HomeMy WebLinkAbout2330 VANGUARD WAY - Building Permits (E101) Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
I PEgT II PER IT NO. TRACT NO. LOT NO. UNIT NO.
CIT OF COSTA MESA CONSTRUCTION PERMIT ) ��o� • 6W F
Prdjent Address230 V/A)NIe1'OAn--Dn I.)p(� A_� � 11 I r'
Applicant's Mailing Address "IST N t�MEL(q .J�1/sJ pj M4g TYPE OF CONSTRUCTION Li NEW DI ADD U ALTERATION LI REPAIR 6457 12�1�6�9.1 i4` r
1 I„ fsgi ❑ CONVERSION ❑ DEMOLISH 0 OTHER A.P.# Zone
Owner's Name N�W�CT Ala fid' Phone 0970—ra�(Z.I
n 1 ', e n
DESCRIPTION OF WORK/USE OF BLDG.
Address �i S45 (.x.12 LS�'l('/`�' 71 W! ' BEA/, al LL$ S Main Building: Accessory Building:
C!J>°V -' lJsOruclGE Z
Arch/Eng. ��--,^�-- 11 ` 1 License No. (� TYPE OF PERMIT LI GRADING ❑ FOUNDATION ❑ STRUCTURAL RAL T Front' 0
Address IISSB Wv tv lie -P et_ Li LAJ?, 70049 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N
Contractor's Name lLJ&! 1CR_R 2" t G Tet ‘C PhSnt 414 -'3558 ❑ 'OTHER I
NrC Right N
PROJECT DESCRIPTION SO. FT. OCCUPANCY
Address(mailing) (Ng Ana au Sena M1�5 K G
3400 i 1�/ CONSTRUCTION TYPE VALUATION$ S Left
City License No: ZONE GRADING CU.YDS. ACRES _ E
LICENSED CONTRACTOR DECLARATION Q
1 n Ping. Ref.# Parking Req./Provided
I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: s..t/tvt . AC s Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code, and 1 ,v CA* rrw•v T
my license is in full force and effect. S
LicenseClass .-1 0 —tic nse No.ifseta + PLUMBING FEES
DateK12-7L-85 Signature 7.� pl/�-�
WORKERS' COMPENSATION DECLARA�N ✓ Bar Sink Showers
'ereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL FEES
Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - ,
•
so�p�r� �1 Automatic Washer Transformer 0 15-50 KW
PoCt licy No. V b I III (Z Company I fill CAn Backflow Irrigation Sewer Cop . 0 50+ KW
f 9 Construction Pole Sub.
I
Certified copy is hereby furnished. •
-
�, �tCertified copy's filed with the city tiding Divis' �` Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date 17 -26^85 KE Applicant PENw Dip
EXEMPTION FROM WORKERS'COMPENS ON DELL RATION Clarifiers Solar Collectors Dishwasher ' Meter Dipver 100 amps 7 01
(This section need not be completed if the per is for one hundred ($100)or
less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank — Fan Motors❑0-1 HP 011/2-8
Workers' Compensation Laws of California. -
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09.15 HP 016-15+
'NOTICE:If,after making this declaration, you should become subject to the
Workers' Compensation provisions.of the Labor Code, you must forthwith Floor Sinks - Urinal Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light
I hereby affirm that there is a construction lending agency for the performance g
of the work fiat which j is ernyiL ys issued 0( a ,qn, 9097 Civ. C.) Interceptors Water Heater _ Outlets Range
Lender's Name rto, (\I Sl��- YI4. %Ka EQo-•� �
Lender's Address `7 7 9 / /A CAA) Let LL66Lc On $ICSL.AAM EARO Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION CAL
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Disposal Garbage
following reason (Section 7031.5 Business and Professional Code: Any city or 9Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P—Trap LaundryTray5
any structure, prior to its issuance, also requires the applicant for such permit y Generator ❑0-5 KW❑5-15 KW Trash Compactor
to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains f
the Contractor's License Law(Chapter 9(commencing with Section 7000)of
^ivision 3 of the Business and Professions Code) or that he/she is exempt •
irefrom and the basis for the alleged exemption. Any violation of Section '
31.5 by any applicant for a permit subjects the applicant to a civil -
enalty of not more than five hundred dollars ($500).
