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750 WINGATE BAY - Building Permits
APD���ant to Till in all spaeas exeepl thosa wit�ln heavy bortler Ilnas antl sign all aDP�ooriaLa Ceclarotions. � � CITY OF'COSTA MESA•, � , ' � � � � � _ . � pER IT NO. ' ' TRACT NO. LOT NO. BL . , ^ , � ' � � � ' � � . �, �� • CONSTRUCTIONPERMIT �- � ' ' . �eZ , • �� , ?,��� - • . . ' � •- ' � Applicent'SMeilingAddf855 - �' � ' � iVPEOFCONSTRUCTION � NEW ADD � �ALTERATION' REPAIR- ^ . , . ' �7OQ ' 6��I ��3 ' '���`G.SI , TL Project Address p �_ ' O CONVERSION '-❑ DEMOLISH OT �R�' y� � • ' ' . � _ • - - , ' � . , I�L T � - I1 '^ DESCRIPTION'OFWORK �������ry,�.���`�nIIT_ •{ I � Owne� i Name / 'I hon . - . � � .y I G REGU� A�/� I AddrB55� �VlD `� � s�' • _,NpEOFPERMIT �, �GRADING. FOUNOATION :STRUCTURAL , , A.P.qY�' I �� -J �I � ZONE (�yLi ' ' �, • � � � � � AfCh/Eng.'� + }�' ^�• LiCen , �.� � ' ❑ TENANT �❑'ELECTRICAL ❑ PLVMBING ❑ MECHANICAL - . PLNG. REF � ��j- � I� BUILDINO� � i '' • Addf855 r � " ' ' ,O,�OTHER . � ' ' ' ' . � i � � �' � ,TO BUILDING� 1 ' .� • � q YARD (TO P/l) � � ' � ' �J'�`�ij : PRQIECT DESCRIPTION 5�. F ' , occuan�l v� E V W E I� . CAMfettof'sNem � I �� ' hane , .�) � . . LEFTSIDE VARD RI TSIDE VARD. � , CON STRU TIp7 �N TVP AL.U'/A�,TION $� MZ ' .AddfeSSlmeiline) i . � � � �ZONE �r"� GRADINGCU.VDS.�IL�;ACRES�r PKG.SPACEREQ. ,' PROVIDED License No. � 'I' � LICENSED CONTHACTOR DECWRATION � ' ' � Ramarks: , - • � ' � ti , I � � -. STREET WIDTH . �. �PqqK FEE,$, � � 1 hereby'a}tirm thdt 1 am Iicensatl untler O�oviitons of �Charte�,9 (commencing '- ' ._ . - � . ' with 5ection 7000) af Divislon 3 Of t�e Busineis anC Professlons Co08, an0 � � I � � '- ' , ' � SPECIAI CONDIT ' � ' �- ' ' my Ilcenu Is In full torce antl�efPoct. , � i ' � � ' � ' � ' . C:I.SAL �ir,(! �j(�lf:.:i� / � ! ' ' ' ' � Llcansa Class � � �icense No.' � f ' � ' ' PLUMBING . . i i ' � . � � Date � � � � ~ 9gnatwa ' ` � i .,. ; ' � Bar Sink I • , ' Sewer Cap- � � . , � � ELECTRICAL � • � WORKERS' COMPENSATION DECLARATtON � . • J � ' .- - - I I _ ' naby alflrm that,l,hava a Certlficate,of Con58nt tD Self;insufe oI a tertlflCate .. ,.' ' 1 ' ' „�. AutometiC Wa5h2r ' , � . �Metef over 10U amps � � . Workers' Compensatlon Insurance„ or a certltietl coOY thereof (Sactlon . BaCkflOw Prevente� . ' - - - Sew2/ COnn¢ctiOn � - . - - - ... . . - , _ . _ .. _ . . ' Construction Pole ' ' Sub Pane6 � ` - ' � ' _..00, Ldb. C.) � �, � � i � � � , Baikflow Irrigation � � Solar Collectors � , ' � i � ' �r '� ' ICY No. ComPanY ' ' ' , " . _ _ _ '. . � . , • _ ... ! j � , Cooking Unit ! ! �Sub Pole � � � �CertHletl copy Is hereby furnlshe0. • � ! t 1 I , Bethtubs $pla� Piping � � � Y � . . ' a-' CertitieC copy is filetl with tne city Builtling Division. � ! l � { �_ Dishwasher ; �Motors O04 HP O 1� 8"`� ^ : Oate � � ' AOPliwnt � ' � • � � Clerifiers SotarTank _ �' � � ' . . -EXEMPTIONjFROMWORKERS'COMPENSATION�ECLARATION � � . -- Dryers-OGas+'OElectfiC - ""�nc.SOlar'O9•15HP�O16-15+ - (Thissactlon neatl not be cOmpletetl If the Permit 15 for�ane �untlr80 (5300) or � � DishwaShEf ' � � SWimming Poal wlSpe � 1 � less). � I I � ' ' i � : i . . , , . Fan � . • 1 .Microwave -I " ' � 1 cartHy �that in the parTormanca ot the work Tor which this perm�t is Issuetl I� � Drinking Fountains . Urinal ; ;. , � . . �'r snal6 nat employ any person in any man�er so as to become subject. to tRe ' , � . � �� F.A.U. ' � Pole Light ' � i�' � ' ', Workers" Compen5atlon�Laws of Californla.� � , I � � . � Floor Diains � � • Water Closetj � � � "' �'- � Oate � � • Signature � ' ' � � ' � : , . ' ' � ,+� . ' '. NOT.ICE:�If,after making this tletlarailon� You slioum becomesub)ect to-the�.: ..,. F.loor Sinks.} -__ •._ ._ ....._Water.Heater� ._.�. '. �_ _� f�xtures i _ , � Range� � i_ � �� 1 ' Wdikers' Compensatlon' proJl5ion5 of thB Labo� Cotle, yau must forthwitlt • ' ' ' ' ' - comply ;wlth 5uth'OroviilOns;�or�tltl5;permit �5ha11 be �tleemed fe4oketl: ! � Ge5S8fViCB� i i0utlets� 'Wete�ServlC2 �� � ' f Device8oxes � � � � Sign; , ' � ,/, � ' � � � � CONSTRUCTION �LENOING 'AGENCV � ' �-" - ` ' ' � - ' ' � � , • � ._. . I nareby ai(irm that there is a'const.uctlon lentling agency tor the periormance, (. Interceptors' � -,� ,� -� I �' � ' Outlets � � ! StanAing Sections � � ,� / of tM1e work tor� wpi ' t Is. pe i It ' ss ed (5 tt n 3087� CW. CJ :- . , � • , �J Lnnaer's• Nama= � ' � T � Kitchen Sink � ' � . �. 1 . V , Switches : �Trash Compxtor � � ' � Lentler'i Aaare« � ° � !,� Il' s ' I I ` . ' � . ' � - Garba e Dis oml - � � ' � � OWNER BUILDER DECLARATIO � " � r CsVetafiei. � , , . , 9 P � I hereby;affirm that I a'm exemOt from tPe �Contractor's' License L'aw Tor the� , p_Tra � � - Generator. OO-5 KW 05-15 KW � i ' � �� following reason_(Sectlon 7031.5 Busine55 antl ProfeSsionaLCOAe: Any clty or P - ' - ; Y; ^ I � county whl<h raquires a permit to construct, alter improve; tlemolish'or repalr ' �' - - � , �' f � . � T�ansforrtier ❑75-50 KW � i • ' ' any structure, prior to Its issuance, also re9uires t�e appllcanYtor su<h permit . RoOf D�2in5 , r � � � � to tile a signetl statement-that he/she Is Ilcensetl pursuant to thelprovlsions of � ���' '" �" � ❑5U+ KW' � � ' tha Contractor's.License law�(Chapter 9 (GommenGng wl[h'Settlon 7000) of ' 1 . � � . ' ` ' f • - �. � � ! ' ReinSpeCtion Fee , $15 . � �- '�lon }3 'of t�e Busine55- antl; Protesslo�s Cotle)-or' [haY� he/she:Is'exempt ' ShOwefS ; I +,� _ � . . Reinspection�Fee • $15 ' ' : ', trom•antl the basis for the alle9etl e%emptlon. My: violatlonloil5ectlon ' � � , � '' -' Me[¢r ❑up to 100 amps � � �Issue Fee � '$ 3 i, 5 by� dny dDPlicant fo� a.pe�mlY'S�bj¢Ct5'the.dppllcant t0 d civil � Serv�ceSink �,� � � � � -' -- ��alty ot not more than fiva huntlretl tlollars (E500): � ' � � � , ' � � � laue Fee � � � $ 3 � � � ,. - � � , 2oning APProved BY ' � Date '� I,`asiowner ot the�pro0erty or.'my 9mployae5'with wagez az [heir