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HomeMy WebLinkAbout2330 VANGUARD WAY - Building Permits (12) CITY OF COSTA MESA 4 BUILDING DIVISION >:�r,„,. ..1I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4. / PERMIT M00-00496 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 2330 VANGUARD WY Status: ISSUED Suite No B104 Applied: 11/15/2000 Issued: 11/15/2000 Vicinity: Parcel Number: 93865196 ISSUED BY: _44_ Applicant: COOTER, LYLE Address: 23052 ALCOLDE DR Phone: 949-770-6920 LAGUNA HILLS,CA Zip: 92653 Owner: FORTE, MARTIN T Address: 2330 VANGUARD WAY UNIT B104E Phone: A COSTA MESA, CA Zip: 92626 "4 Contractor IRVINE PLUMBING HEATING &AIR CONDITIONING INC S (6• Address: 23052 ALCOLDE DR ,D10.101 Phone: 949-770-6920 LAGUNA HILLS,CA Zip: 92653 License: 777854 Arch/Eng: Address: Phone: Zip: License: SCOPE OF PERMIT REPLACE ONE 7500 BTU FURNACE. 1 INST FAU< 100 K BTU. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $14.80 1 Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep. Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Ref rig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0 Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $38.30 COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 244646(WOO) • DECLARATIONS • WORKERS'COMPENSATION DECLARATION: ' I hereby affirm under penalty of perjury one of the following declarations: O I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'� ccompensation Insurance carrier and policy number re: b^A', WG G 0 Carrier: 694 '. I C/ -1 .I N yni C D9 N N17G� Policy Number: 7(98 -) (This section need not be completed If the permit is valued of one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,a gree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provi i I I I S Applicant Signature: Date: b `24, WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,030),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full force and effect.Lia# Class# Contractor's Signature: " Date: / / / CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors license Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement Is sold within one year,of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). O I,as owner of the property.em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law'does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,talsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be tiled with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? . ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LI No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? El Yes 0 No (If yes-,the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) Date �, L0 do And/B odzed Applicant /1 Date CODE$ 'INSPECTION TYPE DAIS INTITIALS CODE? INSPECTION TYPE PAISo 1616 Fixed System Final Fire Prevention 206 Final Mechanical 3-3-o l 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 4`0111 9 CITY OF COSTA MESA BUILDING DIVISION • ' 4 nu,.' ,r DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT J ;orkpassnovt P05-00020 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2330 VANGUARD WY Status: ISSUED Suite No B104 Applied: 01/07/2005 Issued: 02/0 Vicinity: , ISSUED BY: Parcel Nunmber: 93865141 Applicant: COAST ROOTER PLUMBING HTG &NC Address: 17390 MT CLIFFWOOD Phone: (714)241-1414 FOUNTAIN VALLEY Zip: 92708 ED Owner: FORTE, MARTIN T VTA •l, Address 2330 VANGUARD WAY#B-104E DATE Phone: COSTA MESA,CA Zip: 92626 Contractor: COAST ROOTER PLUMBING HTG & NC Address: 17390 MT CLIFFWOOD . Phone: (714)241-1414 FOUNTAIN VALLEY Zip: 92708 License: 529127 1 SCOPE OF PERMIT WATER HEATER CHANGE OUT. FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0:00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain,Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $35.80 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number ere: �--/r'-1 9'&Uu� 2 Carder: StA'T-f= FU,.