bI, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL 1 FEES
License Law does not apply to an owner of a property who builds or improves _ _ _
thereon, and who does such work himself/herself or through his or her own - - - - - DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I 0
•sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II IDZoning Approved By nate
',lotion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By DatO�/�}�/�\
Prove as ownerthe of purpose property,osale). �//- "' —
❑ t rof thet roject exclusively7044, sinesscontracting with licensedioncon- Duct-Structural Refrigeration System Application Issued By Date
etors tactorso the project (Sectionto
Business and of t Code:
The Contractor's License Law does not apply to an owner je property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con- '
tractor(s) license pursuant to the Contractor's License Law). am aware that BUILDING PERMIT $ SMIP $
Exhaust System ❑ Multiple❑ System Repair/Alteration
proof oftheir Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
❑ I am exempt under Section B.& P.C.for this reason' Firepl/Fact.Bit. ICBG# ---I Fire Dampers• PLUMBING $ ISSUANCE $
Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above. • 00.100,000 BTU 0100,000 BT ELECTRICAL $ /L/•� GRADING $
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction,and hereby authorize repre-
sentatives of this city to ter,upon the above-mentioned property for PLAN CHECK 50% $
inspection purpos=-.
Signature Lau I ..--� Date LL-216^5 MECHANICAL $ TOTAL FEE $
Drivers' License or 5 - Reinspection Fee I $15 •
Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
.CONSTRUCTION AND PLANNING POO' SPA
Date Inspector Date Inspector
l • APPROVALS Permit# APPROVALS Permit#
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
Electrical Conduit Utility-Undrgrnd.. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5..Steel Reinforcement. - 56. Rough Plumbing& Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, E Undrgrnd.,Test
9. ,Water Pipe-Undrgrnd. 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 Drains - 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final •-
15. Rough Electrical-Conduit 66. Solar System-Final
16., Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL •
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
. 21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping ❑Gas ❑Oil
.23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation . 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final // /ft 80. FOOD CERTIFICATE ISSUED
33.-Final Electric '/Ll Notes:
34. Final Heating &Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace •
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer ,
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation -
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
La
'., Applicant to fill in alt spaces except those within heavy border lines and sign all appropriate declarations.• ,
CITYA MESA - `} - ` PERMIT NO. TRACT NO. LOT N ). BLDG.NO. 5-'93 /j h/ i i a-
.•CONSTRU•iTION PERMIT C I(ata, L� j` J.L.gB/ / •�-to i
Project Address til ' • L a C - • I TYPE OF CONSTRUCTION IN NEW ❑ ADD ❑ ALTERATION ❑ REPAIR
Applicant's Mailing Address It 13• ••. •• ,aJ�Cq a . a 0 CONVERSION 0 DEM9Ji5);i �❑OOTHER LC• {_/ _ .r
'� . Tl E' . -01 T• DESCRIPTION OF WORK
LfJ/VJ(/ A,P.SW �f9 - / J/ -O6 IZone J� J
, Owner's Name 4. Et*3 ' L (%1t •h n
_ • A S Main Building: Accessory Building: Z
Address e•i, 0 I i GI U r • _ : • L-. E ! tr.
/� N/2�� r 6' O
9 TYPE OF PERMIT NI GRADINGFAFOUNDATION `.i STRUCTURALL T Front / ,J ,, N
Arch/Eng: CLARK - HF.DRIeK License No. C-SC144 0 TENANT 1, ELECTRICAL tot PLUMBING ® MECHANICAL B �t [ I
j_ (� S9.1\1
�� `'1�. p Rear // /TCI -N
tC` Address IL -1GQ 4�SaKSylt F�1 E Pit.1 L. vn01.�9 ❑BOTHER A
' Contractor's Name t"AI]I TFT RICK Ph ne3 Jinn ‘10-0 l PROJECT DESC'IPTION SQ. FT. 1;118 OCCUPANC/Y R I — K Right •� /7PA/„�•S.T G
CONSTRUC ION TYPE v - . VALUATION$ 76i coo S Left T }}-- - R
Address(mailing) Il��B LA GRANCTE AVE. � S T nPnre'S 5/h_ E
I ZONE GRADING CU.YDS, 'ACRES -�- L O
City License No. F 3387 / ' / Ping. Ref.# �' �� 6 g Park.Fees $ ,� 9 r 3 U
M ' LICENSED CONTRACTOR DECLARATION Remarks: #' 5 c0� ey Parking Req./Provided z — ad I
I hereby affirm that I am licensed under provisions of Charter 9(commencing f !/^ _, / R
with -
section 7000) of Division 3 of the Business and Professions Code, and Use of Building: c%•✓ _72, _E
my license is in full force and effect.
