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746 WINGATE BAY - Building Permits
U71b 6/'r_'I/U.I 31�..�1 IL ADD������ to fill In all spaeas eaCapt t�ose wit�in �eary CorOer Iines an0 sl9n all aoVrooriata Eaclarations. � CITY OF COSTA MESA � ' - � pE IT NO. TRACT NO. l0T NO. B D. ', � r , , . CONSTRUCTION PERMIT ' � %,j O'O� � 108 1 1 2 � � � ' � , � AppliCBoYS Meiling Addfe55 ' i rwa � ve. � - osta � e d�yPE OF CONSTRUCTION , NEW ADD ALTERATION REPAI R ' . , � „ 1 ' � ' , - � ' ' PfOje�P.ddfess 746 Winoate Bdy � CONVEq510N ❑ DEMOLISH ❑ OTHER . � � ' � ' ' ' � Ownm'sName M. D.'..Janes Co., 'Inc. anone 97q�4�7F, DESCRIPTIONOFWORK �- ' 1 c e i ' 9950�Airwa ve. D- Cos�Ta �MPca � � � --/ � � Add!lSs� , �, J 7VPE OF PERMIT �GRADING '� FOUNDATION� STRUCTUFAC A. P. qW I '� -'I I' ZONE . ' �' AfCh/Eng. � ` � � Llten58N0. � �%'Q�� ❑ TENANT ❑.ELECTRICAL ❑ PLUMBING ❑�MECHANICAL � � � -ZLj-� l' ', BUILDING� ' � � PLNG. REF. qp Addfeis R r� Dr -Neii 9f� �6d6f1 � � ❑.UTNEti TOBUILDING . ): � ' ' + ��� � ' . ' '. � � • ' . • R PE V 1 E I . I EAR VAFD (TO P/U Convactor'sNam�1AlA8" ' 'Phone n-ro_���c �PRO.IECTDESCRIPTION SO.FT..��OOS E. ��L 5 pCUPANCV � LEFTSIDEVARD IGHTSIDEVARD� Addresslmailinql' Sa111E � : ' � " �� cOnSTRuc�'i8N y7VPF 1li � � VqLU�T10N$�__ - � ' - . . � - � � I � ' ZON� "-J GRADINGGU.V�S. n a �'ACRES � PKG.SPACE'REQ. a � i PAOVIDED �,-5 �130- License No. � � ' � � LICENSED CONTRACTOR DECLARATION � ,� � Ramarks: , � ' I � ' .' ' STREET WIDTH , � PARK FEE § �8� �. S' 1 neroby;aHirm thal I am Iicense0 unGar provisions oT Charter 9(<ommencing ' � � � , . wit� sac:�on 7000) o� Dlvlsion 3 of the Busineis antl Pvofeszions COEe, antl ' . ' � � . � , � ' SPECIAL CONDITIONS: my Il�e�se Is In lull lorce an0;efiect. .- , • - � �•t��n��� � Uunse pau � � Licen» No. ' � PLUMB{NG � � ��jC,[ �O�u��u;iSSS ' ' . . Date,- ' ' Signature • � • ' ' � . . , WORKERS COMVENSATION DECLARATION � � ' ; Bef Sink , � Sewar Cap , . � � l ELECTRICAL � ; ! � � "ero0y.'aHi�m Ihat 1 have a certitiw[e.of tonsent to selNOsura oi a certlfiwte_ 1 � _„ _� Auromatii Washer ' �Mater over 10a amp5 � � ;'� Wo.kers' eompensatlon Insurance, or a certifiea' copv tnereof (SacHon • -' Bxkflow Preventer - � SBWer Connection -� - -- - r -�, , , Consuuction Pole Sub Panel A0� Lab. 0.1 . . � Bxkflow Irrigetion � Soler Collectors �Iicy No. '� ' Cbmpany ' � �-� �. , � Cooking Unit �Sub Pole , C9rlitlatl cbpy Is neroDy fumlihatl, s � � ' � Bethtubs � Solef Piping , � � ' . � � , '�r LJ CBrtifietl copy Is tlletl with tna city BUIICing Divlilon. � , i � Dishwasher Moto�s �0-1 HP ❑1X�-8, �• � Date • ' � /�Ooqcant ' � Clarifieri ; Sotar Tank � - � � � . � EXEMP710N FROM WORKEHS COMPENSATION DECLARATION ' ' . ' Dryefs' OGas' OElecbit �- '' �p0.S018f� 09-15 HP 01645+ � ' (Tnis sectlon nee0 not ba completeC If tne Oermit is for one �untlratl (E�00) or � �����er � I . Swimming Poal w�Spe , I�ca�rU�Y'that 11n t�e performance o1 the wOrk tOrlwhlth tbls Oerm�t i515suetl I Drinking Pountains Urinal , - , I , Faa . • �Microwave �, �� �' ��� Shdll' nOt 8mploy Lny plriOn IO dny mann8� so as t0 bBtOme suG)eGt IO t�le � - . , � - - - ;, . F.A.U. ' . POIC Li9ht �' `�� ' workers•. Comoensatlon; Laws o� Cali/ornia., ' � � � Floor D�a��s 1 � Water Closet� � - ' • oate • Slgnature � � ' � � � . � Fixtures ' � ' ' Ran e � �d' � 'NOTICE:if, atler Takin9 this tleclaratlon, you ihoultl become subje<t to Me � FI00� Sinks '. � ,.. -_. Water Heater .- .� g � � Workers' Compensation Orovislons.of tha LaEor CoOe,-you must /orthwith - � _ - � • Devi[C Boxes � comp�Y �+�th'sucb�Provislons or"this pe�mit shall De tleemetl revokeG. G25Servi[B Outlets• WaterService� , Sign, �� -�'� CONSTRUCTION'IENDING AGENCV•' _ �' '� I �areby afHrm that t�ere I5 a construclion lentling a9ency�for tha performan<e �� Interceprors I �- - . . OuUets � �Standing SettiOnS �� � o/ tne ,work Tor, whic� this Permit' Is � IsSueU (Sectlon 3097 Civ: C.)� ' � - , Lenaor•s Name T;Tg����ef5�a.[^ ,'.°-��'' . . ; Kitchen'Sink� � • , o ; " � ' Switches � , � ;Trash Compactoc � Lentlar's Atltlresi � ' � , , . - I,.av2tOries � � � ' �� � - ' ' - OWNER BUILOEN OEC 1 . ' . i � , • ' ,- I * _ � .. � i � Gefbeg¢ DiSpOsel . i I hereby aftirm that I am exempt from tha Gontractor's Litanse Law tor tha � p_Tre ' ' Generator DO-5 KW �5-15 KW � /ollow��9 reason (Sactlon 7031:5 9uslness ana Professlonal Cotla: Any Uty or P� • � ' 1 ' - �� countY �'��c� requims a permit to <onstruct, alter, ImDrove, Ecmolisn or repalr ' . . - Transformer � ^� �� - '� any 5<ruttura, prior to Its issuance,�alm requ�res the appli[ant far such permit ROOf D�eins .- • . . . ❑15-50 KW to fliB a signatl statament that ne/sha I5 Ilcense0 punuant to t�e provlslons of � � ❑5U+ KW � • �tha Contractor'S Ucense Law (Chapter 9 (commencing�,wlth Sectlon;7000) ot � - ' � � : "' 1 ' ' ' - ' - - ; , �, � fleindpection Fee � $15 p¢_: �on,3'of Me�Bu5ina55 antl Professl6ns Cotle) or that ha/she;irexempt ' 7 �, $how2�5 •- �� " .�_ ., � Reinspection'Fee� �"$15 . ���,���from antl t�e basls for,the allagetl exemption: Any vlolation-oi Section , �', ��' � � � � ` - Mete� ❑up t0 100 amps i � � ' Izsue Fee ' S 3 ���z5 Ey any apPl{cant tor a permlt suEjects tha aPplican[ to a.civil • ' - , . 1 � � Ity of mt moro tnan nve nuntlrea tlollars (ESoo). �. . . � Service Sink . � laue Fee - � S 3 ����g ApP�oved By pau � I'•as.owner of tne:property or my emp�oyees with wages,a5 their sole ' � ' , • ,7 Q� compensatlon wilLEo the work, antl tha�structure Is no[ IntenEed oi o(feretl ' _ .- �• � MECHANICAL • ' � � qppliedtio0 Approved By � ate for sale.