//O Policy Number: I - OOl, (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and aee that if I should ecome subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. "^_/ ..-� Applicant Signature: 27/�i� Copt � Date: WARNING:FAILURE TO SECURE WORKERS' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES up TO ONE HUNDRED THOUSAND DOLLARE(S100,030),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of hapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.LIc.# "yt7(7.'1 Class# e"(n Contractor's Signature: Date: ?/7,C7 5"- -- CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within ono year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044.Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(S)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Cede). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .... .il. . .t..r..r..... 2 Does orr will thee applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication aermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes S No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have ell of the disclosures prescribed by Califomia Health and Safety Cale Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:1 certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sign/tat Owner(s) Date 2/1/v L� x �And Applicant Date CODE M INSPECTION TYPE PAM INTITIAL$ CODE INSPECTION TYPE PATE MELS 1616 Fixed System Final Fire Prevention 206 Final Mechanical• q 1266 Pool Spa Final 208 Final Plumbing 3-'-o! 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy _ Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. _ CITY OF COSTA MESA PE MIT NO. .TRACT NO. LOT NO. BLDG.NO. 1 7q_.`^. I/-1.I.!- CONSTRUCTION PERMIT • 90213 6 -4°, 1'6 11481 ( 13-1 a{ Applicant's Mailing Address POBOX 10843, Bev.Ihlls, TYPE OF CONSTRUCTION id NEW U ADD U ALTERATION• UREPAIR - ProjectAddress 2130 vanguard Way B-104 ❑ CONVERSION 0 DEMOLISH 0 OTHER • - Owner's Name r Nec>nrt Tending, ltd 'hone274-0951 DESCRIPTION OF WORK f' ' C.OIICZOIDLI7113ii1 / }•� D I ' (} .- ZONING REGULATIONS Ad • dress P (] Box 0241, nezerly Hills, CA 90?71 -•TYPEOF PERMIT A_I GRADING 6J FOUNDATION X1 STRUCTURAL A.P.#•1Iq- 15) -OLf1 ZONE �,� - • Arch/Eng. C1 ark r'i7 7r;e¢ TnGrLicense No. C-257Rtg•83-)J3 T-11481 _ g r ❑TENANT 0ELECTRICAL ❑'PLUMBING Ill PLNG. REF.9Y' BUILDING Address 11969 San' VirPnte B1 .14205, T, A 90049 - .;Q 'OTHER . ' •TO BUILDING /�y �I1 t'^' J cFTB/,CK rls ST �! r PROPERTY LINE �T cA 7 itREAR YARD (TO P/L) av' r/' LI(AC Contractor's Name Phone - :PROJECT DESCRIPTION SQ. FT.• 1J50 OCCUPANCY R-1 LEFT SIDE YARD �t .tom 5 RIGHT SIDE YARD �..�I. • G Address(mailing) CONSTRUCTION TYPE V - hr VALUATION$81 ,500 f h4 AA (A-lA ' ' ZONJ= • R-1 • GRADING CU.YDS. Glf-P ACRES PKG.SPACE REQ. d 5 PROVIDED '15 License Nd. lY LICENSED CONTRACTOR DECLARATION Remarks: Building B - Unit 104 / Type D STREET WIDTH . SDI - PARK FEE$ :'e • Thereby affirm that I am licensed under provisions of Charter 9(commencing , 4,1i'n ,rvY.y,�, with section 7000) of Division 3 of the Business and Professions Code,and : SPECIAL CONDITIONS:ROLD FOR SPECIAL REQULREMEN i',•%•; (,t1 l)II ( • my license is In full force and effect. , �.1.