License Class ' - N• J 1.1.it •- • PLUMBING - FEES Planning-Notes: M
Date TX Signature f . Iiir &�7�— r( E
WORKERS'COMPENSATION DECLARATION Bar Sink Showers T FNTh N
_ n onr�t s+ pF nl 7D77 -Q'
hereby affirm that i nave a certificate of consent to self-insure or a certificateHULA tun us a...•:-.. •- -I•- T
f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink $
•
3800, Lab. C.) • Backflow Irrigation Sewer'Cap - . i• ELECTRICAL FEES
Policy No. 561)38-2,4 Company STPrTFCf�HPZTS.FlfrN •
Certified fcopy is hereby furnished, /J j'�/y) ' p2 Bathtubs Sewer,Connection' - L(- 3 Automatic Washer Transformer 0 75-50 KW •
( DO
Cer I led 1J� y i f with the city ng D i "
Date_1 14'' $ —Applicant I6I//�V s Clarifiers Solar Collectors Q 50+KW
EXEMPTION FROM WORKERS'COMPENSATION DECLA RATI Construction Pole Sub. ,
Thissection need not be completed if thepermit Is for one hundred Dishwasher J Solar Pi in
( P ($100)or - p g,�Ud6N est,/ rj co Cooking Unit - -'r Meter Sup to 100 amps - .5
less). - - '
I certify that in the performance of the. for which this permit is issued,I Drinking Fountains Solar Tank . / Dishwasher Meter Dover 100 amps
shall not employ any person in•any manner so as to become subject to the -- - -
Workers' Compensation Laws of California. ••, • Floor Drains' Swimming Pool w/Spa / Dryers ❑Gas ❑ElectricSub Panel
Date Signature — — / s
NOTICE: if,after making this declaration, you should become subject to the Floor Sinks . Urinal l Fan ( Motors 00-1 HP ❑1'/z-s 3�jO
Workers' Compensation provisions of the Labor Code, you must forthwith -
comply with- such provisions or this permit shall be deemed revoked. Gas Service Outlets Water Closet F.A.U.CONSTRUCTION such.
AGENCY - / 6 �, Inc.Solar❑9.15 HP ❑16-15+ ( Q�
I hereby affirm that there is a construction lending agency for the performance interceptors Water Heater /3 Fixtures //
of the work fo it sue 3 C" C.) 2, Z N�
,,,ylrh 5,� 5 r�,.,,gy��Q' O� Microwave
Lender's Name -LIC^P 1 FY 61 1s E Kitchen Sink - / Water Service �.•�� Device Boxes
Lender's Address 171 UMW-3W'(,��,j, 1)I LJ YaC F. nR 1e 2,ori / - - �pnDs3 Pole Light
OWNER BUILDER DECLARATION 5 CRtRHER.iTO (-ll ..adX�' Lavatories - / a&J454/ /�9cy/NE b CX1 zcOutlets Range S 1•
I hereby affirm that I am exempt from the Contractor's License Law for the
following reason (Section 7031,5 Business and Professional Code: Any city or - P-Trap /9 Switches Sign ; SO
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 Roof Drains - +- Garbage Disposal • , Standing Sections ) OD
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 ••
' 7i vision 3.of the Business and Professions code) or that he/she is exempt - - • -
- Generator 065 KW 05.15 KW Trash Compactor
- -ierefrom and the basis for the alleged exemption. Any violation of Section
1i,4031.5 by any applicant for a permit subjects the applicant,to a civil -
• penalty of not more than five hundred dollars($500). Reinspection Fee I $25 .. Issue Fee -$ 3 /� z 0
•
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 owner of a property who'builds or improves Boiler . Hood or Type I 0 •
thereon, and who does such work himself/herself or through his or her own Zoning Approved By Date
employees, provided that such Improvements are not Intended or offered for Canopy Type II ❑
sale. If, however, the Winding or improvement is sold within one year of com- ' Duct-Under Ground I Application Approved By Date
l
pletion, the owner will have the burden of proving he/she did not build or im- - - •
prove for the purpose of sale). Duct-Structural Refrigeration Systern ' ,Application Issued By Date