(Sec�lon �7044, Busine5s aritl Pro(ess�onal Gotle: Tha Contractor's , �3 lJcenSe Law tloes not apply to�an;owner of a Proparty�wl�obuiltls or improvei Boile� � � � Refrigeretion Syscem ' � � 7 there0�; antl wholtloaz such work himself/herself or through his or bar own ' : ' Appli�ation Isfued By �� ' �ata emDid eas, provmee [nat such�imorovements are not intantlea or ofteratl for ' Duct- Under Ground �. � ❑G100,DOOBTU �100,OOOBTU - - ; , . � • - sale. IY howeveq the bulltling or Improvement is soltl witbin one year of com- , , . SUMMARV OF FEES . ' pletlop, the owner.will �hava tha burtlen o( proving ha/she tlltl not build or Im- , � j� �oveforthapurposeotsale). � t • Duct-Structural � SystemFepair/Alteration ,BUILDINGPERMIT $ �_ SMIP � � $� '�� �I, as owner of lha proPerty, am exclusively contractin9 wlth Ilun5e0 con- f �(orsto.construct the project.(Settion 7044, Business antl Protessions,GOCe:_ Dutt - Ve�tilaling , � _ I � PLAN CHECK $ �_ � � PERMIT . • The ContractoYs Llcense law does not apply to an ownar ot property who � . ' ISSUANCE, $'� butlC4 or Improves thareon, and who tontrac[s for suth pro7ecti witn a con- 1 Exhaust $Vstem ❑ Multipl0 ❑ . � . PIUMBING $ � tractar(s) Iicense DurSuant lo Ihe Contractor'S License Law). � � . . , � GRA�ING �$ - ❑���am axempt untler Settion r B. & P. C. for this reason � Firepl/Fact. BIt. ICBO'# � � , � PLAN CHECK' $ f � Date Owner � Heating System & Ducting ' ' ' � ELECTRICAL $ $ ' , � `, PLAN CHECK $ ' MICROPILM . $ ' 1'�erCDy -certi(y t I- re reatl4his applicatlon an0 stata ttiat-tne above ;- ❑0.100,OOOBTU-�700,0006 � � , intorr�ation is c ra a ree to comply with all city and�county ortlinances � � �• ��+ : I � TOTAL� FEE $, antl s<ate laws elat �t buii ng constr on, antl hareby authoriza rapre- HOOd Or Typ01 ❑ � ' . '. 4+1ECHANICAL $ � , � - sentat��es o� hls y o r, upon abo e-mentionetl property for �no T e I I ❑ ' � Reinspection Fee� f$15 • LESS . ' : ' Inspect�on p po � � PLAN CHECK' , S qDVANCE6 PC �$! ' Sl9nature � e 'rn� � . . , , Drive�s' Llcensa or,55 � Registers � , Iswe Fee . • 5 3 ' '� FINAL PEE: �$� �/� S/ � CMF 0�65-46 rav. 12l8 W�ife - BuI1Cln9: CanarY' A cant: Pink - Accountin9: Goldenrotl -Asseisor ' - � . . -- . .' . . _. � . . . ' ' - �- - ' '" " ' -' . " " ' - ' - ' ' - ' - -'" -�' ' '- "' "' � _ ' �_ � _ ADP��eant to flll In a1l svaces ezeaot those within �eavy eorGer Iinas an0 sign all aporaD��ata tleclanHons_ � CITY OF COSTA M�' pE IT NO. TRACT NO. ,LOT NO. BLD . COfiiSii�'l C SN PERMIT � - 'f �S� ' . • , . AppliCent'S Meifing d 55 ' T.yPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR �- � PfOj¢Ct Addf2s5 �� ' � � �,�-�� �� ��-7 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER .. � � ' Owner's Nam^en e �U J ry� �oneLL-L_.1� �-�� - OESCRIPTION OF WORK '� � ' . ^y� Addfeu� ��1 C'" 1� . T,VPE OF PERMIT 'GRADING FOUNDATION STRUCTURAL ' � �A. P. qW "`"' AlCh/Eng: � _ � � �� ' LiC2nS2 Na. ❑ TENANT ❑ ELECTRICAL � PLUMBING ❑ �MECHANICAL _P�NG. REF. �h iAddfeu - _ . . , Q;�OTHER " ' � r . � TO BUILDING � '�S �I' PROJECT DESCRIPTIONI SQ.FT. ' OCCUPANCV' 'PR PE V LINE - Contrector's Nam y hon /� , AddfC55lmailing) � 'yn�/_ ��I � ��n - �UU/d CONSTRVGTIONTVPE �� • � VALUATION$- � ' ' LEFTSIDEVARD CicenseNo; ��'[y' � � � ' ZON�' � GRADINGGU.YDS: ACRES � � ?KG.SPACEREQ. LICENSED CONTRACTOH DECLARATION � Remarks: . . s � � � STFiEET WIDTH � I"hereby affirm that I am Iicensea untler provisloni oT Charter 9(commencing � � with sactlon 7000) of Dlvislon 3 of Ihe Buslness antl Profesilons Cotle, anA � � ' � . � , SPECIAL CONDITIONS: my Iicania l5 in full fQfce. n0 efTe<t. -Q � ' , . ucenu r,..' �-'�O /1 � Ltce se No. �' PWMBING � � Date �a���Si9naturo � �� Bar Sink Sewer Cap � � . 1 � WORKERS' COMPENSATION DECLARATI N , - � � - .- . � ereby aifirm that I nave a certlflrate of consent.to self-insure.or a certlfiWte - gatkflow Preventer ' � SeWer Connection' --� � Automatic Washer. Workers' Compensatlon Insurance, or a cerUfletl�copy thareoT (Sactlon � � _a0o, ub. q.J�"/A�'J 39fa3'rn m� �55�Un , Backflow Irrigation ! Solar Collecton . Construction Pole.,. Pollcy No. �! � ����7Company � �� �� � CookingUnit ' 'ECertlfletl-copY.is hereby turnlshetl. � � . ' � Bathtubs � • $ola� Piping ' � — I ' f� Ceriitlelc'q�Y �s f��etl with tha city Bulltling Division., � ��� _� n.�iA � � Dishwasher � ( i msseawn neea no[ ne compieiea n me parmic is ror one nunarea �aiuu� or - less):_ � I certlty that in-the performanca oT the work for which this permk is Issuetl I zhall. not employ any person In any manner so as to become subject. to t�e : Workers'�ComDensatlon•Laws of Californla. , ' � . , Date Si9nature NOTICE:�If,�atter making�this Ceclaratlon, you-shoultl.become�subject to tne - Workers' Compensatlon provislons of the Labor Cotle, you must.forthwith - comply with, such -provislons br this 'Oermlt shall be tlaemetl revoketl� ' CONSTRUCTION.LENDING AGENCV ' - �' ' I hereby atiirm that there is a construttion lentling a9ency for tne pertormance � ot the work for. which�, this' permit is issuetl (Section 3097 Civ. C;; � Lender's' Name- LenGer's� Atltlress : � �-� � ' ' ' OWNER BUILOER DECLARATION� 1 - - � - ( - I hereby attirm that I am'exempt from t1ie.Con[ractor'S Licanse Law for tha followina reason (Saction 7031.S.Business antl Professlonal Cotle: Anv cttv or ' � ��P..