-�n � }� � �,�f ) ; License Class License No. . PLUMBING 5 l-l.lJ net he I YWtTh.t-Lll' unto aril' (11 rq/Yyl at m I Date • Signature SCC'"`'"'�� WORKERS'COMPENSATION DECLARATION - / Bar Sink , Sewer Cap • ELECTRICAL is( iso a I .i'IV'4, . a • ereby affirm that.Lhave a certificate of.consent to sett-Insure or a certificate . - Backflow Preventer - / Se Wer Connection '- - /. Automatic Washer- . IMeter ❑over.100 amps, - Workers' Compensation Insurance,.or a certified copy thereof (Section / �' .00, Lab. C.) 1 - - Construction Pole Sub Panel. Backflow Irrigation Solar Collectors Policy No. Company • - - _. Cooking Unit Sub Pole 6 Certified copy is hereby furnished. ' Bathtubs ' Solar Piping Certified copy IS filed with the city Building Division. , DishwasherII0-1 ■ _Date .Applicant - _, ■Clarifiers 1 ■ Solar Tank _ ■ EXEMPTION-FROM WORKERS'COMPENSATION DECLARATION Dishwasher Dryers AGei ❑Electric ■• ■ , (This section need not be completed if the permit Is for one hundred($100)or less). • .� Fan I certify-that in the performance of the work for which this permit is Issued I ' ' ' shall not employ any person in any manner so as to become subject to the F.A.U. ' • Workers' Compensation(Laws of California.' I .• • alba/ , / . IIitTLiY?o ,Pole Date Signature ' Fixtur¢s_ _ _ . Range._ NOTICE:if,after making this declaration, you should become'iubject to the ®Floor-Sinks �,�I a■ ■�� - - .. - Workers' Compensation Provisionsr.of the Labor Code, you-must emed,.forthwith -,�rghtaln�._■ -- comply with such ,provisions or.this hpermit shall be deemed, revoked; Gas Service utle �• Device IIISign CONSTRUCTION LENDING AGENCY _ �I • I hereby affirm that there is a construction lending agency for the pperformance• Interceptors �._ . �_■� • IIIStanding Sections 111. ; of the work for which this- permit is Issued (Section 3097' Civ. C. , Lenders Name_ 1 .; El®�ain_ar� III ras . LWNER Address E2,Lavatories` �� �_■in Garbage Disposal Ill _. OWNER DECLARATION I 'affirm that I am exempt Brom the Contractor's License Law for the- � - _■-Generator ❑0-5 KW ❑5-15 KW _ II. county ' following reason'(Section,'7031.5 Business and Professional;Code: Any city or ^�� county which priorrequiresto a permit to construct,alter Improve, t for or repair _. any structure, prior to Its Issuance, also requires the applicant for such permit., ■ 1 Kvy • to file a signed statement that he/she is licensed pursuant to the provisions of _ the Contractor's License Law(Chapter 9(Commencing with Section 7000)of ■ Reinspection Fee $15 1111 , islon 3 of the Business and Professions Code) or that he//she is exempt . . Reinspection Fee _',:1.5 b and the;basis for the allegedrm t subjectAny violation of Sectio1 _ •' El ' Meter eL PV LL up t1�100amps Issue Fee• ` $ 3 f,£'?'1.5 by.any applicant fora permit subjects the applies nt to a civil _ _ �,4Vialty of not more than five hundred dollars($500). ZoningApproved B La - - Date -� Li I,,as'owner of the property or'my employees with wages as their sole ' ,I, 1 compensation, will do the work,antl,the Structure is not intended or offered Application Approved By 4 - / L .t Date /�- -Q 7+ for sale (Section 7044, Business and Professional Code: The'Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does'such.work himself/herself or through his or her own Application Issued By ' Date employees, provided that such Improvements are not intended or offered for •Boiler 00-100,000: 0100,000 sale. If, however,the building or improvement is sold within one year of com- , SUMMARY OF FEES ole n,the owner will have the burden of proving he/she did not build or im- N • po ' • , ,7/ ve for the purpose of sale). BUILDING PERMIT $' 379' SMTP $ S as owner of the property,am exclusively contracting with'licensed con- tracto to.construct the project-(Section_7044,Business and Professions.Cotle: a 'PLAN CHECK' S' PERMIT ' The Contractor's License Law does not apply to an owner of property