LJ I, as owner of the property, am exclusively contracting with licensed con- ❑x100,000 BTU 0100,000 BTU
tractors to construct the project (Section 7044,Business and Professions Code: y Duct-VentilatingSUMMARY OF FEES
The Contractor's License Law does not apply to an owner of property who - - ��// �
builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT ' $ 3(v� •� SMIP $ S ✓`P
tractor(s) license pursuant to the Contractor's License Law). - '' II PLAN CHECK $ • Z2�• PO PERMIT
❑'1 am exempt under Section B.& P.C.for this reason j Firepl/Fact.Bit. ICBG#230 I T PLUMBING $ 30.00 ISSUANCE $
Date Owner. • Heating System& Ducting PLAN CHECK $ S ENERGY P.C. $
I hereby certify that I have read this application and state that the above 1 0O-100,000 BTU 0100,000 BTL U� 3'4-yp -.DING $ — -
Information is correct. l'agreeto comply with all city and county ordinances' '- - 1 L`Q ELECTRICAL - $ •/p - y,•i
and state laws relating to building construction, and hereby authorize repre- - - /5 70....:5; -• „j7OFl LM $
sentatives of�h"sJ Ity to nter o the above-mentioned ,property for • PLAN CHECK - /�` -1.
Inspection p�qy��ss.cc MECHANICAL $ I Soo --f�'O':'f
Signature R"I/�O Date//ffH2� TOTAL FEE r-�'
Reinspection Fee $25 IMAM Fee $ 3 PLAN CHECK $ 7'Oh Drivers' License or 55 59° ' _ - r
CMF 0865-46 rev.-7/83 White-Building:Canary-Applicant;Pink-Accounting;-Goldenrod -Assessor - -- - -• - _ "�•---- -`l`I" -
�. , y a"
'F'• '1V f i
CONSTRUCTION AND PLANNING POO. .SPA
e.• . •APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1.-Te• mporary Electrical Service or Pole 52. Pool & Equipment Location
/IP *2. Soil Pipe-Undrgrnd. •7/45/9fe. 53. Steel Reinforcement •
3. Electrical Conduit Utility-Undrgrnd. . '/„' 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding /
5. Steel Reinforcement /37er IA- 56. Rough Plumbing & Pressure Test
6. Electrical UFER,Grnd. ' -- 57. APPROVAL TO COVER-GUNITE
7. Footings‘
.3/911c
l 11ci - 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test ,
' 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 t/r�t/yf^ // 62. Backwash & Receptor-Final r-
1-401'12. Sewer Cap 63. Heater & Vent-Final' •,
s
13. Roof Drains i • 64. Plumbing System - Final
14. Fiotigh Plumbing 65. Electrical-Final . /
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring ' l,fr/�L P� 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 crAdAr- e-reAp FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough &-Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil '
25. Roof Sheathing 7,49/&r(/c 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
I• 27. Frame and Flashing
/0/W85 da..- 76. Dry Standpipe
28. Latfiirig &Siding - 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PR EV. FINAL
lD�d1fs+�r/v
30. Drywall Nailing /0//Q/fl vt-- HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION .
32. Electrical Power Meter-Final V 06 ' 80. FOOD CERTIFICATE ISSUED
33. Final'Electric C( ,•lf'v Notes:94-0s- &'4977(E v,ECyr Uig.tie)
34. Final Heating & Air Conditioning j//z/sE �/�f€' Al-a:4-6.41-04.
2/r
35. Final Gas Pipe-Test /etv
36. Hood or Canopy
37. Final Factory Fireplace //42--./f ,J"
38. Final Plumbing //iv,/ /!49( i
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
L
44. .Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations . t
ti
47. FINAL STRUCTURE & BUILDING �3 i g tic___ + I ^
t sQ+�'!� a. .;
48. Special Requirements Completed /6, 9O n _ - '--
49. Electric Release to Edison -�`/'/-� - t.,': I i
h 50. Gas Release to Southern California Gas Co p 1.J ,
o1. CERTIFICA/T .O ( 7b � -�(16�'-• N
1 -. ; ....-
No,
i
No -3-5
5ifDate
.1.