��,44��;;.5 by any applicant for-a 1 pei '`�'Ei�fialty of not more than tive �untlred ❑ I, as;owner of the•property oi�i compensdtlon wlll tlo the work, antl for sale:(Sec�lon 7044, Husiness arv License Law tloes not apply to'an owr Ihereon, antl who Ooes such work-,hi Date ' ' - Owner I-hereby certlty that-I-have reai Informatlon Is correct. I agree to antl�state laws r lating to bulltlir seniatives ot;cM�s elty�to ent� inspectlon Dur - s� Slgriahre Orivers' License or �55 � MF 0865-46 rev. 12/82 White - a ppllcant to a civil t ' ! wages�as thelr sole intentletl or offeretl I5 sold within one'year�of com- ! �Ing he/she tlitl no[ bulltl or im- tonba<ting with�licensetl con- ' Business,antl Professions Coile: to an owner of'property who � 'tor such pro�ects with a con- f �Icense Law). � — B. & P. C. f0� this red5on � Canary Pink Clarrfiers Dishwasher � Drinking Fountain:s � Floor D�ainsi Floor Sinks � - � � - ' Gas Service• . �Outlets � ' IntercePtorS Kitchen Sink� t � Lavatories- ' � . , � Roof Drains ' ShOwerS �� ' ' . � ServiceSink' ' , � ne above ��'- - ❑ iances ' repre- � H� v for - Under Ground � -Struttural � - Ventilating _, , � ust System ❑ Mul� d/Fact. BIL IC80 # ng'System & Ductin� • I I Registers � iq; Goltlenrotl - AsseSsor 1 Sotar Tank Swimmina Pool � 1 Water CIOut : �{ Water Heater-- � - � - . - ,WaterSerJice �� � � � ' � � : I . .aJ i ; LP _ . '' I Reinspection;Fee �'$15 . . �'. laue Fee .. ' . . � $ 3 i ❑o-ioo,000eTu ❑ioo,00i System Repair/Alteration t y �e o' . I � i i08T.' ' ' _.__ . -... : . • i , Reinspec[ion Fee Iswa Fee J,! 4 I-an F.A.U. ' Fix[ures i Device Boxes � Dutlets � - :" ' "076A 6/2'I'/`3:;, — " — 3'�;p� Tl ZONE � - BUILDING ' -' � ��ronrvri cT� REAR VARD (TO P/U " RIGHTSIDE VARD , PROVIDED � PARKFEE$ , 1 - t i 'i mecer uover iuuamps � Suh Panel, Sub Pole Motors OO-1 HP O1%-6 � 1 �� InaSolar �9-15 HP 01645+ � �� � ' ' Microwave � . j ! ' ' Pole Light � � � � ' .Range � � � � •Si9n. i i . • � StandinoSections � � . � Swi[ches , ' Trash Compactor � f Garba9e D ispoul � Generator 00�5 KW 05-15 KW ' . . Transformer �75-50KW i � � 05U+ KW. ' `Reinspection Fee $15 Meter ❑up to 100 amps - Issue Fee � � �'$ 3 2oning APProved BY . ' Date � ' , I Applintion Approved By �y '�/j � Date Appliotion laaed By , / J � Date � � �� �� , i � � SUMMARV OF FEES . � . � � �BUILDINGPERMIT $� , SMIP . $ � ,PLAN CHECK ' $� ' � PERMIT � ' � PLUMBING � ? $', vl,�_ . -� ISSUANCE' $ PLAN CHECK� • $, /D — �� GRADING j ' $ � �ELECTRICAL � $ � ' : � $ , �PLAN CHECK $ MICROFILM $ _ � MECHANICAL � $ ' ! � TOTALFEE, � $ t LESS ' � PLAN CHECK $' . � � ADVANCED PC , $ ' i ' : � , FINAL FEE � $ � �3— .. , . � . . : _ . _. �:� �_ - - - - - -- `j,?CONSTRUCTION�AND.PL'ANNING"' -� -: - T' , .:' ��<<;- L,- _PO�� °A. - . ? . - , ; ; �-APPROVALS - Permit;#� �5,7 , ° �Date � Inspector � � � - Date-' I'n;pector,'� � APPROVAL$C Permit # � � � � �Temporary.Electrical Service or_Pole - - - � � � � � ,52: Pool &-Equipmenf Location � - _ � . �Soil �Pipe-Undrgrnd. ^ ! ` ' � ! � 6f �� �+ �53: Steel Reinforcement �. � � . � � � ` � f3: �Electrical Conduit Utilitv-Undrgrnd: � , - �� m %: -54. 'Forins r' �_ ' ' � . _ � � , ' 4: Electiical Conduit-Undrgrnd�. - L � � � ` , ' � x� � , �, �'55.: 6lectrical-Bonding- .. - � '� � . ,�- ' 5: Steel Reinforcement ;'� - • ., �. � _ - ' � -` ,56. Rough Pluinbing:&�Pressure;Test � - - � - � 6. ;Electiical UFER Grnd.� �. ;J: � ;, . � _ �57: APPROVAL'TO:COVER-GUNITE . - 7. Footings � j , - - �� = 58. Electr�ical�Contluit-Undror�d:� �- - ` - - �. 8. Foundation � , ' . � - `-'' �- ' � 59. Gas Pipe; �`Undrgrnd., Test � - � - 9. Water Pipe-Uridrgrnd. � ' � • - . �`60. 8ackwash Lines,-P-Trap, O Undrgrnd. , - ` ` 10.'StructuralFloorSystem ' - _ ' R��' , �.61. APPROVALTO.DECK - - � - � � 11. Property Sewer Line &(House Connection . -. �62. Backwash &�Receptor-Final: - - �. � . � i r _ ` 12.: $ewei CaP ', . � ' � � . "? ' � . � ' �_ � '-63. Heater &-Veht-Final ` � � � � . ` ' - 13. Roof�Drain's , � • } � � - . _64. Plumbing�System.= Final � .. � � 14. 'Rou �h Plumbin ' � . . `. n " - � • . g 9' � �' 65. Electrical-Final � �� P ' F75.''RougK-ElectricaPConduit� � - '� - --.-. - '- ;- � - - - - 66.� Solar SVsiem-Final- - � , - -'-- ` - - ' - - ' '- � , �76� ,Rough-Eleciric Wir;ing� . � .t � ; � � - -- - � �� ,. � � :67: F.encirig & Access Approval� �� -_�-' =- - : -� �_ c j'�17..�Rough_UViririg�Sign�� ry � � � �' a' - � � ' 68. APPROVED FOR PLASTERING � � ' �`78.' �RougFi Electrical'T;Bai Ceiling' , � ' I � �69.� P,OOUSPA SYSTEMS FINAL � - '. 19: �.Rough,Heating &-Air',Conditioning ', _- � � � � FIRE DEPT. REQUIREMENT � ` ' . � �20.' �Rough>Factory Fireplace � �� �� � . ' i � � APPROVALS� � Permit # � � - ,� � , . 21.;Ducts�in Siructuie; ' j' � , � � 70. Undeiground Hydro . � ' " � :22. Ducts, Ven`ilating `_ , � , �� � � i ' �71.' Product Piping � Gas ❑ Oil ' � ' ' � L�'.23. Gas�Pipe-Rough & Test - �., j � ,'� � , � ,72, Underground Flush ' b -24. �Fioof Frariiing'� , , � � ,� , `' - � � � � � � � � . t _ ; 73.i Undergrnd. Storage Tank �Gas ❑ Oil ' 25. Roof Sheathin`g ; � �- �� . - " �74. Overhead Hydro � - ' � � !-26. T,Bar Ceiling (Structura�L &-Monocoat � ! ' �' � � � � J5. Dry Chemical � - - �: � ' _ ��1 � , � 27. �Freme and Flashing' .. � � � � .'' , , • 76: Dry Standpipe � - � � x � 28.'Lathing & Siding , ,, � '� � � � ! 77„ FIXED SYSTEM_FINAL � ' _ 29. � Insulation . �_ ; n , �; ' � '� �, � � � j � �78.� FIRE PREV. FINAL � � f i � � � ° -30.;Drywall Nailing � � "� � }� !! � �Notes: ', , � ' u " ,' � .. -�- -� - - -- - -- � - - 31.;Plaster�Brown Coat I � �� i � ' ► �� ' i' �i i . � , . , ,� . �a , 32. �Elecfrical',Power MeterFinal � � � • � '� � ' � ' � � � , i � ;' - - . � ; - - 33. Final Electric ' � � � �. � 34. Final Heating &;Ai'r Co�ditioning ' � � I i � , . , � � � � 35. Final Gas Pipe=Te"st � ; ' � _ `' ' i � � ' . , '. � � - • � . 36. Hood ;or �,CanoPV_ -. � c � � ' . ; , � , . _ : - . , . - d l t ' i 37. Final Factory Fireplace} i : ` � -' � � � i � _- i ' i ' - , � . i . - � , 9 ; , ; , - � 3/! 1�'/ ��/ � � _ , _ 38. Final Plumbin � , � , � , - ,: i �. 39. Water�Se'rvice-Final � � :.� . � � � � i ' ' .. ' i 40. Gas Service-Final . ; � - '� I ' � . � - � • .., � � 41. Solar pomestio-Final � � �� + I � � � � ' � '� � � � ' � ' � � 1 ' j-' . __ .. �i - - - � : 42. Backflow, P,reventer - , ' � � • ; � ' � � , � -.