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Home My WebLink About742 WINGATE BAY - Building PermitsC�TY OF COSTA MESA �i NSTRUCTION PERMIT I�Project Address � Applicant's Mailin(y �Add s ��. Owner'sName , ' \� ��A'� �h ne- Addreu Arch/Eng. License No. — Address Contractor's Nam h ^ F � Address Imailingl '�� City License No. LICENSED CONTRACTOR DECLARATION I here�y affirm [hat I am Iicensetl untle� provi510n5 of Chart¢r 9(i with Section ]000) of Dlvision 3 0l the Businais antl Prote55ion my license is in f 1'Nprce a] c License ass Licpnse N ` Date �— 51g f � WOf2KER5'COMPENSATION DECLARATION hereby affirm that I have a C¢rti(i[ate of con5¢nt to Self-inzure Or Workers' Compen ❑on(�Insurance, or a certlfletl cop then s00� Lab. Qy/ ('_�j�/16� ComPanY-1— PoIiCY No.��10l�JUV Cert ied copy is hereby fumishFV1 ^ e'Uiiei �p�1 .fj�d wiN Ih¢ d[�A B7H ' v io . �1 AOD�icant to flll in all spaees eacept those within heavy Goreer lines antl sign all apDrovriate aeclarations. PERMIT NO. - TRACT NO. LOT NO. BLD . . -s�� _ TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR _ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p.# DESCRIPTION OF WORK - 5 Main Building: E - TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Ffant - ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL 8 Reaf ❑ OTHER %� 1 C Right F PROJECT DESCRIPTION Sa. Fr. OCCucArvCY K ) CONSTRUCTIONTVPE VALUATION$ S Left ZONE GRADING CU. VDS. ACRES p�ng. Ref. # Remarks: Parking Rey./Provided ) Use Of Building: PLUM8ING ' FEFS P�anning Notes: EXEMPTION FROM WORKERS' COMPENSATION DECLARATI \ (This section neetl not be como�etetl ii the permit Is for one huntlretl 00) or less). I certi(y tnat in the performance of the work for which this perm�t Is issuetl I shall not employ any pe�5on in any manner so as to become subject to t�a Worker5' Compensaqon Wws of Califomia. Date Signature NOTICE: If, a�ter makin9 Inis tlecla�atiOn, you 5nou10 become subject to Ih¢ Workers' Compensation provisions of the Labor Code, you must forthwltb comply with such provisions or tnis ,permif shall be aeemetl revoketl. CONSTRUCTION LENDING AGENCV 1 hereby affirm lha[ NCre is a conSV uctlon lentlin9 agency for the perTormance of tne work for which lhis permlt is issuetl (SecHon 3097 Civ. C.) Lenaer's Name L¢ntleYS AOtlress OWNER BUILDER DECLARATION I hereby at(irm that I am ezempt from the Contractor's License Law for the following reason (Section 7031.5 BuSiness antl Protessional Cotle: Any city or county which requlres a vermit to construct, alteq improve, tlemolish or repalr any s[ructure, prior to i[5 izsuance, also requlres the applicant for such permit to file a signea statement that he/she is licensetl pursuant to the orovisions of the Contra<tor•s License Law (ChaO�er 9(commencin9 with Sec[ion �000) ot '�iviSiOn 3� of the Business antl P�ofessions Cotl¢) or that he/she is exemp[ erefrom antl the ba5i5 for the allegetl exemptlon. Any violation of Section 31.5 by any applicant �or a permit zubjects the aDO��ant to a civil enalty of not more [han five nuntlretl tlollare ($500). ' � I, a5 Owne� of the ptopetty o� my employ¢es with wages a5 their Sole compensation, will tlo the work, antl the structure Is not intentletl or otferetl (or wle (Section 7044, Business antl Professional Cotle: The Con[ractor's License Uw tloes nol apo�Y to an owner oi a oroperty who builtls or improves Ihereon, antl who tlOeS Such wo�k �Imselt/hers¢If or throu9h his o� her own amD�ovees, provlaea tnat such improvaments are not intentletl or ofteretl for sale. If, however, t�e builtlin9 or ImprOvement is soltl within one year ot mm- pletlon, tho owner wlll have the bu�tlen of provin9 he/she tlitl not builtl or im- �rove tor the purpose of sale). , ' U 1, as owner of Ihe O�op¢rty, am extlu5ively contracting with Iicensed con- tractors to consiruct the project (Section ]044, Business antl Protessionz Cotle: The Contractor's License Law tloes not apply to an owner of property who buil�s or improves [hereon, and w�o contracts for 5uch projects with a con- trac[or(5) Iicense pursuant [o tne Contractor's l.icense l.aw). . ❑ 1 am exempt untler $eCtion B. & P. C. for this reason �ate Owner 1 �ereby rertity that I bave reatl tbis aooliw[ion ana state that the above Signature �� Drivers' Licanse or 55 � _ CMF 0865-46 rev. ]/g3 white - Bulltling; Applicant; nk Showers ow Preventer Service Sink low Irrigation Sewer Cap ibs Sewer Connection ers Solar Collectors asher Soler Piping Drinking Fountains Solar Tank Floor Drains� Swimming Pool w/Spa Floor Sinks Urinal Gas Service � Water Closet Interceprors Water Heater Kitchen Sink ' Water Service Lavatories � Roof OuLIetS Reinspaction Fea I $y5 Boiler Duct - Under Ground Duct - Sttuctural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/FacLBIt.IC80# � Heeting System & Ducting ❑ai oo,000 eru � i oo,000 sr II Reinspectian Fee Accoun[in9; Goltlenrotl = Assessor $25 laue Fee Hood or Type I ❑ Canopy Type I I ❑ Refrigeration Sys[em , OP100,OOOBTU ❑100,000 System Repair/Alteration Issue fee 9::03 I'!CS/i: I Zone Accessory Building: ParkFees $ ELECTFICAL Auromatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Ges - Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator �65 KW �5-15 KW ❑ 15-50 KW ❑ 50+KW Meter L�Sup to 100 amps Meter ❑over100amps Sub Panel Motors OO-1 HP O1'/: - 8 Inc.Solar 09-15 HP �16�15+ Microwave Pole Light Range Standing Sections Trash Compacmr FEES 3 Z I N G R E U U I R E M E $ 3 Reinspection Fee $y5 Issue Fee $ 3 FEES PUBLIC SEHVICES REDUIREMENTS: � Zoning Approved By Date Application Approved By Data-7�/— Application Issued By �� Dat��/ � K� � J SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK , $ PERMIT PLUMBING $ � ISSUANCE $ PLAN CHECK $ �� /�ENERGY P.C. $ ELECTRICAL § � GRADING � S P�ANCHECK $ / %, S� MICROFILM $ T MECHANICAL $ TOTALFEE $ SS. �-C� $ 3 PLAN CHECK $ � ' t t� CONSTRUCTION AND PLANNING - POO �PA APPROVALS Permit #��"��J Date Inspector AppROVALS Permit # Date Inspector • 1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 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. S. Foundation 59. Gas Pipe, O 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 � 64. Plumbing System - Final 14. Rough Plumbing ' � 65.• Electrical-Fin 15. Rough Electrical-Conduit ' - . Solar�tem-Final 16. Rough EleCtric Wiring �� `I � -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 Hecting & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in $I�ucture . ' � 7Q. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test � 72, Underground Flush 24. Roof Framing , � 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing � 74. Overhead Hydro 26. T-Bar Ceiiing (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 Brqwn Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating�& Air Conditioning , • 35. Final Gas Pipe-Test � , 36. Hood or Canopy ' � 37. Final Factory Fireplace , 38. Final Plumbing . 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final - 42. Backflow Preventer � 43. Backflow Irrigation . , _ � 44. ,Landscapa, Irrigation System . - 45. Sound Attenuation ' � 46. Handicap Regulations � � 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed � . � , • 49. Electric Release to Edison � • � � 50. Gas Release to Southem California Gas Co . , 51. CERTIFICATE OF OCCUPANCY . " " � . - No. Date ' � � � • ' � . 1 � MESA )N P.ERMIT AOV�lont to till in all spacaa ezeapt t�osa wH�in .. PERMIT NO.� _, � TRACT i �ippliienY�Mailing 7�'� IN J() �' . • (�� Project Addrea Grtq.��7 Owner'aNeme T(�(�eS CU hone�6 Address .�Li �S!) � Q I U ia� G° I�1 Arch/Eng. License No. Addreu ��Iy �q�� ContractorsNem � hone�✓ I�L'Z� Address (mA �'�01 Q� � 8 5'{7=Y1�6�1 LicenseNo. �-R�1�� LICENSED CONTRACTOR DECLARATION I nereby,a/firm tna[ I am Ilcansetl untler provislons oi Chartar 9(com�nencln9 wlth Sattlon 7000) of Dlvlslon 3 of the Builness antl Profasslons coae, a�a my Ilcensa Is In /ull torce a tl effect. � lJcenso Class �� Ucense No.� Date� � /o�lFa%C� Si9natu�e / •�' ' WORKERS' COMVENSATION PECLARATION ' hereDy afflrm that I �ave a tert�t�wta of consent to self-in5um Or a cartHirate • Workers' Gompensatlon Insurance, or a certifleC copy therao/ (Sectlon � �o, �ab. c.) �]� /(�155iU/� �. PoIICY No. ��I//L�.1�1-/��!'�ComPanY . ��Cartl/ietl copy is hereby furn�stieA. ' Certilietl coPY,.li�fileG wit� tne clty B�tlin9 BIWS��_. �. n. .� EXEMPTION FROM WORKERS' �OMpEN$ATION DEtLARATION �'r '(T�Issecllon neetl not �e compl0�etl If the Dermit I5 }or one huntlred'(E300) or " iess)�. � ,• , i , , I certify that In the per/orman<e of the work tor which this Derm�t Is IssueC I � shall not employ any parwn iN any manner to as to become SUD�ect to t�e ' � Workers' Compensatlon Laws of �Iifornia.i , Date ' Slyna�ure ' NOTICEe If, after makin9�this Oeclaratlonp you ShoWQ�becoma subjact to the �-. Workers' Compansatlon provlsionspf the labor Cotle, you must forthwith comply wlth. su<h provi5ioni �or thts,.permit shall be tleematl revokeG. CONSTRUCTION�LENDING �AGENCV ' • • 1 hereby aftirm that [nere is a co�struction lentling agency for tha performance of the work }or which:this permi[ is iszuetl (Sectlon 3097 Civ: C; Lantler's' Name � _ l.enAer's Atlaross � � � � OWNER BUILDER OECLARA710N � ' ' - I hereby affirm that 1 am exemGtfrom the Contractor'S' �icenie Law for the a u ;��'"7 5 Dy any applicant for a, permit subjects l�e applltanl to a. civll "�.