City of Costa Mesa
Development Services Department CERTIFICATE OF OCCUPANCY No. 0 r-
Building Safety Division V 0 V s�
P.O.Box 1200
Costa Mesa,California
The Building located at 211A Vanrntnrrl taco r-lf)1
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group_ n-1 Occupancy.
Use of Building rrynrlryninirTm
Legal Description 41Q-1 cl-AA
ISee reverse side for Metes and Bounds)
Building Permit No r_lconc Electrical Permit No. r•iconc Plumbing Permit No. r sconc
Mechanical Permit No. 816845 Number of apartments ��and/or uest rooms
ISSUED TO: Building Official /r
Newport Landing Limited
' P O Boat 10843 by
Beverly Hills, CA 90213 9- ,/ ,/ L /99
• Date y �.' (o
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 le) U.B.C.
CMF I015.46 rev. 1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File
t\ •
Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. _
CITY OF COSTA MESA • PERMIT NO. TRACT NO. LOT NO. -BLDG. NO., •
'
CONSTRUCTION PERMIT 9aN.3 /O� 2 r //4/6/ E L�I/
• ' . a, 3 ,. -R[.. rter/r
Applicant'sppMailing Address -- A TYPE OF CONSTRUCTION NEW ❑ ADD LJ ALTERATION �REPAI R
ProjeCf'Address -- - • :• Gca • J ❑ CONVERSION ❑ DEMOLISH ❑ OTHER 17uL r
•
413) DESCRIPTION OF WORK cON�OM/N/UM TYPE B I/I 4•
Owners Name & _ . ' •: :• s'• 6- • 'hone 1tr-lrn53
p - 11qq ��l r1��// J ZONING REGULATIONS
Address P0.ao ioR4.3 8F))�121..� NILLS qo,-i3 TYPE OF PERMIT Z.GRADING IS FOUNDATION LEI STRUCTURAL A.P.nye A- i57—i S7_O y/ ZONE .P,5 •
Arch/Eng.C/-ARK T- 4aDK14� xf`IG• License No. C-A612° .,.+-f-•
g ! ❑ TENANT . ELECTRICAL ..PLUMBING - ,MECHANICAL PLNG.REF.ys UILDING /M�
lin? S �IceNr� B�. las AJ I.&S 40049 ❑OTHER 78 63—IID. T I148�FT .sT
Address r TO BUILDING '^I/O II C3 l+'.J.. R YARD(TO P/L) a '
°' PROJECT DESCRIPTION $ 1/90 PROPERTY LINE / J L! 1•1F-
Contfaetof'sName rT s-'¢�� PhoneOCCUPANCY �-'�
,i CONSTRUCTION TYPF FT. NK VALUATION$ G $CO 0O LEFT SIDE YARD a�l bi / HT SIDE YARD 32) G' bid
Address(mailing) ZONE /e'..5 GRADING CU.YDS. S/TE ACRFc PKG.SPACE REQ. Q 5 � . J PROVIDED '1 5J
c� License No. /� N V N
LICENSED CONTRACTOR DECLARATION Remarks: 8i i)c E _ CIN/T /0 yryp/_ &, STREET WIDTH 80 / PARK FEE$ 88/.5/ •
I hereby affirm that I am licensed under provisions of Charter 9(commencing ��` l.` ,L,��,�
with section 7000) of Division 3 of the Business and Professions Code,and SPECIAL CONDITIONS: HOLD FOR SPECIAL RF`11ljpt.srr•a• (t.f ][7/! I)f'l X77
my license Is in full force and effect. kms ,,,I him-tin/It
,, ,,.,- !Wont,
License Class- - - License No.' PLUMBING O µ,u YUJt h I 1 L-ti /It I I n A A ) pr-r 7i n ra ,i-i-Igyt a
Date Signature Bar Sink Sewer Cap ELECTRICAL-W(11-
i- WORKERS'COMPENSATION DECLARATION / _ _ `imp l�J prIWiC 1//
(•'
