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HomeMy WebLinkAbout2330 VANGUARD WAY - Building Permits CITY OF COSTA MESA BUILDING DIVISION :f g&, DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER �y� PERMIT B05-01618 tbsownsv (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.gtpLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2330 VANGUARD WY Status: ISSUED Suite: G101 Applied: 09/15/2005 Vicinity: Issued: 09/15/2005 Primary Occ: R-1 Hotels/Apts/Res>10 Occ Type of Construction: V-N Parcel Number: 93865171 Zoning: Applicant: MARK ZEBARTH Address: Phone: 714-390-3728 ISSUED BY: Zip: Owner: RODRIGUEZ, THERESA Address UNIT G-101 COSTA MESA,CA Phone: 2330 VANGUARD WAY Zip: 92626 Contractor ZEBARTH CONSTRUCTION Address: 9391 EL BLANCO AV Phone: FOUNTAIN VALLEY,CA Zip: 92708 License: 789101 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REPAIR DRYROTTED DECK POST FEE SUMMARY Plan Check: $0.00 Calc Valuation: $1,385.00 Permit: $50.95 Claim Valuation: $1,385.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 • Total: $51.45 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 • R R P NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(WOO) DECLARATIONS WORKERS'COMPENSATION DECLARATION: -- I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers/'compYonsatlPn Insurance carder eqd policy number are: 22 _ Carrier / /`N Weds!? Cord Policy Number: /2775 (This section need not be completed if the permit is valued at one hundred dollars($ Jar 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 agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with ihes proV - Applicant Signature: Date: 0 9 7 0 7 WARNING:FAILURE TO SECURE WORKERS' SATI COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDITION T E 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_u,G,der provisions of Chapter 9(commencing with Section 7 of Division 3 of the Business and Professions Code, nd my license Is in full/' �� pp force and effect.Lic.# 7I"/-/0 Class A s $ 6f �-y Contractors Signature: —1 /"..------ ' Date: (")9‘-45---0-5 l 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.). • ❑ 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. 0 Yes 0 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,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 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? 0 Yes 0 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). 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 Flre 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 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 agermll for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes Ul No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 "j1' -part of th facility tope constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No 1 ••-•'f1e facili�@$tust meeithp requirement of Sections 25534 and 42303 of the California Health and Safety Code). pat X=lt 7 If a pe. it from the South dost AirQesManagement Californiaal or other airpollution ioncontrol district3 agency Is required for the work which is the subject of this eppllch+'�n,heve'eA(ot the dii;closures prescribed by Califoia Health and Safety Code Section 42303 been made? 0 Yes 0 Na 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 a•• city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the abov.-descri•ed• -p'• �fo in�pec'• p .-es.I agree not to occupy or allow occupancy of any building authorized by this permit�-��until final inspection. c �� ` ./ u 7...... S'_ "ur. •f Legal Owner(s) / Date And/Or Authorized Applicant Date COOE a g1$PECnONTYPE DATE MALI CODE! INSPECTION TYPE PM ItilM tti A 1616 Fixed System Final Fire Prevention 206 Final Mechanical 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 RL/C-Dy - 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. 