�81ty of not mom than flve h�nEreO tlollars (E500). � LJ I, as �owner of� the �propertY or �my emploYees with wages as tlieir sole � <ompensatlon wlll tlo the work, antl Ihe sfructu�e�is not Intentletl or offeretl � for salo (Sec{ion 7044', Business antl Vro(esslonal Cotle: T�e Contractor's ' License Law tloes not apply to a� owner ot a proparty'who bulltls or improves thereon, antl who aoes such wOrk himseli/herself or through hls or her own ' employ ees, provlCetl that such Imorovements are noi Intentletl or offorotl tor sale. If, howemr, the bulltling or improvement is soltl withln one year�of <om- O�etion, the owner wlll nave the burtlen of proving he/she tlitl not bulltl or im- ��Ove !o� the pu/po5e af Sale�. I, as owner of [ha property, am ezclusively contracting;wlth Iicensetl con- ' trac[onto construct the�project (Sect(on 7044, Business an4.Pro/esilon5 Cotle:. Tha Contractor's IJcenia Law dOeS not d001y to an Own¢r of property who bullUs or ImOroves tharean, and 'Nho contractz for such projecls with a con- tractor(i�licanse pursuantto the Contrac[or�s License Law). ' ❑ I am axempt untler Section . B. 6 P. C. tor this reaion � r � Date Owner' , 1 hereby, cerUfy [hat �I��have reatl this applicatlon antl itate that the above- Intormation I5 correct. 1 agree to complY wit� all clty antl county or0lnances antl;state laws relating to buNtl�nq constru�tion, an6 he�eGy authoriza repre- santatives of ,thiz'city-'to entCr upnn Me a ove- entlonetl Droparty for Inspectlan ourp -sr � s p C..//�/, �� /] Signature �i[��c. �! Date�/.-+ V � Drivers' Licenso or 55 � :MF 0865-46 rev. 12/82 W�Ite - Builtling; Canary - Applltanh Pink - Accountim TYPEOFCONSTRUCTION l�`I.N[ ❑ CONVERSION ❑ DEMOLISH DESCRIPTION OF WORK TVPE OF PERMIT GRAoiNG - ❑ TENANT ❑�ELECTRICAL C� ❑ �OTHER ' - ' nE si9n all aDO�oD�iate tllcla�ationz. J ADD. LJ ALTERATION- IJ REPAIR OTHER 1 FOUNDATION IJ STRUCTURAL A� P. gW - PLUMBING ❑MECHANICAL . pLNG.REF.yp� PROJECT DESCRIPTION Sq. FT. � �� ocCUPANCv - ' " ' "" ' "" CONSTRUCTIONTVPE ' VALUATION$ � 'LEFTSIDEVARD ZON� GRADING CU.YDS. iACRES GKG.SPACE REQ. y�/—� �� Remarks: '(S .// C.J„ vJ ' STREET WIDTH Bar Si�k Backflow Preven[er Backflow Irrigation Bathmbs Clarifiers � Dishwasher ; Drinking Fountains Floor Drains� Floor Sinks � - Gas Service'� Sink. ' Sevuer CaP . Sewer Connection � -- Solar Collectors � � Solar Piping So1ar 7ank � Swimming Pool w/Spa � ' Urinal � Water Goset, - - � Weter Heater- - -� � � - - - P-Trap - Roof Drains ' . Shbwers : � - Service Sink ' Boiler � • ' � Duct �- Untler Grountl Duct - Structural Duc4 Ventilating.. _ � t Exhaust SVstem ❑ Muliiple ' Firepl/Fxt. BIL ICBO 51� � Heating System & Ducting � -� � �6100,000 BTU �100,000 � Hood or Type I � � Registers anrotl - Assessor C � � � � ❑0.,1 e Cooking Unit � ' � Dishwasher - . Dryers ❑Gas ❑Electrii Fan', F.A.U. � Pixtures ' � Device Boxes � OUtletS ' oC Reinspection Fee- �� $15 Isue Fea ' S 3 r_ m System , 06TU ❑100,OOO�BTU o -- -�- 3 ' _. "r....' ' '_ .. . � Reinspection Fee n$15 . Issue Fee t§ 3 Garbage Disposal Generator �0-5 KW �5-1 Transformer �75-50 KW ❑5U+ KW Merer ❑up to 100amps Zoning APPtoved BY ApPlicetion APProved BY � Appliption laued BY _ SKW fl�� sa�ife3 -�...� r� 'BUILDING � �gn.cr rri eT � REAR VARD (T0 P/L) RIGHTSIDE VARD � • PROVIDED - PARK FEE $ �meter uover iuuamps,_ � Sub Panel, � Sub Pole ' � . � .Motors �0-1 HP ❑1X-8 � Inc.Solar 09-15 HP �16-15+ ,Micruwave Pole Li9ht . , Range _ ,_ . ._. Sections Fw � �� %�Cp� � � � SUMMARV OF FEES � � � � BUILDING PERMIT $ SMIP . ' � $ � PLAN CHECK, $� � PERMIT ' � � . �PLUMBING g .�'--_ • ISSUANCE $ � :PLAN CHECK � $ / D � � GRADING � $ - ELECTRICAL E � ' $ �PLANCHECKI � $ MICROFILM , $ ' MECHANICA� $' TOTALFEE $ ' PLAN CHECK' $: ' � LESS � ; � . ADVANCEDPC $ � � � ' � � FINAL FEE � 3 3 �— . . . ., . , ,. NS7RUCTION AND P�qNN�NG F �� '- � �: � : r ' �OL�! q • • � � - � P.PROVALS ,M Permit�# -t� "75tilo` �ate Inspectoi � ' - - ' ' .,Date Inspector . �. , ' APPROVALS• ��Permir� , u - . .`�T�mporary,Electrical Serviceor`Pole � , , �..52. Pool & Equipment Location � � - -��" �v 2�. ISoil Pipe-Undrgrnd.' �- _ _ � � �: ' �.� C - �a.T�' 53' �Steel Reinforcement � � � _ . . G3t Electrical Conduit Utilitv-Undrgrnd: � � - � ' 54:. �Forms ' - � � " - " - . ' � � s' 4� Electrical Conduit-Undrgrnd'. -� = " ' - ;�r : � � 55.. Etectrical Bonding. � , � . - �. ' 5: Sieel Reinforcement = -- � � 56. Rough Plumbing & Pressure�Test � ' '„ ' 6: Electrical UFER Grnd � ;, ;•' " L� - 57: APPROVAGTO COVER-GUNITE � ' � 7. Fooungs ' � •,„ , �, -" 58. Electrical.Conduit-Undrar�d. � - .. �. _ 8. Foundation , , � � ' �. � � 59. Gas Pipe, � Undrgrnd., Test � � - . � i - - 9. Water Pipe-Undrgmd. � � �� ' . - -60. Backwash Lines, P-Trap, � Undrgrnd. , ' �� 10. Structural FI6or System - � �� '. 61. APPROVAL`TO DECK � . - � � �,. � � � 11. ,Property Sewer Line & House Connection: - 62. Backwash & Receptor-FinaF - � � . � �� 12. Sewei Cap � _ , ' - : 63. Heater & Vent-Final ' - - . . 13. Roof'.Drains '� �. � � 64. Plumbing System - Fioal . � " � � � � 14. Rough P.lumbing ; -� 65. Electrical-Final � • - � ;-15. ;Rough'Electrical-ConduiY , " ' � '" � ' � "'-' � -- ' 66. SolarSysi4em-Final �� ^76...Rough�Elec[ric•Wiring � P � � - ' � � ;'�' - � ' " 67. Fencing & Access Approval - - � . � � ' _ '1•7. �RougFi Wiiirig'Sign:. � . ' ' . " �68. APPROVED FOR PLASTERING ; . � - � 18: Rough_Elect�ical-T Bar Ceiling' �- ' 69. POOUSPA SYSTEMS FINAL . 19: �Rough�Heating &�Air'Conditioning � � � � FIRE DEPT. REQUIREMENT , � 20. Rough Factory Fireplace ' • ; , � I � APPROVALS . Permit # . � �' 21. 