who a • ISSUANCE • $ • builds or improves thereon,and who contracts for such projects with a con- ■ Multiple ■ PLUMBING $, tractor(s)license pursuant to the Contractor's License Law): i 1 • - GRADING $ 0 1 am exempt under Section B. •.C or this reason :• -. PLAN CHECK' $ Date �111Wa Owner ��Ltr»ate 7sz ' • • ELECTRICAL $' _ - • * $ I hereby-certify that I have read this.application and'state• at the'above"'- Pt0-100,000 : ■ I I I s I : II- • • - -- - • III PLAN CHECK $ _ MICROFILM $ information is correct. I agree to comply with all city and county ordinances MECHANICAL $ TOTAL FEE $ and state laws rel. Ing to building construction,and hereby authorize repro- ys - ' sentatives of thl� lcity to enter .'on t•0 .bove-mentionotl prop rty for Hood or Type inspection ou :s - . �� Cann. T •e it ❑ Ill Fee $15 . PLAN CHECK $ ' LESS 1, Signature r�L J_ci ,,,a0.ey DateO/ /./.7 ADVANCED PC : $ Ori vers' License or SS yp � �_� - Mal. $ 3 . ' 1 S<341-' t I FINAL FEE $ CMF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting:Goldenrod-Assessor n '' CONSTRUCTION AND;PLANNING' " . • ' �. - '; .POOL `A - • , _ - _ Date Inspector - Date Inspector >- APPROVALS Permit 4/=' -' - : -APPROVALS: Permit•.# . I. Temporary Electrical Service or_Pole •52., Pool & Equipment Location • ,. . r' 2. 'Soil Pipe-Undrgrnd.' . - j ' - ' ' ^' - `forcement 53 Steel Reinforcement 3' Electrical Conduit Utility-Uridrgrnd. • '',, a 54. Forms - ' 4 4: Electrical Conduit-Undrgrnds, " 55. Electrical Bonding 5: Steel Reinforcement -_ ' : r. L _ . : 56.1 Rough Plumbing & Pressure Test - - 6: 'Electrical UFER Grnd. i • 57'.- APPROVAL_TO COVER-GUNITE - 7. Footings i , 1 .6 ' _ -58. Electrical Conduit-Undrarn=l. " 8. Foundation ,• ,'. 59. Gas Pipe,_E'Undrgrnd:,Test ' - 9. Water Pipe-Undrgrnd. ' , .`60. Backwash Lines,P-Trap, 0 Undrgrnd. • 10. Structural Floor System I `. - - • 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' •--- I - ` 65. Electrical-Final• - - -- - - •ir 15: Rough Electrical-Conduit -- - J ' - r l -- - '_C 7 - - 66.: Solar.1System-Final 1'- - • - , . t- : r16. Rough Electric Wiring, .. ' s1- ;;; i- - '67. Fencing it Access Approval - - -• 17. (Rough Wiring Sign •` -' I : c l 1 _ I 68.1 APPROVED FOR PLASTERING - . 7 f. 18. Rough:Electrical;T,B• ar,Ceiling; 1 _ ( 'I , ' 69.ZOOL/SPA SYSTEMS FINAL , • - 1l , 19. iRou`gK Heating & Air'Conditioning I' I i ' / FIRE DEPT:^REOUIREMENT I. - - ' 20: Rough Factory Fireplace • 1 r i 'APPROVALS `Permit# ,t T I 21. Ducts, in Structure ` • 1: ! 1 I �`r1 ` s � • I I 170.'Underground:Hydro 22. Ducts, Ventilating I I j i ( 71.7 Product Piping El ❑Oil . ,23. Gas Pipe-Rough & Test r j•_ •- I 2' Flush 24. Roof Framing- i -J ' I 73: Undergrnd.StorageTank 0 Gas 0 Oil - ' 25. Roof Sheathing, .'•,,,, i , ' .. { 74:*'Overhead'Hydro - -26. T-Bar Ceiling (Structural);& Montcoati j •I / 75";Dry Chemical - 27. Frame and Flashing . ' . Ii 76._ 7//-: Dry Standpipe - 1 ' 28. 'Lathing& Siding' , it n_{ 77. FIXED SYSTEM FINAL - 29. 'Insulation , ) I ' 1; , : / i , 78. FIREIPREV. FINAL 30:Drywall Nailing - ' 1 f "Notes: ; ' 31. Plaster Brown Coat 1' ' 1 , j ' - • - ' g 32. Electrical'Power Meter-Final ' , . I . - - i 33. Final Electric ' 34. Final Heating &!Air Conditioning - - :1 - - . 35. Final Gas Pipe-Test _ . ' l' 36. Hood or Canopy_ • - c ' I - • - - - - 37. Final Factory Fireplace ' '- ' , ' - -- 38. Final Plumbing - • - 39. Water Service-Final ' , r - 40. Gas Service-Final - • 41. Solar Domestic-Final r 1 42. Backflow Preventers - - _ • , - r - 43. Backflow Irrigation - ' - . : 0 - _ 44. Landscape Irrigation^System = .nt € , :1 •- . . r _ 45. Sound. Attenuation ; - , . . , - -- - , 46. Handicap Regulations ; •` - , . 