I hereby affirm that I have a certificate of consent to self-insure or a certificate Automatic Washer Meter Dover 100 amps
of Workers' Compensation Insurance,'or a certified copy thereof (Section Backflow Preventer $ewer Connection - -
Construction Pole Sub Panel
3800, Lab. C.) Backflow Irrigation Solar_Collectors • / -
Policy No. Company - - - - / Cooking Unit Sub Pole
8 Certified copy Is hereby furnished. Bathtubs _ Solar Piping •
Certified copy is flied with the city Building Division. r
__ Clarifiers Solar Tank / Dishwasher / Motors P40-1 HP 01%43Date Applicant __ Iv1
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishw�sher Swimming Pool w/Spa / Dryers plias ❑Electric Inc.Solar ❑9-15 HP 076-15+
(This section need not be completed if the permit Is for one hundred($100)or /
Iecertify that in the performance of the work for which this permit Is Issued, I Drinking Fountains Urinal ,(� Fan Microwave
shall'not employ any person In any manner so as to become subjectto the ' - F.A.U. s Pole Light „�', • '
workers' Compensation Laws of California.' • •
Floor Drains . ? Water Ooset . - / n' •
-
Date Signature fs Fixtures
NOTICE:It,after making-this declaration.you should become subject to the - ^- Floor Sinks / - Water Heater - / Range - • -
Workers': Compensation provisions of the Labor Code, you must-forthwith • Device Boxes i
comply with) such provisions. or this'Permit .shall be-deemed! revoked. ' -6 Gas Service' ' J Outlets a/ / Water Service • 1 • , Sign
CONSTRUCTION'LENDING AGENCY Outlets
I hereby affirm that there Is a construction lending agency for the performance Interceptors '�7 Standing Sections
of the work for Which this. permit is Issued (Section '.3097' Civ. C.) : Switches Trash Com
Lender's Name ' _ ' -/ Kitchen:Sink - , pastor
OWNer'sER Address • . Lavatories (?�, -0• f Garbage Disposal I
OWNER BUILDER DECLARATION s.-'
I hereby affirm that I am exempt from the Contractor's-License Law for the p_Tre �• �� �*•� Generator El 0-5 KW ❑$-15 KW
following reason-(Section 7031.5 Business and Professional Code: Any city or P, - , 1
county which requires a permit to construct,alter,improve,demolish or repair , _ 1.,1� - - Transformer ❑75-50 KW • '
any structure, prior to Its Issuance, also requires the applicant for such permit' - Roof Drains- -y (�J", '
' to file a signed statement that he/she is licensed pursuant to the provisions of050+KW 1
{:jhe Contractor's License Law(Chapter 9(commencing with Section 7000)of ' U i''' Reinspection Fee $15
-4,9ivision 3 of the Business and Professions Code) or that he/she Is exempt • Showers - Reins ee $15
nerefrom and the basis for the alleged exemption.Any violation of.Section •1 '` Cls" - / Meter Aup to 100 amps Issue Fee -$ 3
7031.5 by any applicant for a permit subjects.the'applicant to a civil l� . .