1 756 I/_C.' I • - i; i CONSTRUCTION PERMIT a -/03/4' 11431 r1 " 1 C, -RI)/ • • Applicant's Mailing Address_p•O. Box 10843, B/L}V.I-I111S9U113 TYPE OF CONSTRUCTION L. NEW LI ADD LI ALTERATION LI REPAIR Project Address 2330 Van ard Way lSr-iii ❑ CONVERSION ❑ DEMOLISH ❑ OTHER Owner's Name NPc YC Landing . Ltd. Phone 274-0953 DESCRIPTION OF WORK 9 0213 •e .;n a Ili YID F [ ZONING REGULATIONS Address • • :•`• ' $$ '' r -� TYPE OF PERMIT P: GRADING II FOUNDATION li STRUCTURAL A.P.• 24/-1 - 6)-01/2 ZONE fa3 ' Arch/Eng. C1 Ark & 1'- rie'k TnC:_ License No. C-2573 El TENANT CI ELECTRICAL CI PLUMBING ❑ MECHANICAL PLNG. REF.Vk 8 T g G Address 11969 Srmi-irnn"P 31 ',}205 L.A. 90049 ❑ OTHER R-1 TO BUILDING ^p'CA h'.4�REAR YARD(TO P/L) .L�B/ • �( PROJECT DESCRIPTION SQ, FT. 1170 OCCUPANCY PROPERTY LINE dO Ll (.1 Address (mailing) � '�-�l'2 Phone LEFT SIDE YARD 1161:) Gott RIGHT SIDE YARD .y/oI) i., ,.J^ Address(mailing) CONSTRUCTION TYPF V – 1 hr VALUATION$61,SOO Gott �� )sy 'r.l `)tCAIA License NO. ZONE R:3 ////����JJ GRADING CU.YDS. Site ACRFS PKG.SPACE REQ. �l G PROVIDED Q 5 �lll LICENSED CONTRACTOR DECLARATION Remarks: Buildup - Unit 101/`1yce B J STREET WIDTH c�0/ PARK FEE$ (e)is/ I hereby affirm that'I am licensed under provisions of Charter 9 (commencing HOLD with section 7000) of Division 3 of the Business and Professions Code, and j; SPECIAL CONDITIONS:HOLD FOR SPECIAL REQUIREMENTS my license Is In full force and effect. License Class License No- PLUMBING Date Signature werr2DSKERS'COMPENSATION DECLARATION Bar Sink $,_ � '• Cap ELECTflICAL g;",' oby affirm that I have a certificate of consent to self-Insure or a certificate Backflow Preventer ' Sewer Connection Automatic Washer Meter.❑over 100 amps - •, orkers' Compensation insurance, or a certified copy thereof (Section - 3i'Uo, Lab. C.) Backflow Irrigation SolarCollectors Construction Pole Sub Panel • • _ Policy No. ' Company - – - Cooking Unit Sub Pole BCertifiedcopyIs hereby furnished. • Bathtubs Solar Piping Certified copy Is filed with the city.Building Division. 'Dishwasher Motors ❑0-i HP ❑1K-B Date - Applicant ' Clarifiers Solar Tank EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Swimmin Po. a Dryers ❑Gas ❑Electric .Inc.Solar 09-15 HP 016-15+ (This section need not be completed if the permit is for one hundred ($100)or -_ 9less). 1 Fan Microwave I certify that in the performance of the work for which this permit is issued I Drinking Fountains Uri - shall not employ any person in any manner so as to become subject to the F.A.U. Pole Light Workers' Compensation Laws of California. r Floor Drains W C set i Date - Signature `, � Fixtures NOTICE:If,after making this declaration,you should become subject to the Floor Sinks - Wa r Heater T+'l Range • Workers' Compensation provisions of the Labor Code, you must forthwith t Device Boxes comply with such provisions or this permit shall be deemed revoked. Gas Service Outle \ %' 9 allSOrtS mice Sign ' CONSTRUCTION LENDING AGENCY ^—Outlets I hereby affirm that there is a construction lending agency for the erformance Interceptors 4 y.. D 1 Scantling Sections of the work for which,,this permit Is issued (Section 3097 Civ. C.) k .