sole � _ - . � .i , ' � � , mmpensatlon wIIPEo the work, antl t�e btructure is not intentletl or otferetl ; ' ,� � � �`" MECHANICAC � � � ' qppji�tion Approved By � " �Date � 8 i . for ule (SecEion 7044', Business, antl Professional Gotle:' The, Con[ractor'S i , , � - i License Law tloes mt aDPly to'an owner o� a property who builtlz or improves ' ' Refri eration S stem ' ' ' � � /� ' � thereon, �anC who Goes such work himself/herseli or throu9h his or her own Bo�ler ' �� 9 ,� � Appliretion I�ued By � � 7 Date '¢mploy ee5, p�ovltletl that such'Imp�OVGme�ts a�e�not Intentletl o� otfereA 10r � ' DucC- Under Ground : : ❑0.100,OOOBTU ❑100,��B7U � , � �� Sale. II, nowevaq tne bulltlin9 or Improvement is sola wlthln one'yearbt com- � , , � , _ � � � ' SUMMARV OF FEES ' � D�Btlon, tM1e owner�will have tha burtlen o( P�ovin9 he/sh¢ tlitl not builtl or im- , . � • � , i • O �r vaforthepurposeofsale)�. � � � . � , � ; � � j DuCt-Strutturel . • I SystemRepair/Alteration ' =� BUILDINGPERMIT $, -3�� � � SMIP , � • $' I, as owna� of the property, ain exclu5��ely contracting with'Iicanzetl con- - � �,` , � ; , tractorsto constru<t the'project (Section 7044, Business antl Protessionz Coda: i Duct _ Ventilating `,_ � � ' 1 � � � ',� IPLAN CHECK ' $, ��' / � PERMIT � � � . � The Contractor's'License Law doe5 not 2POly to an ownet of O�operty-who'�' � . . . . . - _ � ' � ' 1 ISSUANCE � ; $ � ! � i bulltls or improves thereon, antl wno contracts for such pro�ects with a con- { ExhaustSystem O Multiple �j � � ; F � IPLUMBING I � $, ! � � � � . tractor(s) Ilcense pursuant to the Contractor's Li<ense Law): , � � � � . , , ( � � � - ' � � - tPLAN CHECK� $ � � ; GRADING $ � � � I am axempt untler Sectlon � � B. & P. C. Por this reaion � Fif¢pl/FaCt. BIt. ICBO # � � �.� � , � ' �$. - � • l ' �. � � ' ' �ELECTRICAL • $. � . : � � , , � , Date ' Owner • � � ' ' ' � ! � � Heating�System & Duc2ing : - � { . ' ' � ' I PLANCHECK� , i ' MICROFILM 1$� 1 hereby certiT .tha ava.reatl Ihls-aOPlication.antl itate that the•abova-� ❑4100,OOOBTU��700,0008T!. - -__I. _•._ �-� �, , � $. , � intormation iz orre 1 a ree to comply th all city-antl county ortlinances . � . � , � : ' � TOTAL FEEi ,$' antl�state iaw reia g.t buil in9 const �on,+antl hereEy authorize repro Hood or � ! • � � ,MECHNNICAL $ � � , � . sentatives of his ty� o ' er. upo e abo e-mentionetl properiy tor . TYPe � � i � � Reinspec[ion Fee � -$15 �pLAN CHECK� � $� � LESS f ' , insoection po � • • Cano . T e II ❑� � ' • � • . . ' � t ! 9gnature a • -% � � ' � � ; , , � � • ADVANCED,PC � $ �, � � Drlvers' L u or�55 Fe9�sters ' � j ' ' Izsue Fee , � � ! � � � � ��/ i � - �$ 3 � FINAL FEE' �$; . . _.:.. . . . : . , ,'. _._ ..._ , _.�. . CMF0865-46rev.12%8 �Whita-BUIItlIn9:Canary-A canf;Plnk-Accounting;GOltlenioC-Assessor - ' �- '� ���� � ���-�� ' '-'" "-- - "' � • � "'-^ - '—� - ��� noo�to�e eo +ui io ,n :w�e: e.�oo< CITY OF COSTA MESA, , CONSTRUCTION PERMIT ana sign all aoorooriata ' �I�_�' �I .�.�� 'Applican'Ys Mailing Addrea � v� � � TYPE OF CONSTRUCTION , 1�9. rvew' LJ .aoD ALLJ 7enn7�ot�l' RLJ EPai q Projec[Addtess 11�n I/� Q �7 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' ",1e, `- ' - hone.�(� 3 / DESCRIPTIONOFWORK Owner'S,Name ' � � . � Address W �ry ' ' � - . . TVPEOFPERMIT GRADING FOUNDATION STRUGTURAL i Arch/Eng. � Liceni@ No. ❑ TENANT ❑ EIECTRICAL � PLVMBING ❑ MECHANICAL , � Addf2ss � ❑;�OTHER � ' ' �• Contrxtor's Nam� / hon /] p ' �� I PROJECT DESCHIPTION 5�. P7. ocCUPANCv AddfeA�meiling) ��� �� �/, �n -/��06� CONSTRUCTIONTVPF - Vi1LUAT10N$ ' � LicBnseNo. i. (J O � � ZON$ GRAOINGCU.VDS. •ACRES � LICENSED CONTRACTOR DECIARATION ' � ' Remarks: _ � S � . • - I hereby affirm (hat 1 am Ilcense0 un0er provislons oi Charter 9(commencing , , with sacllon 7000) o/ Divlslon 3 ot the Business antl ProteSslonS Cotle, anE . ' ' • my Ilcense is In full tor< anC efTect. ' -�j - License Ctass ' ' �a �'�n n - �Lpic�e�nse o:,�y�7�) � � . PLUMBING �. � . YOR RS/COMPENSA'TION DEC � RA 10'N�.�' � `— � Bar Sink _SeNRr C2p � laraby'aHirm tnatl nave a certlflwte oi.<on58nt to Self-Insure ar a.certlilwte ' gackflow Preventer '' . Sewer Connection' - - / Workers' Companutlon Insurance, or a certifletl topY thereof (Sectlon• � 3800, Lab. C. • - • Backflow Irrigation � Soler Collecron aou�v No. J�'1/,/.L." �(o3�/�comaa�v�i;551�d(1 _ .. . _ �CertifleC copy is hereby turnishetl. 'n � � � ' � + � ' Bethtubs � ' - $olar Piping � y Certifietl copy.75 tllatl with t�e city YI1CIng pIv151p n� p � 6ate (,��l.Fi:e9 n6o�icant ! 1 /YI.LI.'�. G/11/11D./'X:�-1�' . _ Clarifiers - ' Solar7ank'-- ' ' EXEMPTION FROM WORKERS' COM EN$ATION OECLARA� Di5hw2sh2r ' $Wimmin POOI w/Spa -f Iss�isec'lon neetlmot be comD�e[etl It the permit is fonone huntlretl (S1�f0)� or� _ 9 o.0 1 certlfy that In`the pertormance of t�e work for wnich thii perm�t ii issuetl I � Drinking FOunt3in5 1 . U/inal � � , snall:noY employ any person in any manner so �as to becoma subject. to t�e f , -' . . , Woikers'' Compensdtlon Laws oT Call/ornla.j • , /� Floor Drains' � Water CIo52N Date- ' Signature � � ' ' NOTICE: If, after making thls;Ceclaratlon, you�shoWq'�e<ome subject to the . , Floo� SinkS . --� , Wat¢r�HEete� -- ��- ' Workers' Compensatlon provislons of the Labor Cotle, you must fort�wit� . _ ' -' comply wilh. suth -0�ovisions � or t�is � Dermit shall be tleemeB�, ravoketl: � Gas Service• ��. �Outlets Wacer Service .� - - CONSTRUCTION%LENDING AGENCV � • � ' 1 hereby afflrm t�at t�era is a,conitructlon IenGin9 aqency for the performance � Int¢rc¢pto�s � ' � - � oi the work 1or whlctr this. permit .Is Issuetl (Sectlon 3097. CIv: CJ � � l.enCer•z riame . _ _ KitchenSink; " - . lenOer's Aatlresz �. • . � -� . � � . - ' � OWNER BUILDER OECLA0.ATION � , - - .: j � � _ CavatOri25 � - � - - � � ,� �, I hereby'at/irm ShSt 1 am enerimpt from tha�Contractor's-License law tar tha __.. . .. I. d5 ane roverortne puroose I. as owner ot the Data nce, also requlres the applicant for such parmit R he/she Is Ilcensetl pursuant to the provisions of hapte� 9(commencing with Section 7000) of - �, Professlons Cotle)'or that' he/she Is exemdt S e allagoC exemption.