47. FINAL STRUCTURE & BUILDING - - 48. Special Requirements Completed ,' ' 1 1- ' , , - - - - 49. Electric Releaseito Edison , . - - _ '_I _ _ _ 50. Gas Release to Southern California Gas Co I I $ , '. ' 51. CERTIFICATE OF OCCUPANCY ' _ I., : _1 -. _ . _ ,_ - _ ..., No I . . Date i 1 >• - - - - - - ---- . - - - -- - -- . -- - - a - • City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. O O1 U J 2 Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 2330 Vanguard Way II-104 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 Building COndatdSlitn Legal Description 419-151-06 (See reverse side for Metes and Bounds) Building Permit No G16835 Electrical Permit No. G16835 Plumbing Permit No. G16835 Mechanical Permit No. G16836 Number of apartmentsand/or guest •TO: Building Official 4�OA 7_ ! *112 i 1 Newport Landing Limited P O Boa 10843 by , , i3everly Hills, CA 90213r—/.3 Wig/g6 Date / ; This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015-46 rev. 1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - • VCIT'OF COSTA MESA - PERMIT NO. TRACT NO. LOT NO. BLDG.NO. 5680 s 754012 T, �COMSTRUCTION PERMIT' G (83 S //98/ l /3-/Qy l �I rojecttddress a A i 1 k it 1 — II TYPE OF CONSTRUCTION NEW 0 ADD ALTERATION U REPAIR Applicant's Mailing Address 3 a•. Ca.� ' - . 0 CONVERSION ❑ DEM• ISH 0 OTHER � q -. . 13 Ie) �' _- A.P.AP # /�/ ` �.J�'n�' , tone �_.� Owner's Name I 4�G4 II / I •• - -U • 'hone •.1 - 1 •w 3 -DESCRIPTION OF WORK �� S Main Building: Accessory Building: Z Address f'0' ROY 10343•, REUFRt-y HIUS, CA. cl l.Vl:'i It E ''T-' o 1 �s d �n CSS o f TYPE OF PERMIT GRA DING 1��t•1 FOUNDATION P•� STRUCTURAL T FrO lit aLl /P AP �ST / N to Arch/Eng. CLARK HE1JRtLK License No. q. 0 TENANT ® ELECTRICAL ICJ PLUMBING ® MECHANICAL B p / '—� I W Address 11969 'SRN VICFAiTF SL., L•Pt..••eir �7004q ❑ OTHER A Rear / / to 4e,c, EST .7P/ N ' I Contractor's Name PAUL TFTRiCK pr n /84O-67c9l PROJECT DESCRIPTION SO.Q. t5S3 OCCUPANCY R_31RQA) C Right "fire,c AP� -` - �G Address(mailing) )1R.5R LA &RANGE AUC-1 L.A. 9Dtk2S -CONSTRUCTION TYPE _Y."� N VALUATIONS $aiCT� K Left �y-- / r S p/114C-�PO' �' E R !� 1t 337118 ZONE GRADING CU.YDS. ACRES Pin Ref.# 7/-'- 5 -6 - Park.Fees $ `♦ 8 U Cit•y License No. 9 LICENSED CONTRACTOR DECLARATION Remarks: ..„pC 0/ _(�[ /1/ 2/ Parking Req./Provided -- .,e, I I hereby,affirm that I am licensed under Provisions of Charter 9 (commencing f 5 R with sectioh 7000) of Division 3 of the Business and Professions Code, and Use of Building: �.�5 comma - E my license-Is in ful force and effect. Licen'- Cie s C.— � i : N. _9_ 0 PLUMBING I FEES Planning Notes: _ _ M Date Ira Signature �� %/ r� •'E YORKERS'COMPENSATION DECLARATION/ /�/� / Bar Sink Showers • HOLD ffi91. orl;�:/;,t. 1wL��u.i�r:.�JT5 N hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer • Service Sink • ' - '$ of Workers' Compensation Insurance, or a certified copy thereof (Section - - 3800, Lab. C.) 71 b8-29 ' - ' Backflow Irrigation Sewer Cap - ELECTRICAL - FEES Policy No. Company STRTE MHP. T!5•FUND - • ' /" Certified copy is hereby furnished. ..- Bathtubs - Sewer Connection - Certified copy L5 filed with the city B DI i -� CD l Automatic Washer Transformer 0 15-50 KW Date Ili- 19— ?i1{ Applicant Clarifiers • Solar Collectors - Construction Pole Sub. -• ❑ 50+ KW -EXEMPTION FRO h,I1 WORKERS'COMPENSATION DECLARATIO • Dishwishe!