� ' ' _ ' "" _i ' _ 'I 43. Backflow Irrigatio`n r , _ � ;'�' ` '_ � : j _<'� , ^ � ; . ' � , �: � 44. Landscape Irrigetion'System� ��� � � � ` I . � ' I - � � � i 45. Sound.'Attenuation ` � � I + � �' � � I i � . . . ' � , - '. - . . � 46. Handicap Regulations � � .� � ' � � ' ' ' , . �, � ' ' i 47. FINAL$TR,UCTURE�& BUILDING,, � ` � � i'- � � � ' � ' '� ' ' � � . 48. Special Requirements ComplEted ' ' i ` � , �. ' � � ,. , 49. ElectricRelease'to��Edison' � � � �__i ' _ _� _�._�_ ) � � _ _�_ � , ' ' � , , ' � 50. Gas Release to Southern Califomia Ges Co � � � j � � � ' �, �� � � i � . 51. CERTIFICATE�OF,OCCUPANCY ", ;. : _ _.� _,_ I- 1__. ! ' , No. , i � Date I � - - • � . - � -- - . , . " � . � , I I ADP�icant to till in all ipates exeept those wilhin heavy Dortler Iines anE sign all appro0��ate tleclarations. CITY OF COSTA MESA /j/f �O "] O PERMIT NO. TRACT NO. LOT O. 8LD . CONSTRUCTION PERMIT �'� �� � '- ''� �., :r� /6871-� � ,2 Project Address Applicant's Mailing dress � �w �-y�� / Owner'sName ' hone�[��7/� Address �9�n 'rcuav ���� e� i ArchlEng. License No. Address Contractor's Nam ,,v, _V.h_q!ne �l% Address�ma'i'„�1 �(i ��n•/ (jJ�[�( � W�ZQ��Q. City Licnnse No. O� �L�� LICENSED CONTRACTOR DECLARATION I hereby aTfirm that 1 aT IlcenseU untle� provl5ion5 oi Chdrte/ 9(CommenCln9 with section ]000) ot Divislon 3 of the Buslness antl ProfeSsions Cotle, antl my Iicense is In full f Jce ntl eitect. � �� c_�,c_� � License Class LI sse No. /1�� Date � ` — Slgnature F1�I— R�/L WORKERS' COMPENSATION DECLARA ION � . • qereby atiirm that I have a certificate �of <onsent to salf-insure or a certificate r Workers' Compensation Insurance, or a certifi copy t�eraof (Saction 3800, Lab. Qa1�_ ��/� Policy No. l� �� Company � Certifietl <opy I5 hereDy furnished. Certif'e co y t e0 with the city iltl�in�9( �Dl�vision. �`� n �ate�� Appllwnt �ny[.L�J1.�yY�`� EXEMPTION FROM WORKERS' COMGENSATIO DECLARATION �This section neatl nol be comD�etetl it the permit is tor On! huntlretl (5300) or less) I ce�tify lhat In the pa�(ormdnCe of th¢ work tOr which thi5 p¢�m�t IS ISSuetl, I snall not employ any person in any manner so as to become su0ject [o the Workers' Compensatlon Laws ot Californla. ' . Date ' ' Si9na[ure NOTICE: If,'after making this tleclaratio�, You shoultl become subject to tha Wo�ke�s' COmp¢n5dtlon p�ovi5ion5 of tbe-L2bo� COCe, y0u mu5t fOrthwl[h' comply with such provislons or this , permit shall be aeemetl revokeA. CONSTRVCTION IENDING AGENCV- � I hereby afflrm that there is a construction lentlin9 agency tor the performance oi the work far whiqh/�thhaoermit is�lssuetl (SecNon 3097 CIv..CJ Lentler'S Name �V Y Il% Lentler'S Aatlress � OWNER BUILDER DECLARATION . ' I hereby affirm that I am exempt /rom t�e C6ntractor's Licenza 6nw tor the followina reason /5ection 7031.5 Business antl Protessional Cotle: Anv citv or ' ,<a.retrom ana tne oas�s ror me aue9ea ezempuon, any vioiavon oi SecUon �'Fo`31.5 by any applicant for a' permit Subjects thB applicant [O a Civil �enalty of not more than tive huntlretl tlollars (E500). I, as owner o( the property or rtiy employees wlth wages as their 5ole com0ensation, will tlo the work, antl the sVucture Is not Intentletl or offeretl for sale (Section 7044, Business antl. Professional Cotle: The Contractor's Licenu l.aw tloes not apply to an owner of a property who builtls or improves tM1ereon, an0 who tlocs such work himself/hers¢I( or throug� his o� he� own employees, provitletl that such Improvements are not Intentlotl or oiteretl tor sale. If, however, the builtling or improvement is soltl wlthin ono year ot com- pletion, the owner will have tha burtlen of proving he/she tlitl not bulltl or im- �rove forthe purpose o(sale). 1, as owner of the property, am exclusively contracting wlth Ilcensetl con- tractorsto construct the project (Section �044, Business antl Professions Cotle: The Contractor's License Law does not apPly to an owner ot property who builtls or improves thereon, anE who mntracts for such projects with a con- tractor(s) Iicensa pursuant to che Contractor'S License Law�. ❑ I am exemp[ untler SeCtiOn B. & P. C. 10r this r¢ason Date Owner Signature ( �l Drivers' License or TYPE OF CONSTRUCTION ❑ CONVERSION ❑ DI DESCRIPTION OF WORK TYPE OF PERMIT LJ GRADING ❑ TENANT ❑ ELECTRICAL ❑ �OTHER PROJECT DESCRIPTION SQ.FT._ CONSTRVCTION TVPF VALUATION 5 GRADING CU. VpS. A( 75v o ADD LJ ALTERATION LJ REPAIR I FOUNDATIO�yry7 LJ STRVCTURAL VLVMBING ICFMECHANICAL pemarks: � _ Bar Sink Backtiow Preventer Backflow Irrigation Bath[ubs Clarifiers . Dishwaiher � Drinking Fountains Floor Drains Floor Sinks Gas Service OuHets Interceptors Kitchen Sink ' Lavatories P—Trap Roof Drains Reinspection�Fee $25 Boiler Duct- Under Grountl Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO # Heating System & Ducting Ca0-100,000 BTU �700,000 Oate��� Reinspec[ion Fae $25 CMF 0865-46 rev. 7/83 White - Builtling: Canary - Applitant; Plnk -liccounting; Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collecrors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal VuBLCf CIOSCL Water Heater Water Service I�sue Fee Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System ❑0-.100,OOOBTU ❑100,000 System Repair/Alteration ' Issue Fee FEES 3 3 $ 3 0 A.P. 5W S Main Buildi E T Front B fiear A C Ri9ht K Left S Ping. Ref. � Parking Req./Pn Use Of Building: Planning Notes: Automatic Washer 719'� I 0/ I'' / 2': Accessory Park. ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Cooking Unit ' Meter' �up to 100 amps Dishvrasher Meter �over 100amps Dryers �Gas ❑Electric Fan F,A.U. , Fixtures Device Boxes ODUets Switches Garbage Disposal Generator �0.5 KW �5-15 KW � Sub Panel . Motors 00.1 HP � 1'/: - 8 Inc. Solar �9-15 HP 016-15+ Microwave Pole Light Range Sign Standing Sections Trash Compacior � O N I N G R E Q U I R E E N T I Reinspection Fee �$25I, Issue Fee I $ 3 � PUBLIC SERVICES HEQUIREMENTS: � 2oning Approvad By � Date Appliwtion Approved 8y Date Application Issued,6y Deta �� �� �93 SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT � PLUMBING $ �SSUANCE $ PLAN CHECK $ ENERGV P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK $ MICFOFILM $ � MECHANICAL $ � TOTAL FEE $ � PLAN CHECK $ 10 CONSTRUCTION ANDpLANNING ' , POC SPA APPROVALS� -Permit# Date Ins ector Date Ins ector Y\4�LL4j ' P �APPROVALS Permit# � P �1. Temporary Electrical Service or Pole 52.-Pool & Equipment Location 2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement 3. Electrical Conduit Utili[y-Undrgmd. 54. Forms� ' ' 4. Electrical Conduii-Undrgrnd. ' 55. Electrical Bonding _ 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings � ,' 58.! Elecirical Conduit-Undrgrnd. ' 8. 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-Final � . - 75: Rough Electriral-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 Coriditioning � 8 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. Undergmd. Storage Tank 0 Gas ❑ Oil � 25. Foof.Sheathing . ' ' 74, Overhead Hydro � 26: T-Bar Ceiling (Structurni) & 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. Plascer Brown Coat � . 79. FINAL INSPECTION 32. �Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric � ' Notes: � 34. Final Heating & Air Conditioning ���Q�/ � 35. Final Gas Pipe-Test � ' ' 36. Hood or Canopy � � � . 37. Final Faaoiy Fireplace ' 38. Final Plumbing � � � . " 39. Water Service-Final � 40. Gas Service-Final ' ' • i � , � 41. Solar pomestic-Final � ' ' 42. Backflow Preventer . � . � � 43. Backflow Irrigation � � • � - 44. Landscape Irrigation System . � 45. So�und Attenuation . . � � 46. Handicap Regulations ' 47. FINAL STRUCTURE & BUILDING ` 48. Special Requirements Completed 49. Electric Release to Edison , . � 50. Gas Release to Southern 1California Gas Cn .' • ' � 51. CERTlFICATE OF OCCUPANCY. _. _ _ ' � - No. Date - � , . ��� ADO���ant to fill in all spaces axeept thosa wit�in heavy borEer Iines anG sign all aDProoHate tleclarations. CITY OF GOSTA MESA � � , pERM1T NO. �_� � TRACT NO. � � LOT NO. � BLD . . , �, • . � � � � , CONSTRUCTION PERMIT : -• � � ' ' � ' � ' � 1 !1Rl1 N-_ Ratavi�a �iFN _ flranaa ' ' . SS,]� �,� / �.'_,/ 'i - . . {'j� AppliC0nY5 MailingqAdd[re55 ; TYPE OF CONSTRUCTION NEW ADD ALTERATION � �REPAIR' , ' , ` �,. . � . � ., ;'- , . ' t Pfoj2CtAddre55,.1�U Wingr`3.te � � . �❑ CONVERSION ❑ DEMOLISH ❑�OTHER . .. � . - � OwnefSNeme �M-n `�T�p�S Cn PhOn2- DESCRIPTIONOFWORK meta� fi;r-e}zlasa -.� -� z ING�REGULATI NS" � � �� Addrea -TVPEOFPERMIT GRADING' ' FOUNDATION �STRUCTURAL� _ A.P�� ' . ZONE' � � ' ' , AICh/Eng '' - , - LiC2nuN0. . . .❑TENANT ❑'ELECTRICAL O�PLUMBING,C�MECHANICAL �� ' PLNG.FiEF.51E , I, _ , : , -,BUILDING �� - � ,!'` i � Addf¢55� ' . ' � • . .. � �'���OTHER "= - � � � ' . ^. % r • TO BUILOING' . � ' ' ' _ i. ' � � - ' • ' ' r . � ROPERTY INE' ' : G REAR VARD (TO P/U � � �- � � Contrector'sNam[('CLS-t F1Y'A�La1'P �Phon���1�182.0 � PROJECTDESCRIPTION� Sq,FT.� � � ' OCCUPANCv� _ . . . , . . . , . � Addrewlmailin9�n�n'N�.RA1'aVia�.#N�n7`8Y1gP.� �7 , �CONSTRUCTIONT.VPE � � ' VALUATION$ LEFTSIDEVARD " � RIGHTSIDEVARD I �' ' ' 20Np �' GRADINGGU.VOS. �ACRES PKG.SPACEpEQ. , PqOVIDED � : � � LicenseNo; � ��n�� . .' . ' . . '. ' LICENSED CONTRACTOR DECLARATION � . � . � I Remarks: = I J!O , � , � � - STREET WIDTH ' � ' � -_ PARK FEE_$ ' . � '� ! 1=bereDy,aftirm t�at F. am IicenseC untlar provisions oi Chartei 9(commancing . ' � � � . � � with section 7000) of Divislon 3�, of [he Business antl Professions Cotle, antl � ' � , � "� • � � I , ! SPECIAL CON�ITIONS: �, ' � �� � f flly IICen52%i5I�0 tull f0lc� dOd�¢ffeCt. � ' �, � � � � � � � � . , . LJcanse C15s � � � �,- �(^--/-�y'-�/'�4i en e No.�=����7 ( ' � � r � ; PLUMBING , ' . i ; � ' � J � � ; , � � j C� , � ' ; Date '1�1y�.fj � Siy t -C��.�.� _ ' I ' BarSink . � SewerCap• � � j : � t ELECTRICAL � • "`�ORKERS' COMPENSATION DE AffATION , ' � � �� - - . ereby afnrT that I.hdve.a Certinwta of consent t0 ie f-inzure.or a certlfiwte � ' Automatic Washer ,I__ � 'Meter �over 100 amps workers• Como ry,� ��$yr ry� r a certifletl copy theieot (Section , BaCkflowPreventer ,/ - � � -SewerConnecLon-- � - -- � - - - . ���-<- - - - � -' . --f - - - 3800, Lab. C) ,�Vii'O�V��A . � 1 , � ' { - , � Construcvon,Pole • Su6Panel� � i ' ; Backflow IrrigatiOn '� Solar Collectors � � � Policy No. Compaoy � 8. . � � � �- --� - ' � , . Cooking Unit. � � SubPole � � i ' �Certliietl copy Is hereby furnisnea. � � ' ' ' Bathtubs i �;,o! �. Solar Pipmg � � i t CerUtietl co flleC with the Uty. il . I I f I � � � , i - Dishovasher ,�! � � Motors ❑0-1 HP ❑ 1/ 8 . • ♦ oate_ l Q�� Applican � � � Clarifiers . �'. j � S01ar Tank . � . • � ; 1 ThksectionNneetl oot becompRetatl�i/ the permit I�sNor OnG h u dretl (5100) or � DiShwaihef � ' ' SWimming Pool w/Spa , ' ' Oryers ❑Ges' �EleCtnc-' - InC.Solef �9-,15 HP��16-05+ ��l �� �� � lessl: � � ' ' , ' . . . - . . . ' , � � ' Pan . �? � • Microwave ' . I cartiry that in the vertormance of the work tor which thls perm�t is �Issuetl I� Orinking Fountain5 :`� � Urinal I � � � � shall not employ any person In any manner so as to become subject. to the � �� . F.A.U. � , i 1 i �Pole Light � � � Workers•�Compensation Laws of Cali(ornla. � , ' 1 � Floor Diains ,.>•�, � Water Closet� j 7 .` � ' � Date � - Signature � � � � , . � Fixtures � � �Range„ ' � NOTICE:�It,aiter making this tleclaration, you snoultl become�iub7ect�to tna FloocSinks-;.... 