORY APPROVEDBUILDING EXISTING BLDG. g ' MAIN BUILDING BUILDING - -" '- (FROM C/L STREET) SETBACK LINE FROM • • • FT, p//+, �"N/ ✓��FT. CENTER OF STREET 471 FRONT•REAR YARD 25.75 V7 {)_- SIDE YARD LEFT 7. 5 I RIGHT 12_5 R.SIDE /I/ FT. FT. DESCRIPTION OF WORK L.SIDE ( 7 FT. Fr. NEW ALTERATION _ ADDITION REAR ,7) -r. FT. DISTANCE BET. BET.MAIN 8 REPAIR MOVING DEMOLISH MAIN SLOGS. ACCESS.BLDGB. VAR.# DATE BUILDING 2393 NO.OP 13 2 SIZE ROOMS STORIES C.U.P.# APPROVED Shingle & {{ ' �� 6 EXTERIOR WAI,.LROOF APPROVED(l f1�,,,,�,�,L COVERING I7 t UCC0 COVERING shakes BY I�jL,b�' I DATE _ USE OF BUILDING AND WORK TO BE PERFORMED4 �/ L .5- 23 90 SO.FT. O ItV / 131 r. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE £ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G PLY WITH'ALL CITY ORDINANCES AND STAT WS REGULATING BUILDING CONSTRUCTION 1 VALUATION LC �J- )N PERMITTEE OF "Zile? /j/�s/)T/� -^(l '�7�•lT�/Vfp PERMIT FEE $ 334��/ $VI / • PLAN CHECK $ aS pAUTHORIZED AG5 /�� TOTAL FEE $ V