'Ducts, in Structure: �� 70. Unde�ground Hydro ' : ._ �.. ' ��. � 22. Ducts, Veniilating : . „ � � 71. Product Piping O Gas ❑ Oil ' -''1;.23. �Gas Pipe-Rough�& Test �` ' � �. ,� �� . ' •? 72. Underground Flush' � � �.; � � 24. ;Roof Framing ' � � , � � I � , , � 73. Undergrnd. Storage Tank' � Gas .❑.Oil � 25: Roof Sheatfiing � � � '�� " I � � 74. Overhead Hydro ' � • �. � f w 26..T-Bar Ceiling (Structural��& MonocoaY � ! - ,' �' i � 75. Dry Chemical ' - . � - � '� �.27. 'Frame and �Flashing - " � � � ' j ' . � 76.' Dry Standpipe . . - ' � `` ` 28. . Lathing & Siding _ - , ' � ;, { , 77. FIXED SYSTEM FINAL � > - � �' I '' 78. FIRE PREV. FINAL � _ 29. Insulation" i ' ' � . ' j ' , ' 30. Drywall Nailin9 ; '>' ' i ; ' � Notes: , . � ' '31. �Plaster Brown Coat ' � ' � � _ . 32. �Electrical Power Meter-Final . � � � ' 1 � �. � ' � � � � 33. Final Electric � , , � ' � �l 34. Final Heating &�Air Conditioning � � 35. Final Ga3'�Pipe-TesY T , � r� ' ' � � - � � ' � - � _ - 36. Hood or �CanoPY" . . , ' ., � � ' ' � . � - . - ' - - - � r 37. Finai Factory Fireplace : - - , � � � � � 38. Final Plumbing ; , � �� . 3��py ��(/ ' . - 39. Water Seivice-Final. ' • � `� � � � ' � � � �� R � ' 40. Gas Service-Final � � , � , � � i ' � 41. Solar pomesticFinal � � � � ' � _ ' � . :' � ' 4- 42. Backflow Preventen . � � ' � � � : . ' . , _ _ 43. Backflow Irrigation. '� '� r' _ - i � , ' , � . , 44. Landscape Irrigation�System . ' � • ' � ' � " - -' 45. Sound Attenuation �', � � � . ' - ' � ' � � . . , - - - �� 46. Handicap'� Regulations , . , � � � , ( " i . � ' , ' - � � • 47. FINALSTRUCTURE&BUILDING � � �� , 48. Special Requirements Cqmpleted . � ' � � ' � . ' �� i 49. Electric Release to Edi'son� � ' � ' . . 1- i -.- - i _ -. , _ ' ' ; . 50. Gas Release to Sou4hem California Gas Co ' ' � � � .. . ,� � i � �: 51. CERTIFICATE OF OCCUPANCY ' _ . ; � __ . . � No, �� Date � ' � i ' ' �� AODliwnt to flll In all sDaees e:eept t�ose wN�in �eavy Oortlar Iinas anE sign all apP�ooriate tlaclantions. _ ' _ _ "" __ ' ' . ' " " ._ ... ' CITY OF COSTA MESA' � T ' PER IT NO. ', TRACT NO. LOT NO. ' BLD . � � �3;• 33, --- .J t ye 6 r� ,T� G/ t ( . N, CONSTRUCTION PERMIT • � � 108 1 1 2 � , ' . ' � � ''' ' � _ � � � , � AppliCBnYSMellingAddfB55.��r'n %�'I rWA,/ QVP n-a .c�sra �`iP5 �PEQFCONSTRUCTION' NEW ADD ALTERATION REPAIR � - ' ' -t , _ " � � ' , _, ' � � PfO1�tAdd�MS. ' � . . '❑ CONVERSION ❑ DEMOLISFI ❑ OTHER' . . . ' � I � ' • • . . � . . . : • . • . . I i �� D. Janes Lo. Inc. -'.�979-3376.. ' DESCRIPTION'OFWORK T.m�horlrpmm �'t arir� halrnny J � Owner's Name . hone � _ � , : � . � ; . . . - . ;. . , N . ; -- . � 1 . � , . � � G: . T1 � N _ . nca�au `• 2950 Airway Ave. D-9 Costa.Mesa ' .. �y` i , •LVPEOFPERMIT GRADING' ' FOUNDATION .STRUCTURAL A.P:S$' �I �' IJ'.1� I� �20NE � _ Arch/Eng.- Ddfl l E� I dll '& ASSOC. License Na. C-4�S29 . Q TENANT ❑ EIECTRICAI ❑ PLVMBING ❑ MECHANICAI � � -' �— �GI �' l� BUILD�NG - ' � '3848 Campus Dr.'"NEwport 'BBBCII- , Q �pTHER • PLNG. REF.#� . , � I Addreu _ ��p�� ' � ^ ' � � � � . '- TO BUILDING_ ' � ' - ' COntfectOPS NemB ' QWner . � ' ' PhOile J1LlLL� , PRQIECT DE$CRIPTION 5�. FT.� S F' S CCUPANCV R PE V LWE .� EAR VARD (TO P/U . 3� , ; � ' . ' ' • � ' LEFTSIDE VARD � ,�} - IGHTSIDE VARD � � � � AddIe55�meiling) ' Same ' • —_ __ ' ;CONSTRUCTIONTVPE �� VALUATION$��!{�9. . . . Ci.C� . ., . �'� ` �� , LicenseNo: � � � � ' ' 'ZON� '��- � GRADINGCU.VDS. n.�a ,ACRES %��' PKG.SPACEiRE�. a� , � PROVIDED , a-. --i , LICENSEO CONTRACTOR DECLARATIPN � � Remarks: � � � i ' I ' . ( . � • STREET WIOTH / �.Pqq�K FEE $ I . L�areCy;af(irm that I� am Ilcensed untler pfovisions of Charter 9(commencing ' - _' , . , � . wIN sectlon 7000) of Dlvlsion 3� ot the 9uslness an0 ProfesSions CoOe, anO ' � � � a ' ' � � ' � 1 , � � � ' � S7ECIAL CONDITIONS: � � _ _ � ' ' my Ilcense'ds in tull foru antl effect. � � ' , ' �� . ' Licenie Class+ I LJcensa No. ' ' ' ' ' PLUMBING . ' ' , ' H�LD Fv.t S��Q.:� �'' �' - � � � ." � Data - ' ' Signature � ' = ggrSink . ' $ewerCap' , • � ' ELECTHICAL � � ' ' WORKERS' COMPENSATION DECLARAT�ON � • � ` ! � - - - � ' � •reb aftirm that I have a certlfl�ate of consent to SeiNnsure or a.certiilfate._ - - _ , Au[amatit Washer Meter �ove( t0U am S' � � workers' CompensaUon InsurSnce, or a cerUfietl copy thereoi (Section �� Backfiow Preventer- - - - Sewer Connection - - - - � � - - . r - - - P-- - � .,e00, laD. C.) • � ' � ' ' � - - � � ' Construction Pole , Suh PaneP ' ' ' ' � { � Backflo4v lirigation Solar Collectors � • - � � Poncy No. ' Company � - -� � - - Cooking Unit . . � ' Sub Pole ; � � �Cernnea-coov Is hareby turnunad. i � ; . � BatM1tubs ' � Solar Piping � � ' • - . � '� �-� ' CeftliieG topy IS filetl with the city Building DIvi5lon. Dishv25hef ,MotO�s �04 HP � 1X$ ' ' ' Dam • ' Applicant ' ' � ` � ' . Clarifier's � ' � , Soiar Tank ; ; �� - ' � . . �EREMPTION.FROMWORKERS'COMPENSATIONDECLARATION � ' � Di5hWd5hel � � ' � SWlmmin Poolw/Spe � • ' Dryefs ❑GaS�OEleCtnC� In0.5olef 09-15HP �16454 ' { �(Thissection neetl not be <omD�etetl If tne Oermit is for,ane huntlretl (5300)jor � � �' 9 � � � less) t . ' ' i . � � i . . - Fan; . ' , , �Microwave ' � , i I certify,that in the perfo�manCe o1 the Work tOr whiCh th15 permR Is IssueE 1� Dfinking Fountelns I U�inel � �• , � � � ' shalL not employ any perwn In an manPer so �az to become subject to tha . . . , �. � ' . , " • , . � Workers'�Compensatlon�Laws of Ca�Ifornia.; � � Floor Drain'si � j . Water Closet' � � I F'A'U' - � ' ' � Pole Light � Date � Slgnature " ` ' ' 1 ' . ' - � � � �� -NOTICE: It, aTter-maklrig this tleClaratlon� You-shoultl become�sub�ecbto tne- — �� Floor Sinks-. -------�� r - -. . Waten�Heater� � --- _ , j,,,, _ Fixtures. � _ i _ ,iRange,_.._ _ 1 _ , Workers' Compensatlon provislons oi tne LaEor COOe, you must Torthwlth I ' - ' ' � . � I comply with! sUch provI510O5 }o� _thl5„pe�mlt shall bE �4¢¢Tetl revoketl:: .. Gas Service'� .Outlets ,• .., Water Service -„ ��. �� ; Device Boxes 6 ( ` Si9O _ � 4 � CONSTRUCT.ION LENDING AGENCV ' '- - , � ' ' � ' r � I hereby atfirm that there Is alconstrutilon (entlin9 agency tor the�performanee. I Inte�Cepto�s . I �'� _ � _ I ' e Outl2ti ' Standing SeCtions � ' of the work for �µb�h tpI5: a mit I � eE f tlon .309� Civ C) , , . Lentler's. Nama Y 1 rSL -IPlE01"5�8��; B�B�PC� � ± � � KitchemSink : ,' - - _ � I ' Switches' . ,Trash Compacior i � Lentlerz AGCresz' � - -� � - - � � ' . � �,y�atories� �*. 1 ; � . � � Gar6ageDisposal , ' � i � � � ' ' OWNER BUILDER DECLARATIO �� ' �� ' " � ' � � - I herebytaftirm that I am'exemp['from Iha�Contractor's.Liceuse Law for the p_T a, . . • \ _ • Generator �0'5 KW �545 KW � tollowiny reason (SecUon"7031.5 Business antl ProfeSsionallCotla: Any Gty or P� i r. � - �: .county whichl requires a permit to construGt, alter improve; tlemolish-or,repalr � ,•. - 'any structure; pflor to its issuance, also raAulres tl�e apP��canbfor such parmil ! ROOf Dreins .� ' � • .� • � .! .to file a signea itatement Ihat he(she is IlEensetl Oursuant to the�provisions ot � -' ' t e Contractor's License Law (Chaptar 9(comreencing,with Section ]000) of �- " - 4. �. '- � � � �:'<ision'3' oi the �Business antl Profaulohs CoUe) or thaf he/ihe�is�,exempt � - Showen - _ . � ' � � Reinspection'Fee � §7 "�e(rom anG the basi5 for the allegetl exemption: Any violatiomof Saction ' ' �h?'s1:5 by any applicant for a permlt' suD�ects.tha aoG��ant to a civll ' �- �•^• nalty of not more than tive huntlretl tloll5rs (E500)t � . , ': ' , ; SErVic¢ Sink i , , Issue Fee , � � � $ � I;�as,owner oi-the:property or my al*�P�oyaes�with wages'as thelr sole ' tompensation wlll tlo the�work, antl;the�structurelis not intantletl or oifereA I j_ � _ � , i MECHANICAL' � "i , for sale.(Sec�ion 7044, Buslness antl;PrO�essional Cotle:�The ContractoYs � - � , UCenSa Law tloes nOt dpply to18n own¢r Of a p�operty who builtl5 or Imp�oves � BOiICf �` � .Refrigeretion Systerim ; thereoq�antl who tloes�sucM1� work hlmselUherselT or tnrough his or her own ; �>�� ' � ' , � employees, provitletl Ihat such �Improvemen<s ara not intentletl or offereA tor . Duct- Unden ' �0-100,000 BTU ❑100,OOO,BTU� sale. If, however, the builtling or Improvement is soltl witnin one year oF com- Ground � � � ' pletlon, the owner wlll have the burtlen of Proving ha/she alA not builtl or Im- � � . � , � �rove tor. the purpose of 5ale). � ' � �-� � � � � � Duct -Structural ;� � System Repair/Alteration � I, xs owner of the property, am exclusivaly contractinglwith Iicensetl con- � _ ' � � ttmktorsto constructlhe project.(Section 7044..Business anO.Protesslont Cotle: � Duct,- Ventil2ting i Tha Contractor'S Citenie Law does not apVly to an owner ot property who� � ' � . builtlz or improves thereon, antl who contracts for zuch projec[s with a con- Exheust Syit2m ❑ Multiple ❑ � � � tractor(s) Iicense purouant to the Contractor'S Licanse Law)f � ' , ' � � 0 Iram exem t unCer SectlOn B. & P. C. for IhiS reason � - � � . p , Firepl/Fact.Blt.ICBO;f` , f ' Data Owner • ' Heating;System & Ducting � � t - �-I-hereby-certlfy t 1: ave reaA-this� app��cation antl�state�thabthe aDove �� -.- �6100,000-BTU �100,0008T - �, , - - � � intormation is cor ct. 1 e to compry With all city antl counry orAinances � • � i� I ' y' � antl[state laws r atlng b IlOinq onstN , antl ereby authorize repre• � Hood o� T 2 I ❑' ' ' ' zentaiives of t s.ctt to en r pon t e tive- ntloneE property for YP ' , ' inspectlon ou - ses. � � . � � Cano . T� e II �' Reinspeetion Fea, $1 � Signature � Da n � D- � . � , . � I Drivers' LI r� � � ' Registers ' . ' , Iswe Fee � S; CMF 0865-46 rev. 12/82 hite - Builtling; ��ary - Applica ink - Accounting; Goltlenrotl - Assessor � � � � � � � Transformer ❑75-50KW • i � . ❑5U+KW� ; ,RainspectionFee 515 � 1 Meter ❑upto100amps �Iaue-Fee, � � $ 3 Zoning APProred BY , , Date Appliotion Approved By � (..y�� Date / -� Application Issued 8y � , ( � ' �Date v �� i ; � I j � � /S�UM,�MARV OF FEES � : jBUILDING PERMIT $ VJ� � SMIP ' j '.. $ ' ' �� , �PLAN CHECKj � $' _�� PERMIT ' � �PLUMBING ' $ , � ISSUANCE ' $ � � .PLANCHECK, � $" t � GRADWG �. . $ � � i ' ' $ � � EIECTRICAL�., $: ' ' - � PLANCHECK'� $ � MICROFILM � $ - TOTAL FEEi $ � MECHANICAL $ ' . - � - �PLAN CHECK� ' $� � LESS ' � • � : � � ' ADVANCED PC $ � � ' , � . 