-Any.violation�of�5action .a permlt subjects tne _applicant to; a. clvil ' untlrca tlouars (55oo). j- - � � S ty or my employees with wa9e5'a5 thei� sole . k, antl the ttructure� is not IntentleA or ottereG • ezs anU.Professional Cotle: Tha Contraclor's � an owner o/ a property'.who bulitls or improves ' B /O/k Illrtli¢tl/IferseB Or through h15 0� heI own Improvoments are'not Intentled or ofteretl far . p or Improvament I5 soltl wkhin one'year ot com- ' e burden of provin9 he/she tlitl not builtl or Im- 1 . ain eaUuslveW contractina with Ilcensetl con- . D _ Owner have rea� & V. C. for this reaion � S iP � ' . Sink � - � � - Under,Ground ' -Struttural , - Ventilating � ' ' urt System ❑ Multiple � �I/Fact. Blt. ICBO # ng.System & Ducting � sentativez o/ �tbis .city • t0 enter �upo� tna pbove-mentionetl� property for hoaO or TypB Inspectlon ourposes.�j� ✓ / /)�� �� � Cano T e Slgnahro � ��1�� � / �X/ Date �� � Drivers' LJcensa or�55 $ _ '� � � � Re9ister5 CMF 0865-46 rev. 12/82 White - Builtling; Canary - Appliwnt; Pink - Accounting; GOltlenroG - Assessor - � Reinspection.Fea ' ' laue Fee � ' ❑0-�100,OOOBTU �100,000 i System FepeirlAlreration � � . ` � Reinspection Fee laue Fee � $15 $ 3 $15 $ 3 PLNG. REF.,M4 � TO BVILDING•- PROPERTV LINE ' L'EFTSIDE VARD PKG: SPACE REQ. STREET WIOTH SPECIAL CONDITIONS: Automatic Washer Construction Pole; . Cooking Unit i ;', ' Dishwasher - �� � Dryers-�Gas ❑Electric Fan � F.A.U. "� � � Fixtures ' Device Boxes , GarbageDisposal ' Generator �0-5 KW �5� Trensformer �15-SOKW � 5U + KW Meter ❑up to t00ampi Zanin9 APGroved BY . ' � I ApPliption APDroved BV — APPlication laued By — 2 Q75'• 6/�I/�i� REAR VARD (TO P/U'.- RIGHTSIDE VARD ' PROVIDED i PAflK FEE $ , � o;; ' TI. IMeter LJover100amps . Sub Panel. Sub Pole � ; � ' Motors �0-0 HP O1K-8 � � Inc.Solar��9-15HP ��16-15+ � Microwave ' ' Pole Light , � . ' Range_ .i Sign ` i Standing Sections � Trash Comoactor � � � �Reinspection Fee � �'dLB � � ' ^ate �._._ �lo '/%8� � ' , � � SUMMARV OF FEES . , . � BUILDING PEFiM1T $ ; SMIP ' • $ � PLAN CHECK S : PERMIT � PLUMBING ' $ � ; ISSUANCE� $ . PLAN CHECK� $ •/d _ , , GRADING ' $ ' ELECTRICAL . $, ' � � $ � PLAN CHECK � S � MICROFILM $ MECHANICAL $ ' � TOTAL�FEE ' $ ' LESS �PLAN CHECK , $ � , ADVANCED PC �, $ � I � . FINAL FEE. � $ 3 �"' i �_ ry ' ' -. _ - � � . -� -�.POOI PA � � , - _ . �CONS`fRUCTION,AND'PLqNNING; ' ' � �'� � �` �_ � ' - , . - - `. " )54;L,� �'Date�_ Inspectoi � � � - "Date �Inspector - > :APPROVALS ; Permit#� • - �'APPROVACS= Permit# � ', I - . n, . . . _ �;1� Temporary Electrical Service or_Pole v ''' c - 52� Pool & Equipment Location ,. , ' - - �.. {_, 2. Soil Pipe-Undrgmd ° - . _ : ;. � : � : � . 6`,tp �� 'r � � 53. Steel Reinforcement _ �� . ,� � : r; -. - " •� 3: Elect�ical Conduif Utilitv-Undr§rnd � �,; - � - � , .�54.� Forms � - _ _: �- � � • . � ' � � '; 4; Electrical Conduit-Undrgmd�. - . '_ . , 55: Electrical�Bonding - � � '. _. 5. Steel Reinforcement, _' � ' !' � • f ,, ' - _'.. ` + � 56., Rough Rlumbing & Pressure Test '' , ' � . ' 8. Electrical UFER Grnd. ' � ' �, .. ' ^.: � ' 57.; APPROVALTO COVER-GUNITE . 7. Footings ' ' , ' , � . - y " ; . _ - - `�58.' Electricai Conduit-Undrarn�.. � , . , 8. Foundation � � , , _ . � .� 59. Gas Pipe,�� Wndrgrnd., Test ' � ' - 9. Water Pipe-Undrgrnd. '� - � � ' 60. Backwash Cines;-P-Trap, O Undrgmd. _ - i _ �: 10. Structural Floor System -' a: ���; 61. APPROVAL TO�DECK � - " - 11. Property' Sewer Line & House Connection , 62. Backwash & Receptor-Final �, ' �- - � 12. Sewei�C2p : 1 � • ' ' ' 63. Heater & VenbFinal _ " � _ 13. Roof Drain's . � ' , ' � � 84. Plumbing System -. Final , � � � ,; 14. Rough Plumbing �: � 65. Electrical-Final �= P D ,15�''��Rough'Electrical-ConduiY�� -� ' - '-�j;� r •�'--- '66. SolarSystem-Final'� �-��� -- - - -� - , �i � i '16. Rou h Elec'tric Wirin , ' '.�'=-�� � ' - - . -� � � - � - . r•, 9 • ,� , 9' '�� . - I :• - T �� � �67: �Fencing & Access Approval � . 1.� �Rough Witing Sign` ' , � � . " j ' � ". : • � � , 68. APPROVED FOR PLASTERING � � � - � - - z - ��'�18:"Rougti�Electrical-T;BaiCeilingf �i �i . � � _ ';� �69.P,OOL/SPASYSTEMSFINAL � .; 19:"�Rough:Heating & Air Conditioning ' ' � �. FIRE DEPT. REQUIREMENT � _ . ,:: _ 20. Rough.Factory Fireplace � ; � , i�! APPROVALS. Peimit# � , , , � . � 21. Ducts, in Structure , � �� � ' ' , i � 70.� Underground Hydro , '�22. Ducts, Ventitating � � � 71.� Produc[ Piping �Gas OOiI � �� ''.23. Gas Pipe-Rough & Test ` ! � , �, . , � '-'i �72„ Underground Flush � �.• � ' :� � 24. �Roof Framing- _ � ' �'� i: . � � _ : �73. Undeigrnd. Storage Tank O Gas ❑ Oil . 25. ,Roof Sheathing ' „ � , '- 4 ��' � ' � ' _� � 74, Overhead Hydro � " .�-26. T-Bar Ceiling ��Structural6& Monocoat � + � _ I' � ' 75.� Dry Chemical , . . � - 1 .. 27. Frame and Flashing = � � . � � , � � 76. Dry Standpipe • � 1 ' � 26. �,LatHing & Siding � � n ' � , � � _ � ;77. FIXED SYSTEM-FINAL - I � 29.'lnsulation ��, _ ` ` ' � , � � � � � � �78. FIRE PREV. FINAL . � �� ��-30. Drywall Nailirig � � ` � � f �Notes: , � - 31. Plaster Brown Coat' ' �� ; , � � . ; � i� � - � - • ; �- -�. . ' . - -. � , 32.,Etecfrical'Power Meter-Final � p � ; ' i � � '� � ' � n _ � � 33.'Final Electric ' . � E ' � j � i 1 � ' � • 34. Final Heating & Air Conditioning . �, � � I ' • � '�' m 35. Final Gas Pipe-Test ' �� � � � ,. , � , ; � � . " �� ~ . � ,la, s' ,� I ' . ,� .. , . . . 36. Hood or CarioPY_ �I . i ' „i : � '. � :� � j � . � � - � - � . 37. Final Factory Fireplacer � _: L� ' �.. � ' � , � � � � t , 38. Final Plumbing �' � � i �i � � 3�/�7�l��J , lQ(� I i " ' � 39. Water Service-Final� i I , ., , � , � . - '`. . � 40. Gas Servi.ce-Final � � � I ! i , ' . � 41. Solar pomestio-Finel ; ' � ,. ' � , � ; • � - , , 42. Backflow;Preventer ; ! � � � �' . � � . � . r 43. Backflow Irrigation -" � • . � ,'�, „ � � �� . .!