�,1y �/ $witches Trash' Lender's Name - - Kitchen Sink S y '' .,y.Y ICompactor Lender's Address - Lavatories I T G• ^Garbage Disposal • OWNER BUILDER DECLARATION I - y I herebyaffirmthat I am exempt from the Contractor's License Law for the _I i �L /\ Generator 00-5 KW 05-15 KW following reason (Section 7031.5 Business and Professional Code: Any city or P–Trap 161 . county which requires a permit,to construct,alter,improve,demolish or-repair 1! ,. • —�Transformer ❑15-50 KW any structure, prior to its Issuance, also requires te applicant for such permit Roof Drains N to file a signed statement that he/she Is licensed pursuant to the•provisions of L Contractor's License Law(Chapter 9(commencing with Section 7000)of O i' ❑5U+KW Reinspection Fee $15' s Sion 3 of the Business and Professions Code) or-that he/she is-exempt Showers Reinspection Fee $15 M ••efrom and the basis for the alleged exemption. Any violation of'Soctlon - Meter Duo to 100 amps issue Fee I $ 3 *7.5 by any applicant for a permit subjects the applicant to a civil s_ _ �p P1 Cenaity of not more than five hundred dollars($500). i Service Sink • Issue Fee i $ 3 Zoning Approved By Date /oZ./n (/�J I, as owner of'the property or my employees with wages•as their sole • /�� //. i j /moi' compensation will do the work,and the structure is not intended or offered , - MECHANICAL Application Approved ByVVR L G- o< Ate`' �.2-. �j for sale (Section 7044, Business and'Professional Code: The'Contractor's , App PP I Date • ./p ` License Law does not apply to an owner of a property who builds or Improves Boiler Refrigeration System Application Issued l/ ;•3 "tl 4•c thereon, and who does such work himself/herself or through his or her own . PP By / 'Date ' employees, provided that sucn Improvements are not intended or offered for ❑x100,000 BTU 0100,000 BTU sale- if, however,the building or improvement is sold within one year of com- Duct'-Under Ground • n, the owner will have the burden of proving he/she did not build or kr- * - SUMMARY OF FEES ' for the purpose of sale). Duct-Structural System Repair/Alteration 00• i$1' as owner of the property, am exclusively contracting with licensed con- BUILDING PERMIT $' 3 19� + SMIP $ 4� rs to construct the-project (Section 7044,Business and Professions Code: 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 0 Multiple❑ PLUMBING $ • tractor(s)license pursuant to the Contractor's License Law): I - - ' GRADING . $ ' . ❑ 1 am exempt under Section B.&P. for is Basan Firepl/Fact.BIL PLAN CHECK $ICBG# l /3 / • ' r� _ Heating SystemDucting ELECTRICAL $ $ Date l n owner _ w . _: ,,-a.:. �a . & MICROFILM $ • • I hereby certify that I have read th application and state that he above ❑x100,000 BTU-❑100,000 BTL - - - - PLAN CHECK $. information is correct. I agree to comply with all city and county ordinances TOTAL FEE1 $ and.state laws relating to building co str tion,and hereby authorize repro- MECHANICAL $ santalives of thl sty to enter upopn ' e Hood or bove-mentioned pro arty for Type I ❑ Reinspection Fee $15 LESS inspection p rp _ / �+ Canopy Type II 0 - PLAN CHECK $ Signature / / • Date ' ADVANCED PC $ ' Drivers' Lic n'se or SS 1 _ ' - Registers Issue Fee $ 3 FINAL FEE w $ ���`5'/ CMF 0865-46 rev,12/82 white-Building;Canar -Applicant;Pink-Accounting;Goldenrod -Assessor I=CONSTRUCTION-AND PLANNING: t-,.., 'an ;` 'r _ ''6 " ' ' POOL--- 'A •- - -_ Rate Inspector - - , • . Date Inspector - APPROVALS , Permit"*. ;r APPROVALS Permit •T 1:. Temporary Electrical Service or'Pole �] -? 'r" 52 Pool &Equipment Location. ' , - :; ca 21 6oil Pipe-Undrgrnd:.' S -- _ 53.. Steel Reinforcement _ _ 3; Electrical Conduit Utility-Undrgrnd., " - `- _54? Forms - " . , ' • • - -y4': Electrical Conduit-Undrgrnd' - � ' 55. Electrical Bonding - ._ 51 Steel Reinforcement) - - • 9: - 56._ Rough Plumbing & Pressure Test - - , 6. Electrical LIFER Grnd.l `' " ' ' -- ^ .-- - ' 57. APP.ROVAL'TO-COVER-GUNITE- ' • 7. Footings ' ' ' . ' ri,' - J' ' ".58. Electrical Conduit-Undrarnd. . 