penaltyof not more than five hundred dollars $500 ' Service Sink l slue Fee $ 3 — 1
l )- , 1 Zoning Approved By nne- �U • /_ Date /- a- A
I, as owner of the:property or my employees•with wages'as their sole ••// / �C '
compensation will do the work,and the structure Is not intended or offered ' .. - e-( -.ME.CITANICAL • Application Approved By U���� h• lEr� Date /.2.—. /7�$3
for sale (Section 7044, Business and Professional Code: Thel Contractor'sL:/ / ( '/d
License Law does not apply to an owner of a property who builds or Improves • Boiler �� Refrigeration System ! A ) '�/ ��: p .-&
thereon, and who:does such work himself/herself or through his or her own , Application Issued BY ///CCC Date
employees, provided that such'Improvements are not Intended or offered for , ❑0-100,000 BTU ❑100,000 BTU '
sale. I however, the building or improvement is sold within one year of com- , Duct-Under Ground SUMMARY OF FEES
Pie on, the owner will have the burden of proving he/she did not build or im- , I • 1 '
ve for the purpose of sale). ' Duct-Structural System Repair/Alteration i�. •..4....SI*
/ as owner of the property,am exclusively contracting.with licensed con- - BUILDING PERMIT $ .31 9 SMTP $ 4
V rectors to construct the project(Section 7044,-Business and.Professions Code:. 4/ Duct--Ventilating PLAN CHECK $ PERMIT
The Contractor's License Law does not apply to an owner of property who ISSUANCE $ , •
builds or Improves thereon,and who contracts for such projects with a con- ' . Exhaust System ❑ Multiple O. PLUMBING $ ,
tractor(s) license pursuant to the Contractor's License Law): •
- PLAN CHECK $ GRADING $
❑ i am exempt under Section i, B.& P .fo this reason _ / Firepl/Fact.Blt.ICBO iW $ i
'Date 4Wt-.171S Owner' v%!'7L!p i,,,- I Heating System& Ducting j • ELECTRICAL $ ,
•
I-hereby c-rtify at I have react is application-and state that he above _'� NO-100,000 BTU❑100,0008TL— - ' ' - .PLAN CHECK i $ 1 MICROFILM $ 1
information is correct. I agree to comply with all city and county ordinances - TOTAL FEE• $ f
and state laws rola ng.to building constr ction,and hereby authorize repre- �xfd1 - MECHANICAL $ • •
sentatives of':thi city'to enter upon he -Dove-mentioned pro arty for Hood or Type I P
/ - Reinspection Fee $15 LESS
/Inspection our, , J DeOOpY Type II ❑ PLAN CHECK $ � ADVANCED PC $
Signature I/" �L Date
L.,,,,,
Registers Issue Fee $ 3 �s z
Drivers' License or SS 9p 7 FINAL FEE' $ �•L✓
CMF 0865-46 rev.12/82 white-Building;Cana y-Applicant;Pink-Accounting;Goldenrod-Assessor
9 „CONSTRUCTION"ANDIPLANNING7 9 �: c I UI ' - ;c :` c { :^POOL SPA • ' . •
c 1 ` , .Date': : �1 nspector -` - . Date Inspector
,•:=APPROVALS r: Permit# - . • - ;APPROVALS _ Permit
. • to ri S ,-
'". 1- Temporary Electrical Servicaor.Pole t+: :r- ' F. _ '.52.;Pool & Equipment;Location '
0 21 Soil Pipe-Undrgrnd. - - ? ' 53 Steel Reinforcement _ _ • - . -
3:' Electrical Conduit Utility-Undrgrnd I 1T.S .-- ?-`." " 54z Forms''.(-_ • _ " • - - -
`4 4: Electrical Conduit-Undrgrnd: _ ' ' i ,. -' r 55?Electrical Bonding • - • -
' ' m , - a ITr Fy'sb ,- _ - -
5: Steel'Reinforce'ment ! i .; -- M f :' ;.16...."Rough Plumbing-& Pressure Test
r lt
6' Elect!ical OF ER Grnd.' 1 '= j • ).7.- _- 57 APPROVAL-TO-COVER-GUNITE . .. ..
7. Footings , ! ' ' a .. j' P I .58� Electrical-Conduit-Undrornd-.
' 8. Foundation ' , I . o s l'.' '59. Gas Pipe,.❑ Undrgrnd.,Test
9. Water Pipe-Unargmd. " ' . F- -," ' 60. Backwash Lines,0-Trap, U Undrgrnd. " •
.
10. Structural Floor System , ." ., 'ZT 61. APPROVAL TO;DECK _
11. Propeity.Sewer Line& House Connection ; - g , : '162. Backwash:&'Receptor-Final: '
12. Sewe!' Cap , ' I j P' I --c' -' I S:63. Heaater'&Vent- ..Finaln _ ..
W, , .^ • - -
13.- Roof,Drains _
- 64. Plumbing System- Final _
a 14...Rough Plumbing I I - ' u` '-O : • 1 65. Electrical-Final - - - "
t_
,15? Rdugh'Electrical:Conduit`(-- r -- -1 - ••T -T' 1 -i--I- 66.,SolarSystem-Final -- • .- . - -- -
•
.116. Rough'Elediric Wiring, : j F I l _; gr. : I i-•';i,'_ .'-67.1 Fencing&Access Approval'- - �, -" „ - ' - -
'r17. Rough WiringSigni • I , : I =+' I ^ i t :' 'I i 68.1 APPROVED FOR PLASTERING -
18. Rough.Electrical,T'Bar Ceiling i i , 1' - i , • i': ' f. I 69 . POOVSPASYSTEMS FINAL
19. Rough Heating& Air Conditioning j I 1• o i I I I ' I I - FIRE DEPT REQUIREMENT
s 20. Rough:Factory Fireplaces I I I I I 11 1 APPROVALS,rf Permit# - •..