� .'�' ' M 1 i �� �. ..' i • , 1 , . 44. Landscape Irrigation'System r���• .- � � , �. � � . . • � 45. Sound� �Attenuaiion'. i'' � � � ; '� ` � " � � ; , , � - � � � � _ 46. Handicap, Regulation`s j r � ' ' � � � �- ' ' ' ' ' � ' � . � I ¢ i` i i i: 47.-FINAtSTRUCTURE&BUILDING � . ' ' � ' � � - ' 48. Special Requirements Completed ;. j � ' , i ' , , - ' , 49. Electri'c Release to �Edisonl � � � ' _ _ � , � � - - , - �' 50. Gas Release to Souihern Catifornia Gas Co �! � � , . ' . � � 51. CERTIFICATE�,OF.00CUPANCY �. ' .T�__� - 1. � . � � - � - -, � . . � No. t ' � Date ( .� � i , � . ' ' 1 CITY OF�COSTA MESA - CONSTRUCTION PERMI AVV���ant to fi11 in ali spaces except those within heavY eoreer lines antl sign a11 aDorovrlate tleclarations. PERMIT NO. TFACT NO. LOT NO. BLD . . Project Addren �1` � Applicant's Mailing Address Vy�. �� ' �Ii !L 1' Owner's Name Phone 7� Address ru% — C• Arch/Eng. � Licenu No. Address Contractor's Nam hone Address Im�"����I ��� /�� � � ���-� CIIY LICBn[a Nn I `7 .%� ' LICENSED CONTRACTOR DECLARATION I hereby. aifirm that I am licensetl untler proNsions ot Charter 9(commencing witn section 7000) of Divislon 3 ot the Business antl Protezsions Cotle, antl my Iicense is in full (o e n effect. �_, _.,_� License Q s �� ice No.__� Date� Signature � - WORKERS'COMPENSATION DECL ATI 1 nereby aftirm that I have a certiticate of consent to self-insure or a certificate N Workers' Compensation Insurance, or a certiti tl<opY thereof (Section 3800, Lab. f�.�l,,, �6��� Company ,' "' ^-' �� PoIiCY No. ��{v�i �Certitietl copy is hereby tumishetl. � . � , � Certifietl c p_ i filetl with the city Bui m9 ivision. Date�n��'�� - APPlicant .��A[L ' � . EXEMPTION'FROM WORKERS'�COMPENSATIO DECL RATION. (This section neetl not be cOmpleC¢tl ii the permit'is tor One huntlred ($300) or , less) I certify�that in the pertormance of the work for which this permit is issuetl, I Shall not employ any p¢�son In any mann¢� so as to becOme SubjeCt to [he Worker5' Cortip¢n5ation' LawS ot Califomia. ' . Date Signature � NOTICE: If,'after makinq thi5 tleclaration, you shoultl become subject to the Workers' Compensatlon provisions of'the labor Cotle,-you�must forthwith • comply with such provisions or this permit shall be tleemea revokea, GONSTRUCTION LENDING,AGENCV � " I hereby aHirm [hat Ihere i5ppp,,,rrFcconstruction lentlinq agency fo� the pe�fo�mance of the work for whicM1q/ ermit is issuetl (SecHon 309� Civ. CJ Lentler'r Name �� / L.entler's Atltlress ' OWNER BUILDER DECLARATION ' I hereby affirm that I am exempt trom tne Contracfor's License Law tor tha following reason (Sec[ion ]031.5 Business antl Professional Cotle: Any city or county wnich requi�es a permit ta construct, alter, improve, tlemolish o� repair any structure, prio� to Its issuance, also reqWres the applicant to� such pe�mlt to file a signetl statem¢nt that he/she is licensetl Ou�suant to Ihe prodi5ion5 oi the Contractor'S License Law (Chapter 9(commenCing'with SecUon 7000) of �Jivision 3 oi the,Business antl Professions Cotle).or that he/she is exempf •erefrom antl the basis for the allegetl exemption. Any�violation of Section )31.5 by any applicant tor a pe�mit subjects the applicant to a Civil enalty of not more than five huntlretl tlollars ($500). - �� I, as owner oi the proper'ty or my employees with wages as their sole mmpensation, will do the work, antl ihe sVucture is not intentletl or otferetl for sale (Seciion J064, Business antl Professional Cotle: Tne Contractor's ' LicenSe Law tloes not apON to an owner of a proper[y who builtls or improves thereon, ana wha-tloes such work-himselt/herself or through his or her own ¢mployees, p�ovitletl that such improvements are not intentle0 or of(eretl fo� saie. If, nowever, the Dulltlinq or Improvement Is soid witnin one year of com- pletion, the owner will have tne burtlen of proving he/she tlitl not builtl or im- �rove for the purpose of 5ale). I, as Owner of the prOperty, am exclusively cont�aGting witM1 licensetl con- tractors to construct the project (Section ]044, Business and Protessions Cotle: � The Contractor's Licenze Law tloes not apply to an owner of property who builtls or improves tM1ereon, antl who contracts for such projects with a con- tractor(5) license pursuant to�the Contractor's License Law). ' ❑ I am exempt untler Section � B. & P. C. for tnis reason Date Owner I hereby certiry that 1 have reatl ihis applicatlon antl state that the above information �is correcL I agree to comply with ail dty and county ortlinances antl state laws relatin9 to builtling constructlon, antl hereby authorize repre- � sentatives of this city t enter upon the above-men[ionetl property for Inspec[ion purposes. ,/_p.2 $ignature � r�T p J Drivers"License or 55 � TYPE OF CONSTRUCTION LJ 7EWn U� ADD LJ ALTERATION LI REPAI R ❑ CONVERSION ❑ DEMO{�IyH -' "0.THER DESCRIPTION OF WORK �D�,L�h b TYPE OF PERMIT � LI GRADING LJ FOUNDATION LJ STRUCTURAI ❑ TENANT ❑ ELECTRICAL O PLUMBING � MECHANICAL � ❑ OTHER PROJECT DESCRIPTION 5c3. FT. � oCCUPANCv CONSTRUCTIONTVPE - VALUATION$�� ZONE GRADINGCU.VDS. ACRES_ Remarks: — �"7 �i R '7 3ackflow Preventer 3ackflow Irrigation 3athtubs Clarifiers . Dishwasher ' Drinking Fountains Floar Drains Floor Sinks • � � Gas Service Interceptors Kitchen Sink Lavatories . P—Trap Roof Drains �� Reinspection. Fee Showers ' Service Sink � Sewer Cap � ' Sewer Connection Solar Collectors Solar Piping . ' ' Solar Tank � - Swimming Pool w/Spa � Urinal Outlets Water Closet� � � Water Heater � � � Water Service � � � Boiler , � Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ FirepVFact. BIt. ICBO�# Heating System & Ducting ly�p-100,000 BTU 0100,000 BT Reinspection Fee � $25 �CMF 0865-46 rev. 7/83 W�ite - Builtlin9: Canary -APplitant; P.ink - Accounting; Goltlenrotl - Issue Fee Hood or Type I ' ❑ � Canopy Type 11 ❑ Refrigeration System �0.100,OOOBTU ❑100,000 System Repair/Alteration Issue Fee A.P. # S Main Building: E T Front� A Rear . C Right � SLeft Ping. Ref. # • Parking Req./Provided . Use of Building: Planning Notes: Automatic Washer Construction Pole Sub. Cookin9 Unit � � ' Dishwasher Fan F.A.U. Fixtures Device BOxes Outlets Switches Garbage Disposal � Generator �0.5 KW 7"c01 1::/ I �/�i � zone Accessory Building: ' - i Park.Fees $ , - ;o... T' Z O N I N G R E Q . U I� ; E E ELECTRICAL � FEES . .Transformer ❑ 15-50 KW ❑ 50+KW � Meter �up to 100 amps Meter ❑over 100amps �Sub Panel � . Motors � 0-1 HP � 1'/: - 8 Inc.Solar �9-15 HP �16-15+ ' Microwave � � � • 'Pole,Light � Range Sign Standing Sections 5 KW Trash Compactor . $�1�. . Reinspection Fee � $25 �ssue Fee FEES _ PUBLICSERVICESHEQUIREMENTS: , . Zoning Approved By Application Approved By _� APPliration Issued BV $ 3 BUILDING PERMIT PLAN CHECK PLUMBING PIAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK $ 3 �SUMMARY OF FEES $ SMIP $ $ PERMIT $ � ISSUANCE $ ` $ ENERGV P.C. $ $ GRADING $ � $ MICROFILM $ �_ $ �� TOTALFEE ,$ �_ $ � � CONSTRUCTION AND PLANNINGT, � � � � � P��� 'P'�' APPROVFILS Permit# n��U�'"n Date Inspector qppROVALS Permit# Date Inspector t: TemporarY Electrical Service or Pole - �. 52. Pool & Equipment Location _ 2. Soil Pipe-Undrgrnd. �- � _ 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgr.nd. - 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, O�Undrgmd„ Test� 9. Water pipe-Undrgmd. � - 60.� Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System � . . 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final � 12. Sewer Cap � - 63. Heater & Vent-Final � 13. Roof•prains - 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 � 77. Rough Wiring Sign � "_ �� .68: APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL 19.^Rough Fleatin9 & 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. Undergmd.StorageTankOGas ❑Oil 25. Roof�$heathing � � 74. Overhead Hydro 26. T-Bar Ceiling (StrOctural) & Monocoat , 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding ' 77. FIXED SYSTEM FINAL � 29. Insula7ion . , 78. FIRE PREV. FINAL 30. Drywall Nailing � ' ' , HEALTH DEPT�. REQUIREMENT 31. Plaster Brown Coat� � ' 79. FINAL INSPECTION 32. Electrical Power MeterFinal ' 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning ���Yy � 35. Final Gas Pipe-Test • � � � ' 36. Hood or Canopy • 37. Final Factory Fireplace - � ' - 38. Final piumbing 39. Water Service-Final � . . � 40. Gas Service-Final • � 41. Solar bomestioFinal _ _ _ ,_ 42. Backflow Preventer � ' 43. Backflow Irrigation 44. ,Landscape Irrigation System � ' � � 45. Sound Attenuation " i " - 46. Handicap Regulations ' . - 47. FINALSTRUCTURE&BUILDING � 48. Special Requirements Completed • 49. Electric Release to Edison - - � 50. Gas Release to Southern California Gas Co � , , 51. CERTIFICATE OF OCCUPANCY . _- , No. - Date � � Applicani ta fill In all 50aces exeept thosa within heavY bortler Ilnas anC sign all approoriate tleclarations. , CITY.OF COSTA MESA. , � � . } � ' PERMIT NO. TRACT NO. LOT,NO. � BLD . . , . . . ' ` , ,. � ' CONSTRUCTIONPERMIT . . - /i/� — J�S41 � � , � � � ' ' 951�� I'1,?.;.:' � i ",.; � i Applitent'SMellingAddless �-nRn T�i R�tdvi •�� �ICTt .Il„..„:... ,rypEOFCONS7RUC710N � NEw ADD �ALTERATION - REGAIR • � ' - ' �. � .� i �, � " � ProjectAddreu-��.0 ���i^^'0�B ' ' ' OCONVERSION _❑DEMOLISH ❑OTHER, _ , � ' . . �, . - . • , ^ _� � .. ' �^ ,� ' �' - ' ' ', DESCRIPTION OF WORK ��(e-�.`�� �'i�e ��2Q�+ ' - . . Owner's Name - hone � � I � . . � - � � - � , _ . ZO 1 G�R GULATIONS�. Addf2ss . . . ' - TVpEOFPERMIT � GRADING_ FOUNDATION ' STRUCTURAL A.P:aW� : ' ZONE ' � ' ' y. :. ArCh/Eng: � ' ' ' � ' ' LiC2n52 No. ' ' ' _ ' O TENANT ❑� ELECTRIGAL O PLUMBINQ � MECHANICAL � , • �pLNG. REF.qW� � i ' ' BVILDING' ` � -.� � .. Addrea' � . . ' , .❑,�OTHER � " . . � - - ' - ' I •c , �' TO BUILDING . ' - - ' � , � ,� �� h �2 � ' - � _ . . . .REAR VARO (TO P/U � t ContreCtOr'SNam COi3.S't� Fi re �'d P one •PROJECTDESCRIPT�ON� SQ FT. � OCCUPANGV � PR PER V INE "- ' Addresslmailing) �nR(1' 1�'Rca'taiyi�_ �N_-•llr±an,rro O��j,6 • � CONSTRUCTIONTVPE V{iLUATION$ � ' _ LEFTSIDEVARD '. RIGHTSIDEVARD ' < <. �������i ��s�-�_�- ZON� - GRADINGCU.VDS.. ACRES PKG.SFACEREQ. . PROVIDED ' License No. l �i�L�%F+- ' . - = . LICENSED CONTRACTOR DECLARATION � � ' Ramarkr. �- - j O�� � � I ; = i STREET WIDTH , PARK FEE$ ! � - f hereCy affirm that Pam licensed under provisbnz oT Charter,9 (commencln9 - , , , . . . � with se<tion 7000) of Dlvislon 3 af the Busineu a tl Vrofe55ions CoOe, antl ' ' ' � � , ! � � SPECIAL CONDITIONS: i � ' � � ' �� my licen3¢�is In full torce antl�efiect. ' � ' ' ' . . , ' . ; . ,_ , . License Clas - 9 i I � � _LI � n e No.��.:.�j�.�� i ; � � � ` PLUMBING �: ' - � � � -� ' � -. � ; , Date '� n�% SI tu e ` . � � � � '� WORKERS' COMPENSATION DE r RA71oN �' � . � , Bar Sink { 1 �'n'er C2p � i � ELECTRICAL ' �ereby'afflrm.that.l have,a terdflcate of consent to self=lnsure oGa certlfl<ate ' ' � �,Automatic Washer �Meter �over 10� amps � �� : Workers' Com nsa I I sur nce or z certlfieG' copy thareot (Section " Baekflow�Preventer � �-- � Sewer Connection: . -- - ,�- - -doo, �b. �, 7�g��3�CCA � ; � Backflowlrrigation , SolarCollectors Constructio"n'Pole ' SubPanel � � Policy rvo. Company ' - ' - � . � ` "- � CookingUmt�� , ' SubPole ' - � ' •� Certitietl copr is hereby furnlshetl. i ' ' i � Bethtubs , 1 � Solar Piping I ; � � � 1 Certifietl co y s filed with the city, u ng i i . E � ,, � �� � ; , � Dishwasher '. ' Motors �0-i HP 01 % 8 '. { Date - ADoi��ant • Clarifiers . ,. Solar Tank : . � EXEMPTI N__,'(�RKERS' COM SA ON DECL RATION � ' ' i �, . — - , � , Dryefs'OG�S. �Electiic. .