1.. � _ . Wat2r-HeatCr -�. � . - - - - - - - _ - _ ___ __L. .�__. Workers' Compansation provlsions of the Labor Cotle, yoqmust torthwith� � � . ._ : . � � � . � 1 ' ' � 7 comply with 5uch Orovlsions'or th(S.Dermlt,shall be�tleemetl reyokea: ' GasService� •�Ou[lets � WaterService �'�� DeviceBoxes � i Sign• � � CONSTRUCTION LENDING �AGENCV 1 � ' � ' I harBby dffirm Ihdt thGra i5 a conSVuction lentling agency fo� the'perto�mance Interceptors �' � - - , Outlets � � Standing Sections i ' I o/ the �work for wnich- this Dermit is'issuetl (Section 309] Civ. C�; - ' ' , , i Lentler's Name_ � - � - ' � Kitchen Siuk � " � , , - �� ' , Switihes ; Trash Compactor ; � � Lentler'S AtlCY055 ' ' � � � - � • � • � � � ( . 1 ' � �, i : lavatories�, ;.� ' GarbageDisposal � � . OWNER BUILOER DECCARATION � � : � .= . . ' . l ; ` !� � �' - •� i � f � �•' � - ' - I hareby.affirm that I am`exemp[ trom the Contractor'S License L'aw tor the � � � - - Gene�ato� �0-5 KW �545 KW � ' � � ' tollowin9 reason (Section 7031.5 Business antl Protesslonal Cotle: Any city or ?` � P-Trap - - .�� � � county which reauires a oermit to tonstruct, alter Improve' tlemollsh or repatr ,. - Transformer � 75-50 KW ' � ' � any Slrutture' prlor to It5'.issuanc¢, al5o requires t�e.applicxnt.tOr such permib � RoOflDfains ' �' - � � � ' � , � �. � � . i � ' ' to flle a'signetl statament. that he/sha is Ilcensetl pur5uant to the provislons of ' ' , ' " � ' - he Contrattor'S'Licensa Law,(C�apcer 9 (commencing wRh,Section ]000) of , ' � ' ' ' - � ❑5U+KW� I � � �Reinspection Fee i $15' '�-ri5ion,3 of the Bu5ine55 antl Pwfessions Cotle) or that he/5he-is exampt � � Showers � � , ReinSpection�Fee $1$ ', , - , . � , ����refrom �anG tbe' Gasis for the allegetl exemption. Any_ violatiod of Saction � , _' " Mete� ❑up to 700 amps i laua Fee � 5 S. -'31.5 by'any applicant tor a�.permlYsub7ects'the�applicant to a dvil I � 1' " � � � � � $ 3 __. -. - ' � _ . �enalty of not mo�e than fiv¢ huntl�Btl tlolla�s ($500). +" � � : 6� � Service $ink - ; ISSUB F80 ,� � 1 ' I, as owner of the property oi-my employees �with wages as Iheir sole ' ' ' ' � ZOning Approved By Date� � � compensatton wIICGo t�e work, antl the�structure is not intentletl or offeretl . - .- '' ~ 1 � . MECHANICAL ; � i j ', , � � ! Appliotion Approved By � ' Date for sale'(Set�ion 7044, Business antl'Professional Cotle:-The�Contractor's � . . , yn� n,I �� . i Licenu Law Coes not applY to an owner ot a property who builCs or improves ' Boiler� �' - Refrigeration Systerrm qpp�iqtion IsSued By ^�� �v' �� � �ate �� 9�g3 thareon,;antl who;tloes� such work himself/herselt or tnrou9h his or her own . `� `� ' '' � . � employees, provi0etl tbat such improvemenis are mt Intentletl or offeretl for ' ❑0-100,0006TU ❑100,OOOBTU , - ' sale. I(, �owever, t�e builtling or Im rovement is soltl within one ear of com- � Duct- Untler�Ground � � , . , � , � � � o v : � � , � SUMMARV OP FEES ' � i pletlon, [he owner�will have the burGen of proving he/she tlitl not bulltl or im- 1 �, - - - : . I � ' � I erovetorthevurposeof�sale)l � j •�' � �, �� ; Duct-Strucmral . � SystemRepair)AlteFation , - iBUILDINGPERMIT $' � � ' SMIP : I $ � IJ I, as owner oi the property, am exclusively contractlng�with Iicensetl con- ' i ! i tractorsto construct the project, Section 7044, eusiness antl Professions,Cotle:. �, ' Duct - Ventilating �, ___� , _ � __ _ . ' �PLAN CHECK� f $ �� ; PERMIT � � The Contractor's License Law �oes not appry to an owner of proper[y who � . �� . ' - , � � � ISSUANCE �$ bullas or improves thereon, antl who contracts for such projects wlth a con- ; � Exhaust System ❑ Multiple �� � � ' �PLUMBING � $ � � i tractor(5) licensa pursuant to me Con[ractor•5 License Law). , 7 • ' • � 1 � GRADING '$� � � ❑ � am exempt untler Section ' B. & P. C. for this reaion � Fiiepl/Fact.8lt. ICBO � � � � /�. � Q �P�N CHECK , $ : � , � 1 , , $ ' � ' ' ' Heatin �S stem & Ductin � , . ' � ELECTRICAL' $ ' ' � Date � � � Owner' � ' , 9 Y 9 : � � ' ' � � �' MICROFILM I-hereby�certify-that-Phave-reaC tnis-application antl�state tnat�ttie-above � -' �0�100,OOOBTU��100,OOOBT - - . -�•- -� --- � PLANCHECK ; $ ' � � � $ j � Information is correcL 1 agree to compty with all clty antl'county ortllnances , i � . F . ' � � . � ' � 'Z 00 I ' TOTAL�FEE� ;$• ' antl state lawz relating to builtlin constru<iton, antl heretiy authorize repre- . ; . . � IMECHANICAL $ � . sentauves ot tnis Hood or . . . . , , y enter upon the above-mentionea property for ( TYPe � �� Reinspection Fee $15 !pLAN CHECK $ 2. �� �ESS � InspecHon u os - t � � Cano T e II ❑ � � • i , ADVAf�CED PC $� 519nature � . , ' Date��g3 , � � ' . ' r - . . � , , . D i ' L� � � S � _ - �, - � � I Registe�s , I�sue Fee $ 3 � , � � . FINAL PEE � $ � . � ._ .' . ' "'__'' ". _' _' . - _-'. ._. .. ' ",....'_._' __"' ___ _'_ _' _ "_ ' " "'- ' _ :MF 0865-46 rev. 12/82 Wbite - Bulltling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor � - � � � - � ' - -- � ��'- � �� � '�,CONSTRUCTION�AND;PL'ANNING' = ' ���>` �' - �= � � , �� - - _��� 'PA' _ '` - r' :�Date Inspector -- ' - - � Date Inspector =APPROVALS Perinit�#- ' - APP.ROVALS" Permit #� . .. � • V .0 _ . . .� � . ��1. Temporary�Electrical Service or�Pole i ^ � ' ; ' o�� � ��52' Pool &:Eguipment Locaiion �' ' . - -- •- 2. 'Soil Pipe-Undrgmd. ,.� ' � � _ » - � ;' � � � - ' � � . � .53{ Steel Reinforcement � , , � . - 3. Electrical Conduit UtilitwUndrgrndJ � > - `�= ' _� . � -54. Forms � - � - �` ..� . : 4. Elecirical Conduit-Undrgrnd: , . � � : - !" '� - _ $5: Electrica6Boniiing "�- ' - - - �; � . � 5: Steel'Reinforcement � � I � � t .''; � � � °� -.56. Rougfi Plumbing &�Pressure Test ' . 