1 '1 I I ' . t t 1 c� -, .
21. Ducs,'in Structure._ I I I I gvy
90. Under ound H `d o
t22r butts, Ventilatin I i c f ' d iI I i • i I I I71-.';
j`'
r ,� g 1 I � 71'.;Prod�,ct Piping ❑Gas ❑Oil ; , I • -
!1'!23. Gas Pipe Rough&Test "-..i I � r' .• ( i -72.1 Und round h Flus _ " -;1'24. Roof Framing° 1 n I I I I I • i c' I ,T'„ Iv I )I r,�: 73., Uudergrnd:Storage Tank O Gas toil
2.5_. Roof.Sheathing ! -A j ' ,i_ I . r 1 I t I .21 74. 00vefhead Hydro i : ' '
26. ;T-Bar Ceiling (Structural)',& Monocoat° I j n 1 . ft I ! I 5.i D Chemical I r. '1/
',27.-Frame and Flashing' j ' 1 I , 76'Dry Standpipe .';
I ;
28. (Lathing & Siding I r :11 I I 1 1 ,_
I { 1 1 "j ! 72;' FIXED SYSTEMAFINAL ,
I- d a
29. Insulation - ' S ' n I , ' ;I I I I I I 1/478. FIRE PREM. FINAL
'30. ,Drywall Nailing I > . ! 1 • 1: II 1 1 ! i I 1 (Notes:;` ! . I ,: ,
X031. Plaster Brown Coat • ; I -I I-- _ .j_ _i _, ..I • _,___._.� _ '
5 ,-32. EIectrical'Power MeterFinal ' 11 _ 1 1 I I I I ' ; l
33. Final Electric - 1_- J
_ . _ !-. _ I, -r_ w . _ 1_. ,. _ . I :._"4 .. !.. 1 ! _ . . -
34. Final Heating&IAic Conditioning 1 ,` - 1 i , ,.f 'I ,, I I _ .
35. Final Gas Pipe-Test '- It 1 "2' '• - - -2 I•• .
36. Hood or Canopy:' 1' i !'
i. •
37. Final Factory Flreplace. i t_ 1 ; II ` 1 J 1 •
•r -
38. Final Plumbing I i ! �! '1 1 I I 1 I I ! 1 ! .
39. Water Service-Final' I I.-: '' I l I I I 1 I I ' '- c • . .
40. Gas Service-Final. i " • 1 ! ; I
L I I ! , IrI I ! I I I I '
41. Solar D'o'mestic-Final ( I I'-.' ---1 �-i -_ __ , -- _ I-r- i- ! _.-_ I- .,-i- -
42. Backflow Preveriter: I ' ` ' '
I ".n ', ' I `- • t '
ni
43. Backflow Irrigation [-It.• 1 � -' i'�'• I^I I ' _
44. Lands ape irr4.igation'-S tem I -1 r. • -- i c ' ; j - ! I ! I .
45. Sound -Attenuation '. 1' 1711 1' ii'I I , _ ' I • I _' •, -
46. Handicap Re •
guiations: I I - 1 I 1 , I x 1 I I I 1 -
47. FINAL STRUCTURE& BUILDING : I. , ! �2 -•I ' I I I I I • '
48. Special Requirements Completer! ri I I I I I ' -
49. Electric Releasejto Edison I I _ ' ; _ __i _-' _. _- . .
50. Gas Release to Southern California Gas Co ! '
•51. CERTIFICATEIOF:OCCUPANCY 'I ! H . _
. I , t--� __1-.4---t I ' t ,
'1
No '1 1 Date i ii 1 i ' I : • :