- (This section need not be completed If the permit is for one hundred 100)or Solar Piping��r �0�(v JC' Cooking Unit i Meter Imp to 100 amps'-' , . ' • :„ OC.) less). -a - I certify that in the performance of the work for which this permit isissued, I Drinking Fountains • Solar Tank - 1 Dishwasher Meter Dover 100 amps I 'D6 shall not employ'any person in any manner so as to becomjsubject to the • Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa I Dryers 74Gas ❑Electric / Sub Panel 0 OC Date Signature — NOTICE:If,after making this declaration, you should become subject to the Floor Sinks j Urinal Fan. Motors❑a1 HP 01%-8 3 OC 'Workers' Compensation provisions of the Labor Code, you must forthwith- - - " - -' - - — _ comply 'with' such provisions or-this Permit' shall be deemed revoked. / Gas Service ...5- Outlets - • Water Closet - • .A.U. • Inc.Solar 0915 HP ❑1615+ CONSTRUCTION' LENDING -AGENCY - 1 CO.� 1 a- . I hereby affirm that there is a construction lending agency for the performance ' Interceptors Water Heater u� Fixtures - 'Microwave - p of work for syyvh��g�111I �gRyyyttt prr]it Is_issugq �$�{iqn 3097 Clv, C.) - C the's Name VJ tVt 41pHFV�ER• MOf7TC�/��sP �]. Kitchen Sink. • • Water Service - • eo Device Boxes ' ' Lender's 'Address 9'71q tM(A -Al 11 I A �F. h R S'1'Q' �t, 1 ." Pole Light ' OWNER BUILDER DECLARATION tQ NFJ STC GA.e} d� 3 Lavatories / �lf� �1$//NE g � Z2,Outiets - Range (,, 40 I hereby affirm'that I am exempt from the ontrac r s License Law or,[ e _ 7 following reason (Section 7031.5 Business and Professional Code: Any city or P-,Trap - • Z, Switches �' • county which requires a permit to construct,alter,improve,demolish or repair • — — / Sign C any structure, prior to its issuance, also requires the applicant for such permit Roof Drains - 1 Garbage •Disposal ' Standing Sections •I 'to file a'signedstatement that he/she is licensed pursuant to the provisions of . —_ - • - •- the Contractor's License Law(Chapter 9(commencing with Section 7000)of _ Division 3 of the Business and Professions Code) or that he/she is exempt _ ' ' • f -: Generator 00-5 KW❑5-15 KW Trash Compactor therefrom and the basis for the alleged exemption. Any violation of Section - - _ _ • 2 703115 by any-applicant for a- permit-subjects'the applicant'to a civil .. (ienalty of not more than five hundred tlullars($500). _ Reinspection Fee ' •I $25, Issue Fee $ 3 •ptT 1-t i'� OO LJ I,,as-owner of the property or, my employees with wages as their sole Reinspection Fee • $25 ' Issue Fee. $ 3 compensation will do the work,and the structure is not intended or offered • - • -MECHANICAL FEES - - _ for sale (Section •7044, Business and Professional Code: The Contractor's PUBLIC SERVICES REQUIREMENTS: License Law does not apply to an ownerof a property who builds or Improves Boiler • • - ' - Hood or Type I 0 1 thereon, and who does Such work himself/herself or through his or her Own - employees, provided that such improvements are not intended or offered for Canopy Type II 0 - .: Zoning Approved By fl1 C/6426 nate A sale. If, however, the building or improvement Is sold within one year of com- • Duct-Under Ground Application Approved By Date / T pletion, the owner will have the burden of proving he/she did not build or Im- prove for the purpose of sale). ' Dlict-Structural Refrigeration System - ' Application Issued By it•P' Date (-3-8 s LJ I, as owner of the property, am exclusively contracting with licensed con- DO-100 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: L- Duct-Ventilating • • - g • , .SUMMARY OF FEES • The Contractor's License Law-does-not apply to an owner of property who- - ' Q,-(7 �1 builds or improves thereon„antl who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration -- BUILDING PERMIT $ L't OO•D SMIP $ �`( / tractor(s) license pursuant to the Contractor,'s License Law). PLAN CHECK $ 2-�0•O0 PERMIT ❑i am exempt under Section ' B.S P.C.for this reason