6: �Electrical UFER �Grnd: : i. `.' r i'' - 57_' APPROVAL TO COVER-GUNITE � 7. Footings � , ? , � ; -- . _ � ^„ � ..58� Electrical�Cpnduit-Undramrl. ' - - 8. Foundation � � � .' - � • ' . - -: � - ' _ '-_:� ;' ' i � � � `59. Gas Pipe, O �Uridrgrnd ; Test' , 9. Watei Pipe-Undrgrnd. t � ' � . ' � � - . 60, Backwasti �Lines, P-Trap,�� �Undrgrnd. , ., ,.. - . r . , n �. � - � - . 10. Structural Floor System ' t : : � � � �61. .APPROVALTO�DECK =� . 11. Property Sewer Line &;House�Connection � ` i-62. Backwash & Receptor-Final = �� 12. Sewer Cap � � � " � ' . �5• ��63. Heater &�Vent-Final , ' �' . � � 13. .Roof�Drains � �! ' ! '. i � - 64. Plumbing SYstem - FinaP '� - � 14. Rough Plumbing� � � � � � � � � � ' `- ' i65. Electrical-Final' � • � �� � � �15. Rough Electrical=Conduit"'-"` '�� � - � � j-�"�:' " " -j � 66. Solar'System-Final ' �--' �- - -' � - �- � _16: Rough-Electric Wiring� I - { ' - �_' _.�'- � _ � � �67. �Fencing & Access. Appioval . ' - - . - ' 17. Rough Wiring Sign�_ �-� �� 4� �`� y' � - 68: APPROVED FOR PLASTERING � • ` 16. Rough_Electrical;T-BarCeiling � ' i � � _' t � - iC � ;69! POOUSPASYSTEMSF.INAL' � � , 19. RougFi,Hea'ting &•Air Conditioning • � � F�RE DEPT. REQUIREMENT � 20. Rough-Factory Fireplace � � ` � ��, APPROVALS Permit.# ' - . � - 21: Ducts,�in Structure; � � ' '� " } � j � 70. Underground Hydro ' � ' � � , �� r � 22. Ducts, Ventilating ; i ; � � � ' - 71 � Product Piping O Gas OOiI � 23. Gas�Pipe-Rough & Test � � �' � , � ' ^ � '72. Underground Flush ," � �24. � Roof F�aming'. � I � � � �' ;�� � �' ; - , r i � �73. Undergrnd. Storage Tank �� Gas �, Oil � • 25. Roof�Sheathing ' ` � - � �.� , %_ ;i - ' � = i. '` � _ i �74. Overhead Hydro . � ., -26. T-6ar Ceiling IStructural�i & Monocoaf : �. 75. Dry Chemical ; - -� : i y , , � � �27. Frame and�Flashing� : : � + t �, � � �' , � , 76. Dry Standpipe . 28. � Lathing & Siding, . � I; � �� r � � � �. ' �77. FIXED SYSTEM FINAI ,� � 29._ Insulation � - - ' � �� I � � � � • � ,78. FIRE PREV. FINAL ' � 30. Drywall Nailing ; ''� � y: 1; � ' � � � Notes: . , ,_ . , �� -� - - ---- --- - ._ . .. _ � . _.._ . . . . , 31. PlasYer�Brown Coat� . � ; �j , � , � � � � �32. Electrical�Power Meter-Final � j_ � i � � ' � � � � - � - � i� • . � • 33. Final Electric '� 1 ' �� � � 34. Final Heating�& Air 6onditioning ; ' . ; � ' ' , - � i . , 35. Final Gas Pipe-Tesf ' , � , ';� � � ; : i � , : -' , � . :�; , � � 36. Hood or'CarioPY'�'.� •; � . y, _ ` i : : � � . . , , . . . _ {. �� 37. Final Factor�y�Fireplace�, � �'! . -. iyj,� ,y� � - � � - . 38. Final Plumbing, ; ' � � ?i ' '' , ' ; . . � - � 39. Water,Service-Final � � - � � � �� ` ^ � ' P , 40. Gas Service-Final ' . i ' � ' � . � , � 41. Solar pomestioFinal � . � 4 � ' _ _ _ _ _�._ �. . .__ _ � � ' - , . � 42. Backflow Preventer - , . i �,� i i ' ; � ' . , � � .-,:- �--- - - �- 43. Backflow Irrigation � . . .� � ' ' - , ' � 44. Landscape IrrigetionSy,stem i � ; : � - � � , , . . .. . vi � . . , , � . . - • � 45. Sound -Attenuation 1 � m � , � i . � . , • , � r �, i i - � 46. Handicap Regulations � ," i � . � . _ - � , . - � - 47. FINAL STRUCTURE & BUI�LD�NG ., � � ' , . , ' 46. Special Requirements Completed ' � � � � � i ! ; , � - . 49. Electric Release to �Edison � � ., � _ )_ � _ ' � _. _ . ' � _ ' + . _ . � � � , � � i � � - - 50. Gas Release to Southern Califorriia Gas Co � � � � � ' ' ' � � : 51. CERTIFICATE OF OCCUPANCY �; ! _.'_ _ ' ' , -_ - . _ _ . • No. ' � Date ' � . � , � J.. J- AVP�ieant to fill in all spaces except [hose within heavy DorGer lines antl sign all appropriate tleclarations. CITY OF COSTA MESA - -..�.,..,_ .,,. _ . . . ro,,,,r .,,,_ . , „r ,,,, o, „ _ CONSTRUCT,ION PERMIT .; Pr0lect Address _ t � Applicant's Mailing Address Owner's Name ��� J��� Pho e - Address Arch/Eng. License No. � Address Contractor's Nam Address (ma'�'�g) � ,c � CISY LICBnca N[� 1� U ' LICENSE� CONTRACTOR DECLARATION I hereby affirm that I am licensetl untler provislons oi'Charter 9(commencin9 with secllon 7000) ot Dlvision 3 of the Business antl Professions Code, antl my license is in tull ce antl f ct. � Licens Cla 5 �' Licen Date �' Signature WORKERS' COMPENSATION DECLARATION hereby atfirm that I nave a certlftcate of consent to selhinsure or a c tificate .f Workers' Compenssj�on Insurance, or a� certitlep Copy thereo Ction�+ 3800, Lab. C�.1/_( �C''�-1�� �} PolicY No. �lllL?)w ComPany'C��' Cer' ietl copyY �iys hereCy fumishe�� Datee_,LIf �_. =�P��WAPPI canty uiTY'n Division. EXEMPTION FROM WORKERS' COMVENSATION DECLARATION � (This section nee0 not be completetl if the permit is tor one huntlretl ( ) or ' Iess). ' ` I cerfity that in Me pertormance of th¢ work fOr whlCh this pe�m�t is�i55uetl, I shall not employ any person in any manner so as to become subject co the Work¢rs' ComOensatlon Laws of California. ' ' Date Signature ' � - NOTICE: It, aRer making this tleclaration, you shoultl become subject to the Workers' Compensation provisions ot che Labor Cotle, you must forthwith• comply with such provisions,or-this permit shall be tleemetl revoketl. CONSTRUCTION LEN�ING AGENCY' ' ' I hereby afiirm that there is a mnstruction lentlin9 agency for the performance of Me work tor which .IhiS, permit is ISSuetl (Se<Hon 309� Civ. C.J�. Lentler's Namn Lentler's Atldress � OWNER BUILUER DECLARATION I her¢by affi�m t�at I am exempt trom the Contractor'S License L.aw fo� the tollowing reason (Settlon 7031.5 Business antl Professional Cotle: Any city or county whlch requires a permi[ to construct, altei, improve, aemolish or repair any structure, prlor to Its issuance, also requires Ihe applicant tor such permit to Tile a signetl stalementtthat he/she is licensetl-pursuant to the provisions ot �he Contractor's Licenze Law (Chapter 