1 � � FINAL.FEE. j $ �3/�� , ADp�ieant to fill In ill Tpa<as axceDt t�ofe wlt�in haavy Do�Oa� Ilnas anE si9n all aPp�oDHata tlecla�atlons. CITY OF COSTA MESA � PERMIT NO TRACT NO. LOT NO. BL . . CONSTRUCTION PERMIT - �/J — S L� D AppliCent'S Malling Addfess , TyPE OF CONSTRUCTION . NEW ADD ALTERATION ' REPAI R Project Address � 7�'�'2 W1Ylg8.'t�0 � � ❑ CONVERSION ❑ DEMOLISH ❑ OTHER OWnerSName M•D. TaneR (:O. Phon2 " ' DESCRIPTIONOFWORK TnPt.%a�. fli.'P;JZ$Og J Add�2u , ' . TVPEOFPERMIT ' GRADING FOUNDATION STRUCTURAL Arch/Eng. _ LiC2n5B No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBINO � MECHANICAL AddfC55 �- _ ❑��OTHER � ' Contractor'sNameCO$St:' FlY'P� l�1rP� -Phone��LC0r}� PROJECTDESCRIPTION 5�. FT. �oCCUaArvCv Addreulmailing) �n�� N B%a�'��T�`^��#N,Orange q�Cli.�r' CONSTRUCTIONTVPE VALUATION$ � ��. ZON� GRADING GU.YDS. ACRES License No. IICENSED CONTRACTOR DECLARATION Remarks: ' - I hereGy affirm that I am Ilcensetl untler provisions of Charter 9(commencing . , with section 7000) of Division 3 ot the Business antl Professions Cotle, antl my Ilcanse iSln full force antl effect. � IJcense pass_(�'- - YJSeP aG^' �'?6�% PLUMBING ' DatB�Q.L2s1i�d Slanat ne � . _ii-u ••'00.KER�' COI�VE SATION DEC Rdriorv � Bar Sink Sewer Cap �raby afrirm tnat 1 nave a certitiWte ot con5ent to 581binzuf0 or.a tertlflWce - � Backflow Preventer ,• SeMrer ConnECtion�--- � Workers' Com nutio surance or a certitletl copy thereot (Sectlon � ae00, ub. C.) �`Z ��`��30(,'(�% Backflow Irrigation � Solar Collectors � � Policy No. � Company - �' - " , �erHfletl copy is hereby turnishetl. Bethtubs � Soler Piping � � Cartiti tl p Is fllatl with the city tlin i' i Date]�� Appllcant • � • � C18rifiCro ' � Salar T2nk ; ' EXEMPTION.FROM WORKERS' COM N ATION LARATION Di5hN25h2f Swimming POOI W/Spa � (ThlsSecUon neaC not be completetl H tha permit is fo one huntlretl (E300) or ' .'1 — less)- � ' ' Drinkin Fountains • Urinai ' I cettliy tnat In the perlormance of the woik for wnicn tnis perm�t Is issuetl I 9 shall not employ any person In any manner so as to become sub7ect to t�e , , Workers' Compensatlon.Laws oi Calltornla. ' ' Floor Drains '" . Water CloSet Date 9gnature ' ' . ' . NOTICE:'If, after making t�is daclaration,'you 5hou1E become iun�ect-to ene--: - � Floor Sinks - - Water-Heater --- - - Workers' ComDensation proviSlons of [he Labo� Cotle, you must torthwith - - . " tomply wiM such .Orovisions or thi5, permit 5�ail be tleeme0 revoketl.; Ga5 Servic2 ' OutlEtS � Wetef $ervice - � CONSTRUCTION LENDING AGENCV � -' . , I hereEy afflrm that there is a con5truction IentlVng agency for the pertormance Interceptors � ' � o! tha work for which, [his permit is •tuuetl (Section .3097 Civ. C; _ _ _ LenAer's Name Kitchen Sink ' � ' newucns�e tltlras ' � � � . . e .,��, eser,,.0 . . _ _ . Lavafories � . ' - . � ' . , � 'antl the basl5 for the allege0 i i any applicant for a I permi� riot more than five huntlratl tla �wner of the property o� my �Jon. will ao the work. antl� the Bver, tne ounamg Or owner�wlll �ave the : purpose of sale). Ll I am exempt under Section— Date � Owner License Law !or the al Cotle: Any tity or ve, tlemolish or repair ' icant for su<h parmit [ to tne.provisions of � ch SecHon 7000) of at he she' I5 exampt viola lodoi Sectlon applicant to a civll wd9¢5 a5 thBlf 5018 , IntentleC or o(feretl re noi mcenaea or orrerea ror I5 3oltl withln one Year of com- ' iin9 ne/S�e tlitl not bulltl or �m- tontractlng'with Ilcansetl con- Buslness antl Protesslonz Cotle: to an owner ot property who : s for such Oro�ects wlch a<on- � .icenta Law)_ — B. & P. C. tor this reason above iances repre- y tor Roof Drains ' ` ' � Showers ServiCaSink - � , ' . _ , . . . - MECHANICA Bailer � � , Duct = Under Ground �uct - Structural .. Duct - Ventileting � Exhaust System ❑ Multiple ❑ Firepl/Fact.Blt.IC80;1� 1 ' Heating System & Ducting i ❑ 0.f 00,000 BTU O 100,000 BT , Hoodor Typel ❑� . Driverz' Uce or' S� _ � � � I � I%1e9isters CMF 0865-46 rev. 12/82 White - Bulltling; Canary - Applicant; Pink • Accountln9; Goltlenrotl - Assessor flainspection�Fee laue fee ; ❑ 0..t 00,000 8T U❑ 100 System Repair/Alteration � � . � . .I � � � I - , , � � -aed6 i : � � �y �; ^' i ,- �,� r . ., , i �, , i i� � � ; . . , ' i . ' ' � ' . � _ ' . . � ' i i � ' _ ,_ , . � ....u.�n occrii .r�...�� ' . - . � - . i , PLNG. REF.SM' LEFTSIDE VAqD PKG.SPACE REQ. STREET WIDTM Automatic Washer � � � REAR VAPO (TO P/U �' � RIGHTSIDEVARD ' PROVIDED . ' PARK FEE $ � Dishwasher';� � Dryers��Gas ❑Electric Fan � { ' F.A.U. Fixtures • - � Device Boxes � L�' Generatar LJO-5 KW 1J5-15 KW Transformer �75-50 KW � ❑5U+KW $75 Meter ❑up to 100 amps $ 3 Zonin9 APProved BY . i , ApPlimtion APVroved By Appli�ation Issued BY _,.