• _ ` 'Inc.Soler 0945 HP �1645+ ' • � '(Thissection neetl not be tam0leteA if the ermit is for�one untlretl ($100j or Diihwashe� ; SwimTing POoI w/Spe • � - � � less). • � � ' � ' � -� • � � , . ! Fan 1. ' � �Microwave � ' � ' 1 certlfy that In the per(ormance of tne work for,which this perm�t is Issuea I' Drinking Fountains 'f •. � Urinal ' . , . ( � ��'.+ � ; shali� not employ any penon in any manner so,as [o become subject to t�e � � ' � •�/ , , ' ' � Workers• ComDenwtlon.Laws ot caiifornia.; - � � Floor Drains, � Water Clout ' � � i I F.A.U. `PoleLight . � � � ,�. Date ' Si9natura - � � � ' � � � - � �.', � ' - ' ' ' ' � . � � ' �� Water Heater ' ' Fixtures I � g �� NOTICE:df, after making�t�is tleclarat�on, you should become suGject to�the� .- -- Floo� Sinks� �.1-, �._ _� _ .__ _ Ran 2,_ _ I_ _ . . . . . � . ' . . _ ...'. . _ ' _ � Workers' Compensation provislans of the Labor COUe, you must torthwith ' . � . ' , -, . - ' camply with Such'p(ovl51on5; or tM�s"permit'shatl be aeemea revoketl. . GasSerJice � Outlefs� �WacerService � ' DeviceBoxes Sign � • ICONSTRUCTION�LENDING AGENCV ; ' � � . ' ' ' Outleti � ' � 1 hereby affirm that there Is a�construc<�on lentling agency,tor the performan<e Inte�cepto�s ' _ - : � . Standing Sections �. of itie work fon which tNs; perm�t �s �Issuetl �(Se<tion 3097 Clv_ CJr Switches � Lentler•s� Name ' - - • - Kitchen Sink - . - ' - i ' . Tresh Compactor � � Lentler•s Atltlress � _ : . . ' � ' � ' � � �� . � ' ' ' Garba p . ' OWNER'BUILDER DECIARATION ' � S � '„ ' � - ' Lava[Ories _ _ � �'. �. � 9e Dis oul • � . � � . I hereby atfirm that I am exempt Trof� the,Contractor's'License Law tor the � . • . . Gen2r3t0�� �0�5 KW �545 KW ' ' following reason.,(Se<tlon 7031.5 Business antl Prufesslonal Cotle: Any city or P-T�ap � t. - �� <ounty which requlres a permit to construct, alteq improve; tlemolish or, repair ��� � � . � , T�ansfo�m2� �' 15-50 KW � ' ' any stru<ture; D��or to Its:issuance, alSa req Wres the appllcanE tor such parmlL RoOf-0�ains - �• - � �� . � ' � � ' to tile a slgnetl statement that he/she Is Ilcensetl pursuant to the provisions of � ' � � ! the Contractor•s�License law.(Chapter 9 (�ommencing'with�5ettion 7000) of .- I ' � � ' , - ' � ' . ' - � ❑5U+ KW'� � � � �Reinspection Pee � $75� ' a;islon r3��of the,8usiness antl Protesilons' Cotle) or thatl he/she is'exemp[ " � Showe�s ., �^ ' �' � Rainspection�Fee i $75 ' � r+ �::efrom antl the ba5i5 for the allegBtl exemption. Any violatiod-of Sectlon , ' ' � i -' Met2r ❑up to 100',amps � 'ISSue Fee: � � �$ 3, �.�$.5 by any appllcant (or��a � permit subjeds the •applicant to a civll - � . � • � � .. _ .. - �iialty of not more than (ive huntlretl tlollars ($500): . i - j : � Service Sink' � „ j Issue Fee � $ 3 , ' ' - ; ; 1 .- � � Zoning Approved By �' Dat9 I; �as �owner of: the property or^TY employees.with wages as their sole , ' . , , � compensation' will tlo the work, antl the struc[ure is not IntenAetl or offeretl •�~ . �, �� -. MECHANICAL � i � � � tor sale'(Sec4lon 7044, Business: and Profe55ional Cotle: The', Contractor'S ' � • %�PP���tiOn Approved By 1 Date License Law Uoes not apply tolan owner oi a property wbo builtls or (mproves Boilec ' ��� Refrigeration System i � ' ' � ' ' ' � I thereon„antl who tloes�sucn'work hiinseli/herselT or throu9h his or her own ' , Application ISued By ,Date '� emoloyees, provitletl Ihat such�improvements are•not intentletl or offeretl for � � - ❑0-�100,OOOBTU ❑100,OOOBTU saie. If, �awever, Ihe bulltling or Improvement Is solU within one year.of com- Duct - Under Ground ; , , � � , � � � . pletion, the ownerlwlll have the burtl9� of proving he/she tlitl no[ bulltl or Im- � . � SUMMARV OF FEES • • �roveforthepurvoseofsale). � � . _ � , � , Duct-Structural , � SystemRepair/Alteiation � i �BUILDINGPERMIT $, � � � SM�IP : ' t $ � � � � I, as owner o( the pioperty, am e%clusivaly mntracting'wiM�licensetl con- � . � . � � . � � � � ' ', ' � trattors to construct the.project,(Sectio� 7.044, Business antl Rofesslons Cotle: _„ � Dutt - Ventilating _�. _ _ �, _ _ _ _ ' ' �PLAN CHECK� $� � � PEflMIT • � The Contrattor's License Law does not aOPly to an owner ot property who � i , ' � � � • ' ISSUANCE � �$' � � ' builtls or improves thereon, antl who contra<ts tor such proje<Is with a con- ExhaustSystem ❑ Multiple �, • � PLUMB�NG � $ ' tractor(s) Iicensa pursuant to the ContYactor's License Law). �. . ' ' ,PLAN CHECK $ � ' GRADING $� 0 I am ezempt under Section B. & P. C. for this reason 1 FirepUFact. Blt. ICBO # 3�. JS � � � i , ' , $: � , � ELECTRICAL � $ , MICROFILM � $ ' � Date , ' ' � owner � ' � Heating�System & Ducting � � ; i , , i-hereby�certify-thabl�have reatl tnU`appii<ation-antl state�that the above 04100,OOOBTU-0100,OOOB � - -. - i -+ - � �- - P�N CHECK• $ � � ' information iz correct. I a9ree to comP�Y with au tity antl county orCinances , � ; ' ' ; TOTAL'FEE �$ � � ' antl state laws relating t bulltli g construction, antl hereby authorize repre- ' Hood of T e I ❑� ' - •MECHANICAL $' �Q� � . � , sentatives of nls` it t enter�upa� �he above-mentionetl property for � �P ' Reinspec[ion'Fee $�5 1�•�� � LESS i � � inspection o o s - . � � ' . Cano � T e II ❑� ? � � i �PLAN CHECK � $ —L�L�L , ADVANCED��C ��, $ ' Si9nature � � D,ate � Q�3�, , � � , � � , � , : , I . ; Drivers• Licen o 5 � t � � Register,s ! � � , Issue Fee $ 3 � i � � ! FINAL FEE � : $ � ��� CMF OB65-46 rev. 12/82 White - BuilG�ng; Canary -Applicanh Pink - Accounting; Goltlenrotl -Assessor � �-- � -''CONSTRUCTION AND�PLANNING � ' -� ' - -' . -: •' '� POOL �q � - . � � � - �,Date ��Inspector ' - - Date Inspector . �`_<APRROVALS. Permit#-�� ' _ . APPROVALS 'Permit#�` ��i ' e a � - . ' � ;1. Temporary,Electric5l Service or'Pole .� � - . ' 52: Pool & Eguipment Location � - -- _ � . _ . ...,.:� - - .,. . 