9(commencing wi[b Sectlon 7000) of 'vision 3 of the Bu5ine55 antl Pro(e55ions Cotle) o� that he/she is exempt ere�rom anC the basis tor the alleqetl exemption. Any�violation ot Section J3L5 by any apP�icant to� a pe�mlt subjects tne �appllcant to a' civil ��enalty of not more Ihan tive huntlretl tlollars ($500). � LJ I, as owner of the pmperty or my employees with wages as their sole � tompensation, will tlo the work, antl the sbucture is not intentletl or offeretl for sale (Section ']044, Business antl Professional Cotle: The Contractor's License Law tloes not apply to an owner ot a property who builtls or improves - thereon, antl who doe5 Such work him5elf/h¢rselt o� th�ough his or h¢r own � emploYees, provitletl that such imp�ovements are not intentletl o� otfe�etl to� sale. If, however, tbe bulltling or improvement Is soltl withln one year of com- pletion, the owner will �have Ihe burtlen ot proving he/she tlitl not builtl or im- �rove tor tne purpose of sale). � ' LJ I, as owner of the property, am exclusively contracting with licensed con- tractors to conztruct the project (Section 7044, Business antl Professions Cotle: The Contractor•s License Law does not apply to an owner ot property who builtls or improves thereon, antl who contracts for such projects with a con- tractor(s)license pursuant to the Contractor's License Law). ❑ I am�exempl unAer Section B. & P. C. for this reason Date � Owner I h¢r¢by cerfity that 1 have reatl this apl information-is correct. I agree to comply a antl state laws relatin9 <o builtling mnstru sentatives s city to-enter 1 inspectlon u pos S�gnature Drivers' License or 55 � �CMF 0865-46 rev. 7/83 - White�- Builtlinq; TVPE OF CONSTRUCTION XJ NEW LJ ADD Ll ALTERATION� �LJ REPAIR � ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.p.�(6 , DESCRIPTION OF WORK � � � - S Main Bu TVPE OF PERMIT GRADING. FOUNDATION ❑'STRUCTURAL . . T Front O TENANT ELECTRICAL ❑ PLUMBING ❑�MECHANICAL B Reat ❑ �OTHER � . . A PROJECT DESCRIPTION 5Q. FT. �oCCUPANCv C Right K Left CONSTRVCTION TVPE VALUATION $ $ ZONE GRAD�NG CU. VDS. ACRES p�ng. Ref. # Remarkx . Pafking Req. Bar Sink . ' Backflow Preventer Backflow Irrigation e�ath[ubs ' � Clarifiers Dishrvasher ' ' Drinking Fountains � Floor Drains� � Floor Sinks � � Gas Service Outlets Interceptors Kitchen Sink Lavarories ' . P—Trap Roof Drains . � Reinspaction Fae � $25 Duc[ - Under Ground � Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact.6lt. ICBO # Heating System & Ducting ❑ai oo,000 eTu 0 i oo,000 . I � I Reinspection Fee Pink - Accountin9; Goltlenrotl - A55eS5or . d $25 Showeri Servite Sink Sewer Cap Sewer Connection Solar Collectors � Solar Piping - Solar Tank ' Swimming Pool w/Spa Urinal , Water Closet � Water Heater Water Service Isue Fee Hood or Type l' �' Canopy Type I I� 0� Refrigeration System � � ❑0�100,000 BTU ❑100,000 Bi System Repair/Alteretion . laue Fee FEES $ 3 $ 3 Use of Building: Planning Notes: 0 Automatic Washer � Construction Pole Sub. Cooking Unit Dishwasher � � Dryers ❑Gas ❑Elec' Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Dispoul Generator 065 KW C 3`�l 1 I /[l�/R� . 'r �, -1 Zone . " Accessory Building: Z O � N I G � R E Park.Fees $ � � ' ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW 15 KW PUBLIC SERVICES REOUIREMENTS: Zoning Approved By Application Approved By � Aooliption Issued Bv BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL � PLAN CHECK Meter L�lup to 100 amps � Meter �over100amps Sub Panel Motors�0.1 HP �1'/:-8 Inc.Solar.�9-15 HP �16-75+ Microwave � Pole Light Range � Standing Sections Trash Compactor luue Fee. SUMMARYOF $ $ $ $ � $ g %7r�� $ $ R E M E $ 3 SMIP $ PERMIT � � ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ TOTALFEE $ .SS.at� "• CONSTRUCTION AND PLANNING � POG SPA - APPROVA�S Permit#' ��U'1� Date Inspector �'AppROVALS Permit# Date laspector� �� -1. Temporary Electrical Service or Pole . 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcemeni _ - :31 Electrical Conduit Utility-Undrgrnd. 54. Forms � - , '_4. Electrical Conduit-Undrgrnd. - , , 55. Electrical Bonding :-5: Steel Reinforcement � ' � ' 56. Rough Plumbing & Pressure Test � '`6: Electrical,UFERCrnd. � � � 57. APPROVALTOCOVER-GUNITE 7,' Footings _ - ' � � . 58. Electrical Conduit-Undrgrnd. �' 8: Foundation . . , � . 59. Gas Pipe, O Undrgmd., Test 9. Water Pipe-Undrgrnd. � . 60. Backwash Lines, P-Trap,�O Undrgrnd. 10. Structural Floor System . � 61. APPROVAL TO DECK 11. Property $ewer Line & HouseConnection , 62. Backwash &�Receptor-Final 12) Sewer Cap ' ' � _ 63.� Heater & Vent-Final � 13.. Roof Drains - . , 64.-Plumbing System - Final � �- 74, Rough Plumbing � - - 65. Electrical-Final - . � � 15. Rough Electrical�Conduit � - ' , 66. Solar System-final 16: �Rough Electric Wiring . ' f I �1i $3 � C� 67. Fencing & Access Approval 17. Rough Wiring Sign �- 68..APPROVED FOR PLASTERING' 18. RoughElectrical-TBarCeiling . 69.�POOL/SPASYSTEMS�FINAL 19. ,Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � 20. flough Factory Fireplace APPROVALS Permit # 27. �Ducts, in Siructure � .� ' . 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 Chemicai 27. Frame anq 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 MeterFinal , i 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. ,Landscape Irripation System , ' I 45. Sound Attenuation � � 46. Handicap Regulations � , 47. FINAL�S7RUCTURE & BUILDING '!` ' � � � � 48. Special�RequirementsCompleted � � ' ' . -' � , . . . 49. Electric Release to Edison • � - - ,- - - � �; �- - ' i 50. Gas �Release to Southern �California�Gas Co ' . � � � � � � � . i 57. CERTIFICATE OF.00CUPANCY � ' _ " " - j " � . , ..r.;� .'; ' . . - . - No. - . �Date '- �� ` � � . � . ' � - .