Firepl/Fact.Bit. ICBG#�b0 ' �1. PLUMBING $ : 38.0 • • 1 t 1 1 ' D ISSUANCE • $ Date Owner Heating System& Ducting ' PLAN CHECK $ - 3 75 ENERGY P.C. $ I hereby Certify that I have read thispplication and state that the above ' / IJ�0-1OO,000 BTU 0100,000 BT - - _. - 4 00 ELECTRICAL $ Rel.95° GRADING $ infOrmatien is-correct. I aatee•to comply with all cityand county'ordinances - and state laws rel g,to building construction,and hereby authorize repre- , I'^ MICROFILM $ sentatives of- icy to ter u on the above-mentioned 'property -for ' - PLAN CHECK $ • 1-a"CV /' inspection pu s. MECHANICAL $ 1�• • 7-1 t Z Signature • Date/%/_-Ler Reinspection Fee0O TOTAL FEE . $ �- • Drivers'.License or 5$ I ' P $25 Issue Fee S 3 PLAN CHECK $ y' ICMF086S-46 rev. 7/83 White-BuildIng;Canary-Applicant;Pink-Accounting;Goldenrod--Assessor - --- - - - - --- - -- - - _ . . . _ . _-. __ - ,/ C AJSTRUCTION AND PLANNING POt._& SPA so APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location -2. Soil Pipe-Undrgrnd. 5(/�153. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. -/ � 54. Forms , 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding it ' 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test• , ,.6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings !, 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test 1 i 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System ,'. 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 6/ji/yr Bj�.' 62. Backwash & Receptor-Final 12. Sewer Cap 1: / ,' - ` 63. Heater & Vent-Final 13. Roof Drains - 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final ' 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring I4ectr lecA 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning Id/./r85 Gib FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test _ 72. Underground Flush 24. Roof,Fiaming 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing q fre/ vL 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat (( 75. Dry Chemical 27. Frame and Flashing *ill (/L 76. Dry Standpipe l 28. Lathing& Siding 77. FIXED SYSTEM FINAL - 29. Insulation 11151f, 78. FIRE PREV. FINAL / Iitfr dc.71-.- .-30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat / 79. FINAL INSPECTION 32. Electri6 l Power Meter-Final 3/4 t, 80. FOOD CERTIFICATE ISSUED 33. Final'Electric is (D Notes:/a4 O„d ni,.r. -, _- 34. Final Heating& Air Conditioning .J_7_yy /7�C ' ' 35. Final Gas Pipe-Test //`4/ 4/, 36. Hood or Canopy . 37. Final Factory Fireplace 7-7-N ac 38. Final Plumbing _ 3-SI ,�i£ 39. Water Service-Final . 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation • 46. Handicap Regulations • { 47. FINAL STRUCTURE & BUILDIN'G 3 it II t /-- /`48. Special Requirements Completed {� v 49. Electric Release to Edison -- 50. Gas Release to Southern California Gas Co t. C /DDate IFA�E OF 0 PANC lr� No . :THIS 1110 CERTIFY THAT 1RSULATIOR WAS tall INSTALLED IN CODtO11UIMt WITH T4 CUD41R [NER[T NCDUTATIOIR, CALIFORNIA ACTIIRISIUTITE CODE. TITLE Et, Of CALIF NIA. I TM BUILDING LOCATED Alt 2330 VANGUARD WAY, COSTA MESA [3l 104 Street tot r Tract M. EIILRIOR BALLS Manufacturer MANVII I F TAI ctne,,/Typo R11 To II TAtet R11 CEILINGS Mitts: Menu MANVTI I F Ti'! R19 6'h" D R19 flews: N.nuf.ctur.r Thick,,.,, Me. Tees vt./E.t Sq. ft. Covered I Value FLOORS D.nuf.cturn MANVILLE Thickets./Type R11 3Y2" II Tele. R11 SIRE ON StADE M.nufacturer thic►:M,,/Type D Value Width of lnValetlee Inches fOONDAtl0I1 v*IL$ N.nufecturer TMckn,,./Type E Telae URINAL CONTRACTOR LICENSE NInES of TITLE DATE IM :UTICD�ODT Ion L.A. INSULATION CO. , INC.ucas( musts 430486 I, Z �� TITLE PPPS1fENT DATE 1/2R/9S I f: nhl An - -- -- -