2: Soil'Pipe-Undrgrnd.! �. � y � � � r � t � . y - ' ��' � 53. Steel Reinforcement �� ' - " , � ti � �` � 3i �Elecvical Conduit UtilitwUndrgrnd. - � � � � 54.' Forms - � . � � � � = � � 'O 4-. Electric9l Conduit-Undrgrnd.: � - �:' i > � . :55: Electrical Bonding.. �� - , _ � � , - _ ,n` 5�. Steel Reinforcement ; ;, ,�;, z � ' �'� ' � , - 56. Rough Plumbing & Pressure Test . � �6.'Electrical UFERiGrnd: 'r<:= - ''"` � � '� 57.�� APPROVALTO-COVER-GUNITE � � �' 7. Footings ' � � ~ , ,� '�.�.: `' . - y 3 ��� ` � ��58. Electrical �nduiYUndramd➢. . , � � � 6. �Foundafion , � _ - 1-: � 2 ' _ : � � ' 59. Gas�Pipe .���:Undrgmd., Test � . � . � _ 2' I - 9. �Water Pipe;Undrgrnd. � � - < _. ' ' 60. Backwasti "Lines,-P-Trap, O Undrgrnd. , � 10. Structural Floor Sy,stem � " s ' � � _;'� ; �- � ;61. APPROVAC TQDECK � � - 11. ,Property Sewer L'ine &�House Connectio� - � � � 62. Backwash &�ReceptorFinaf . � ' 1 12. Sewer Cap � ' � , � � � I ` - 63. Heater & Vent-Final � -" , • � 13. !Roof Drains � � � `' � � ? � �, 64. Plumbing.S/stem.=Final .` . • - , 74. Rough Plumbing � _ � . � � � �65. Electrical-Final � ' - - 15. Rough'E�ectricaRConduit�r+`-," �"-'� - -,'.- � -� 66. Sola(System-Final �� � �- � -1'6' ,Rough;Eleciric Wirinq c i ' ' � �-""� _-` � -- , � .� 67. Fencing & Access Approval � - . � 1Z. RoughTWiring Sign� ,1 r� ��� � -� ' �. " 68: APPROVED F.OR PLASTERING 16. �Rough�ElectricafT;Ba`r Cei�ling � � i�� , � � � ' 69. POOUSPASYSTEMS FINAL . ' ' � 19. �Rougli Heating & Air �Conditioning ; � ; � , �FIRE DEPT.,REQUIREMENT �0. Rough.Fa'ctory F�ireplace � �, �� �, � ' � APP�ROVALS' Permit # ��� , ` , � ' 21. Ducts; in Structure� '` � ; �' ' � � ' � ' � � f , . 70., Underground Hydro � 22. Ducts, Ventilating' � c�.�f iI '� � ' 71. Product Piping O Gas ❑ Oil ,� � 23. Gas�Pipe-Rough & Tesi ; i� i'' ;' � �. ' 72. Underground Flush � -24. Roof Framing, , � ; � �;� ��� �. , .� . ., �. 73. Undergrrid. Stora9e Tank O Gas ❑ Oil � 25. Roof Sheathing �' ' �;�5 �, - � 74; Overhead Hydro 26. �T-Bar,Ceiling �IStructuralh & 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: ' i �, cr- � � - - - - -- ' 31. �PlasYer Broviwn Coat � � ' ' . I 32..Electrical�Power Meter-Final � , j � ' . 33. Final Electric � � j � � � � �, " 34. Final Heating & Aii Conditioning � � �� � ' � � '. �, � ' � d ; ' , � 35. Final Ga's Pipe=7e;t � � �� " � -' - ' ' , - - . �:.i? ^ �' � - �� - < 36. Hood or CarioPY� . . ' � � ,: - ' .: i � . . . . . . � 37. Final Facto,ry Fireplace- _ _ �U�b7 '� (,,�{j ' � - " , � � 38. Pinal Plumbing ' � 7 , . . � � � . � 39. Water.Service-Final � � . �� � � � � - � � 40. Gas Service-Final � ' ' � ' � � � 41. Solar pomestiafinal : ' � � � . � � • ^ � , _ _ 42. Backflow Preventer .. j i, � , � _ . ' . � . � .: ti � .- - - - 43. Backflow� Irrigation ;� ' � '"_�c � � - - � . � I_•; ' 44. Landscape Irrigation System � �' 1. � � = � �' � �' � � r , i � �� - ....... I,' . .�'i�' � � ' " � - - ' ' • . 45. Sound Attenuation " �;; � ' � - ' , ' � � , , a. i: , ,' . 46. Handicep Regulations � � � . � � � i � � _ � � 47. FINALSTRUCTURE&BUILDING' , , �� ' . � 48. Special Requirernents Completed ;� � ; � �� � "• � � _, 49. Electric Release�to �Edison, , �_ _ __ _ � _ . � -. . ' . ! 50. Gas Release to Southem Glifomia Gas Cq � � � , � � . : � 51. CERTIFICAT�,,OFi OGCUPANCY �; � _ _ _. _ _ � . . _ _ . . _ _ . _.. .. - _ � �- No � ' � Date ' � ' � � - . � Applicant to fill in all spaces axeept thase wit�in �eavY Dortler Iines antl sign all aoG/opriale Eeclarattons. CIr.Y OF COSTA MESA� -- � - ocannir nin - - rcnrT nin- i nT n�n oi n_ -- �CONSTRUCTION PERMIT Prolect Address � Applicant's Mailin Address � Owner's Name ��� ��� c—P one Atldreu Arth/Eng._ License No. Address Contractor's Nam h Addreu (mailing) City Licanse No. LICENSED CONTRACTOR DECLARATION - I hereby af(i�m thdt I am IicenseU untler p�ovlsio�s of Charte� 9(comm¢ncin9 with section 7000) of �ivision 3 ot the Buslnes4 antl Professions Cotle, antl my Ilcense is in f IF�(orce � efTect. License C ass �IGans . .J Date � Si9nature WORKERS' COMPENSATION DECLARATION � hereby at5lrm tha[ 1 have a certiilcate ol consent to salfinsure or � tf lcale �t Workers' COmpanSa on Insurdnc¢, o� a ce�Uf�etl cOpy there 5 Ction 3800, Lab. Policy No. �� Company� C itietl copy Is �ereby tumisnetl� rti �tl �y i�WiM the clty BUll�in Dl��sion. Date � ^ 75�� Applicant EXEMPTION FROM WORKERS' COMVENSATION DECLARATI (This sec0on neetl not De completetl if the p¢rmit IS fo� one huntl�eU § 00) or less). 1 cer[ify tha[ In Ih¢ p¢rformance O( th¢ wOrk tor Whlch th6 permk is issuetl I shall not employ any person in any manner so as to become sub7ect to t�e Workers' Compensation Laws ot California. � , Date Si9nature . NOTICE: If,-afler making [his tlaclaration, you shoultl become subject to Iha Workers'-Compenzation provisionz of the Labor Cotle, you must fortbwith� comply witn suc� provisions or this permit shall be Aeemetl revokeA. CONSTRUCTION LENDING AGENCV I hereby af(irm that IM1ere is a conitructlon lentling aqency for the pertormance ot the work for w�ich this permit � is IssueA� (Section 3097 Clv. C.) Lentler's Name � Lentler'S Atltlresz � OWNER BUILDER DECLARATION I her¢by a}firm thdt I am exempt f�om Ihe ContYactor'S license L.aw for the following reason (Settion ]031.5 Business antl PrJfessional Cotle: Any city or munty w�ich requires a permit to ConStruct, alter, Improve, tlemOlizh or'rapalr 'dny stru<ture, prlo� to Its issuance, alm reqWr¢S Me aOP���ant to� such permit to file a signatl statement that he/she is licensetl pursuant to�the Orovislons of tne Contractor's License law (Cnapter 9(commencing with Sectlon 7000) ot �ivision 3 of [he Business antl Professions Cotlel or that he/she is exempt �ere/rom antl the basis for the alle9etl exemption. Any violation ot Section 031.5 by any applicant tor a pe�mit sUbjeCIS -the aOP�icant to a<Ivil �endlty of nol mor¢ Ihan tive huntlretl tlollars (550�1• I, as owner of the property or my emo�oyees with wages as their sole tompen5ation, will Eo tne work, antl the structure is not intentletl or offeretl for sale (Section 