� _ `_ .i .. .� ' Reinspection Fae� $15 Izwe Fee S 3 Meter LJover lOU amps ' Sub Panel Sub Pole Motors �0-7 HP ❑1X-6 � IncSolar 0945HP �16-15+ - �Microwave ' ' �Pole Light . � Renge � Sign Stending Sections ' Tresh Compactor � • . ReinspeMion Fee $16 Issue Fee' ' $ 3 , Date � Date �� oaee /�' 9 8 3 � � SUMMARV OF FEES � � ,BUILDING PERMIT $ SMIP , $ , , 'PLAN CHECK $ PERMIT ' PLUMBING $ ' ISSUANCE � , $ . �PLAN CHECK ' $ GRADING $ .ELECTRICAL $ 'PLAN CHECK' ' $ MECHANICAL �� $� _�� _ ,PLANCHECK � g G VU i � $ •. ' MICROFILM � $ TOTAL'FEE, � $ ' LESS � ADVANCED PC � $ ' � � FINAL FEE. . $ 9. QO CONSTRUCTION AND PLANNING 'f'�� P'�' � t APPROVALS Permit#�!-9�� Date Inspector qpPROVALS Permit# Data Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soii Pipe-Undrgrnd. � 53. Steel Reinforcement �� 3. Electrical �nduit Utilitv-Undrgrnd! . 54. Forms 4. Electrical Conduit-Undrgmd. � 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-Undrar�d. 8. Foundation � 59. Gas Pipe, � Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. ' - 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Stcuctural Floor System ' �" 67. 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 75. Rough Electrica�-Conduit 66. Solar SYstem-Final 16.. Rough Electric Wiring 67. Fencing & Access Approval � 17. Rough Wiring Sign g$. APPROVED FOR PLASTERING 16. Rough Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL 19. Rough H¢ating & Air Conditioning FIRE DEPT. REQUIREMENT - 20. Rough Factory Fireplace ' APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating , 71. Product Piping O Gas ❑ Oil - 23. Gas Pipe-Rough & Test � 72. Underground Flush 24. Roof Framing �"� 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing � 74. Overhead Hydro 26. T-Bar. Ceiling (Structuraq. & 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 � Notes: . 31. Plaster BroWn Coat . 32. Electrical power Meter-Final 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or �nopY 37. Final Factory Fireplace lry��1t� (�j 38. Final Plumbing . 39. Water Service-Final 40. Gas Service-Fina! 41. Solar pomestic-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 qelease to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date GTV OF COSTA MESA � ' CONSTRUCTION PERM17 AoO��anl to fill in all spaces exceo� t�ose within heavy boraer Iines ana sign a11 apvroD/iale tleelarations. PER I ��a� �OAC`T�NO. - LOTNO. BLD� . i� o i � cf-. Project Addr25s A TVPE OF CONSTRUCTION 'NEW ADD ALTERATION REPAIR AppliCant'S Mailing Addreu -f/ ❑ CONVERSION ❑ DEMOL 5 ❑ O HER q p# Owner5Name -Phone � //v DESCRIPTIONOFWORK �pQ�/�. Addreu Y � �fG Arch/Eng. License No. Addreu Cantractor'sNam • hone q57-�C'� Address(mailing) � qW' Ow�Q/7d �/l.-� Q.IIlA� CityLicPnSeNo. C��C7� LICENSEO CONTRACTOR DECLARATION 1 hereby af5irm that 1 am ➢censetl u�tler provislons of Charter 9(mmmencin9 wiih section 7000) ot Dlvislon 3 0� Ihe Buslness antl ProfeSzions Cotle, antl my Iicense is in ful torce antl e�fe<t. � ��/� License Class ��%� LI<e No.�% � oate [b-�-�3 Signature �)^7�/�- VORKERS'COMPENSATION DECu1RA V iereDy aftirm tnat I have a certifica�e ot mnsent to 5elt-insure or a certlflcate .f Workers' Compensatlon Insurante, or a certitie copy �thereoi (Settion 3800, Labp��o�g,5y Company Policy No _� Certitietl copy is hereby fumished. Certi ieC cop filetl with the citY �tlin,g/ �D,i,visi� .�/C Da e �n- ��_ qpplicanC ��7l�(L� EXEMPTION FfiOM WORKERS' COMPENSNTIQD DECLARATION (Thi55ection ne¢tl not be completetl if the permit IS fo� one huntlretl (E100) Or less). I cerUty'�tbat in the performance of the work for whlch this permk is issuetl I shall not employ any person in any manner so as [o become subject to t�e workers' Compansation Laws o/ Cal��ornla. . Date Signature NOTICE: It; atter making thit tl¢Claratlon, you shoultl becOme subjett tO.tha • Workers' Compensatlon provlsions o� t�e Labor Cotle, you must forthwith comply wilh such provisions or fhis Dermlt sha11 be deemed revoketl. CONSTRUCTION LENDING AGENCV 1 hereby aHirm that thme i5 a conSlN�t�on Ientling agency fOr tha performance O( th¢ wOrk 1or w�i thi OeYmit is issuetl ($ectlOn 309] Civ. CJ Lentler's Name �%� Lentler's Atltlress OWNERBUILDER�DECLARATION � I M1ereby at(irm that I am exempt f/am [he Contractor's Ucense Law for the tollowing reason (Section 7�31.5 BUsiness antl Professional Cotle: Any city or county which requires a permit to construct, alter, Improve, tlemolish or repalr any structure, prbr to its Issuance, a�so reqWres the applicant for such permit to tile a sianeG statement that he/she is Iicensetl oursuant to the orovisions of '-f".,i�.r.+ivision 3 ot the Business antl Professions Gotle) or that he/she is exemp[ -:;�eretrom antl the basls for the alle9etl exemption. Any violatlon of 5ection °3W1.5 by any applicanl for a permit zubjetts the applicant to a tivil �enalty of not more Ihan tive huntlretl tlollars (E500)_ I, as owne� of the prOperty or mY amployees with wages as Ihei� sole <ompen5dtion, wlll tlo the wOrk, and th¢ st�ucture Is nol intentletl o� o(fe�etl for wle (Section ]044, Business antl Protessional Cotla: The Contrac[or'S License Law tloes not apply to an oWner of a property who builtls or ImOroves tnereon, ane who tloes such work nimself/herzelf or through niz or her own amployees, proviaetl that such imorovements are not Incendea or oHeretl for sale. If, however, tne �uiltling or improv¢ment Is soltl within one year of com- pletion, the owner will have the burtlen ot proving he/she tlltl not builtl or im- �rove tor lite purpose ot sale). I, as owner of the property, am exclusively con[ractinq with licensetl con- tractors [o construct the project (Section ]044, Business anC Professions Cotle: TM1e Cont�acto�'s License law tlOeS not apply to an owner of p�ope�ty wh0 builtlz or Improves thereon, antl who mntracts for such projetts with a con- tractor(5) Iicense pursuant t0 the Contractor's LICenSa Law). ❑ I am exemp[ untler 5ection B. & P. C. for t�is reason S Mairi Bi TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING C�MECHANICAL B Reaf ❑ OTHER %� C Right PRWECT DESCRIPTION 5q. FT. oCCUanrvCV K CONSTRUCTION TVPE VALUATION $ �� $ Left ZONE GRADING CU. VDS. ACRES p�ng. RCf. # Remarks: Parkina Reo. Preventer Roor Drains ��'- FloorSinks ' V23$CIVICC DUlIC15 Interceptors Kitchen Sink Lavatories . P-Trep Roof Drains Reinspection Fee $25 Duct - Under G�ound Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Date Owner Heating System & Ducting I hereby certify ehat I have reatl this applicatlon antl state that the above /�0.100,000 BTU �100,00067 intormation is corretL I agree to comply wlth all tlty antl county ortlinances antl state laws relating lo builtling GonStrucUon, and hereby authorize re0re- sentatives ot tMs city to e ter uPop Ihe above-mentloneA proper[y tor inspection puro ' Si9nature ' Date (0-�.s3 Driverz' �icense or Reinspeetion Fee CMF 0865-46 rev. 7/83 White - Builtling; Canary - APPlicant; Pink - Accounting: Goltlenrotl - Assessor $25 Showers Service Sink Sewer Cap Sewer Connection Solar Collecrors Solar Pipin9 - Solar Tank Swimming Pool w/Spa Urinal Water Closei Water Heater Water Service Issue Fea Hood or Typel � Canopy Typell ❑ Refrigeration System ❑0.100,OOOBTU ❑100,000 System Repair/Alteretion Issue Fee Use of Building: Plenning Notes: Automatic Washer . Construction Pole Sub. Cooking Unit � Dishwasher . Dryers ❑Gas ❑Elec Fan F.A.U. Fixtures Device Boxes Outl¢t5 Switches Garbage Disposal . Generator �0.5 KW C $ 3 $ 3 71'a7 1 1/; "/," 2one Park.Fees $ �, T, 2 O N 1 N G R E 4 U I R E � E ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW � Meter LJup to 100 amps Meter ❑over100amps ic Sub Panel ' Motors � 61 HP � 1 X- 8 InaSolar �9-15 HP �i6-15+ Mlaowave Pole Light Range I I Standing�5ections 75 KW Trash Compactor � Reinspection Fee I$25 � laue Fea PUBLIC SERVICES REQUIREMENTS: Zoning APProved By APPlication APProved By Aoolintion laued Bv � BUILDING�PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK SUMMARV OF FEES $ SMIP $ PERMIT $ ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM S �,� - TOTAL FEE $ � $ 3 $ � CONSTRUCTION ANDPLANNING �� " � P�� `SPA APPROVALS Pe�mit# �r1��Z� Date Inspector' AppROVALS Permit# Date Inspector 1. Temporery Electrical Service.or Pole ,. . - 52. Pool & Equipment Location �2. Soil Pipe-Undrgrnd. . � - 53. �Steel Reinforcement - 3.� Electrical Conduit Utility-Undrgmd. � - - 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,�O �Undrgrhd., Test 9. Water Pipe-Undrgrnd. � � , 60. Backwash Lines, P-Trap, O Undrgrnd. �0. 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. Electrica6Final 75. Rough Electrical-Conduit - � �. 66.- Solar System-Final ' - �' 16.� Rough Electric Wiring . � '67. Fencing & Access Approval � 17. Rough Wi�ing Sign ^ , 68. APPROVED FOR PLASTERING 18. Rough Electri�l-T Bar Ceiling - 69. POOVSPASYSTEMS FINAL 19. Rough Heatiqg & Air Canditioning � � FIRE DEP7. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure � , 70. Underground Hydro ' 22. Ducts, Ventilating , , 71. Product Piping O Gas ❑ Oil _ 23. Gas.Pipe,-Rough & Test 72. Underground Flush 24. Roof Framing ;, • �, 73. Undergrnd. Storage Tank O 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 & Sitling ' � 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 '1�%(�ff�/ ��j,(� � � , 35. Final Gas Pipe-Test .� ' ' . � . � ` � 36. Hood or Canppy � - , �. � . ' 37. Final Facto'ry Fireplace � . . - 38. Final Plumbing - � � ' . 39. Water Service-Final � ' , 40. Gas Service-Final ' � ' � � � 41. Solar pomestic-Final . . ' _. . _ _ 42. Backflow Preventer . � � 43. Backflow Irrigation , . � � ' - 44. .Landscape Irrigation System ' � � - • 45. Sound Attenuation ' � , 46. Handicap R�egulations , � . ' , � � 47. FINAL STRUCTURE & BUILDING . , 48. Special Requirements�Completed . , � � � , 49. Electric Release to Edison - - � , � - � - � 50. Gas Release to Southern Califor'nia Gas Co ' 51. CERTIFICA7E OF OCCUPANCY ' � � i - No. Date � , ~ � i ,