7044, Business antl �rotessional Cotle: The Contractor's license Law tloes not apply to an owner of a property who builtls or improves the�eon, antl who tloes such wo�k himself/he�sel} o� [hrough h15 or ha� own employees, provitl¢tl that zu[h improvem¢n[5 are not intentletl o� olter<tl for sale. It, however, the Duildinq or Improvement is 4oltl within one year ot <om- pletion, the owner. wlll have'tne burtlen of proving ne/she tlitl not bW Itl or im- �/Ov0 for th¢ purpOSa of Sale�. I, as �owner Of the p�operty, am exclusively contracting with Iicensetl Con- tractors to cons[ruc[ [he prqect (Sectlon 7044, Business antl Profestlons Cotle: The Contractor's License Law does not apply [o an owner of property who builtls o� Imp�oves Ihereon, antl who con[�acts fOr such proj¢cts wltM1 a con- tractor(5) Iicense pursuant to the Contractor's Lice�se Law). . ❑.I am exemp[ untler Section B. & P. C. �or thls reason Date Owner _ I hereby certlfy Ihat I have reatl this intormation Is mrrecL I agree to comp antl 5tate laws relating to buil0in9 �on 5entatives of his city to enter' up0� Inspection pur s. e Signa[ure Drivers' License or 55 � �— above TYPE OF CONSTRUCTION CJ NEW U ADD LJ ALTERATION LJ�REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER p,p.# DESCRIPTION OF WORK S Main Build TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front ❑ TENAN�ELECTRICAL ❑ PLVMBING ❑ MECHANICAL B Rear ❑ OTHER %� C Right PROJECT DESCRIPTION 5�. FT. oCCUaANCv K CONSTRUCTION TVPE VA�UATION $ g Left 20NE GRADING CU. VDS. ACRES Ping. Ref. # Remarks: � Parking Req.IPr � O`' Use of Building', v � , . PLUMBING : FEES P�anning Notes: Sink Preven[er Irrigation Dishwasher Drinking Pountains Floor Drains FloorSinks ' GasService Ou[lets Kitchen Sink Lavatories " P—Trap Root Drains � Reinspection Fee � $25 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. IC80 # Heating System & Ducting ❑aioo,000 sru Oiao,000sr Reinspection Fae � $25 CMF 0865-46 rev. 7/83 White - Builtling; Canary - APP�i�nh Pink - Accountin9: Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issua Fee" $,3 1ANICAL FEE Hood or Type I ❑ . Canopy Typell ❑ ' Refrigeration System � ❑aioo,000eru ❑ioo,000sru System Repair/Alteration Issue Fee � $ 3 F �9ialfZone'/�9/i?� � i, „ .. Accessory Building: _ • Z � N I N G • . R � E Park.Fees $ . � U 1 R E N E N T ELECTRICAL � Automatic Washer Transformer 0 15-50 KW Construclion Pol¢Sub. � 50�+KW Cooking Unit ' Meter up to 100 amps Dishwasher Meter �over100amps Dryers ❑Gas � lectric Sub Panel Fan Motors DO-1 HP �1'F, - 8 F.A,U. Inc. Solar �9-15 HP �76-15+ Fixtures . Microwave Device Boxes Pole Light Outlets SwiLcheS Garbage Disposal Generator �0.5 KW �5-15 KW Standing Sections Trash Compactor F I Reinspection Fee �$25 � Issue Fee ' $ 3 � PUBLIC SERVICES REQUIREMENTS: Zoning APProved BY �ate Application Approved By Date Appliption laued By !�'y � Data �/ � g 3 SUMMARV OF FEES BUILDING PERMIT $ SMIP $ � PLAN CHECK $ PERMIT ' PLUMBING $ ISSUANCE $ PLAN CHECK $ ENERGV P.C. $ ELECTRICAL $ , j� �i fi�_ GRADING $ PLANCHECK S � MICROFILM .$ - MECHANICAI $ � � TOTALFEE $ SS��'� PLAN CHECK $ � �CONSTRUCTION AND PLANNING � POO. SPA APPROVqLS Permit#'F��4¢� Date�` Inspector AppROVALS Permit# Date Inspector . 1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location 2. Soil Pipe-Undrgmd. . - . 53. Steel Reinforcement � .�3. Electrical Conduit Utility-Undrgrnd. 54. Forms � - - 4 4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding . 5; Steel Reinforcement-� . - . 56. Rough Plumbing & Pressure Test •6. Etectrical UFER Grnd. � � . 57. AP.PROVAL TO COVER-GUNITE 7. Footings . 58. Electrical Conduit�Undrgrnd. $. Foundation , 59.•Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. � - 60. Backwash Lines, P-Trep, 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 " . 15. fiough Electrical-Conduit -� -' 66. Solar System-Final 16. Rough Electric Wiring �� ��„ edy L+ � .g7, Fencing & Access Xipproval 17. Rough Wiring Sign �' � 68. APPROVED FOR PLASTERING, 18. �Rough Electriral-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 Strucwre � , 70. Underground Hydro � 22. Ducts, Ventilating , 71. Product Piping OGas ❑Oil 23. Gas Pipe,Rough & Test 72. Underground Flush 24. floof 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 � � . 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,Gonditioning � � � � ' ' � , 35. Final Gas�Pipe-Test � � , 36. Hood or Canopy , ' , " 37. Final Factory Fireplace � ' 38. Final Plumbing ' . � ' ' 39. Water Servicz-Final � 40. Gas Service-Final ' 41. Solar pomestic-Final' .• � ' 42. Backflow Preventer ' � 43. Backflow Irrigation .- � ' ' � 44. ,Landscape Irrigation System • ' � 45. Sound Attenuation � � 46. Handicap Regulations ' � �, � 47. FINALSTRUCTURE&BUILDING , , 48. Special Requirements Completed ; � , . ' �� i 49. Electric Release to Edison � - +- - - ,- - � - � 50. Gas Release to, Southern Califomia Gas Co � - , � ' . , � . 51. CERTIFICATE OF OCCUPANCY � � -� - - - No. " � Date ' I �� � � � � ' ' � � � ,• City of Costa Mesa Developmen[ Services Departmem Building Safety Division P. O. eox 1200 Costa Mesa, California CERTIFICATE OF OCCUPANCY No. OGL�4ab The Building located at 7S0 LJrYC',ATF. T�IY has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R-1 Occupancy. Use of euilding CCY9DQ�IILi•1 Legal Description 418-131-17 (See reverse side for Metes and Bounds) Building Permit No B—i502 Electrical Permit No. Fr9480 Plumbing Permit No. P-7569 Mechanical Permit No.i•ton�ll n�o�nd Number of ap�ayrtments (..','!. • ISSUED T0: Build ni g 01 Pi.D. JAI�S CO.. INC. by �l,%/ 2950 AIIb�Y AVL.. D-9, Q0.STA A'IESSA. C�.. _, i7 This Certificate of Occupancy SHALL BE posted in a conspicuous place on tlie Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. (� crotF �o15-a6 rev. i/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permi[ File and/orguest and SHALL NOT BE removed except by the