8. Foundation - - - -59. Gas Pipe,_d ,0 UndrgrnTest - 9. Water Pipe-Undrgrnd. .-,.E _ _ - r60. Backwash Lines,.P-Trap, ID Undrgrnd. 10. Structural Floor System t • . - - 61. APPROVAL TO DECK ' 11. Property Sewer Line& House Connection _ I 62. Backwash &:Receptor-Final:. ' - 12. Sewer Cap ' 63. Heater,& Vent-Final . 13. Roof Drains ' r , ,•64. Plumbing Final - • c 14. Rough Plumbing • • : - "65. Electrical-Final - ' Z. ,,15=Rough-Electrical:Conduit -- . - ---- T" '- ,- ' "66. Solar System-Final' ' - - '16. Rough Electric Wiring- h • 7".; -- -_ L. - _ "67. Fencing&Access Approval 17. Rough Wiiing,Sign ' ._ ' . I : ••;!'"7 t , ,' ` ; 68..APPROVED FOR.PLASTERING ' 1; 18. Rough-Electrical=T Bar.Ceiling ' I I i f I 69., POOUSPA SYSTEMS FINAL . • - - 19. Rough,Heating&'Air Conditioning - • ' , r' •fIRE•DEPT.REQUIREMENT C 20. Rough,, Factory Fireplace' II ; , � i APPROVALS Permit# . ' 'I 21. Ducts,in Structure 1 ' i I i I I . I _ I �70.. Undergroun. -• . ro• ' Cr 22. Ducts• , Ventilating " 1 • : I ' P 71.. Product Piping fp Gas 0 Oil 23. Gas Pie-Rou h&Test r ' P 9, i " ' ! I ! h72:-rl�ndeiground/Flush .-24. Roof Framing• ') I " -• I :, ''• 'r 9 t , - . �73:';Undergrnd.iStorage Tank 0 Gas El Oil r • 25. Roof Sheathing 'r • a ; 1 . I Yr I i�:_ - 74. Overhead1Hydro -26. T-Bar Ceiling (Structural).& Monccoat- I = al tI .- 5. Dry Chefnical , : 27. Frame and Flashing '' jI './r `e Y -:76.•Dry Standpipe ' - - d ' k 28. :Lathing &'Siding ,.r . - I I I f r' t 77. FIXED SYSTEM FINAL 29. Insulations_ - i j jt i I Z ' I ;;'I j78. FME PR,EV. FINAL '•r30. Drywall Nailing ^I I • ' ! ` I1 I 1 I `'. Notes • 31. Plaster Brown Coat I I II - • , l illi /1 s ; I ' I - - - - c 32; Electrical Power Meter-Final i it . ; i j i ' I , ' 33. Final Electric b ' Z. 34. Final Heating&Air,Conditioning; 35. Final Gas Pipe-Test. ' ' ! I - ! : '`% r . ; r . 36. Hood or CanoPV6 - , . , ' ' I ii i , i _ - ' , I 37. Final Factory Fireplace,-_ 1 - - , • 38. Final Plumbing - l •s.' , ' - '. ' 39. Water Se vice-FinalI tr 1 �; I 1 I ' 40. Gas Service-Final I , I I I I 1 I II I , � , I I : , 41. Solar Domestic-Final - _ • ;In 1 , r '�. _, _ _ • . 42. BackflovJ;IPreventer .- I 'c,, . _ I I ' -u v. I _ '�' ._. - - - I ._. - _ _ 43. Backflow Irri•gation = • '._• ,• ' I - '." 44. Landscape Irrigation-System /._._' ail I r- I . '. I �• • 45. Sound7Attenuation • - I - - ` 46. Handicap Regulations' I _: I'r1 ' I I I l I . 47. FINAL STRUCTURE& BUILDING ' I ' I• ' ' . - 48. Special`Requirements Completed I - 49. Electric Release to Edison j f- t ' l J : __. I I - ; 50. Gas Release to Southern California Gas Co , I ' 1 I I - 51. CERTIFICATEOF'OCCUPANCY I • I No. J II I I Date , I { , -I - -, • - - . ..I - . - - - City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. G L i J?1 Building Safety Division P.0.Box 1200 Costa Mesa,California The Building located at 2330 Vaixmard Way f—ini has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto fora Group R-1 Occupancy. Use of Building Condominium Legal Description 479-151-06 (See reverse side for Metes and Bounds) Building Permit No C161461 Electrical Permit No. G16861 Plumbing Permit No. 616861 Mechanical Permit No. r1 tt t 1 Number of apartments and/or guest rooms � l ISSUED TO: Building Official A'/ L Nramitt Tat-Winn T,imitpd P O Box 10843 by Y3nuc'rly Hi 11 R. CA 90213 4-1 `/ / 7,/ / /91/6 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 (e) 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. CITY OF COSTA VESA - PERMIT NO. TRACT NO. LOT NO. BLDG.NO. 5612 I /L 4/B0. J 1 2pQ I `I, CONSTRUCTION UCTION PER691T G ( (,�(� /.y�� /a / . PrOjept Address a3�1 _____nuar__. ui TYPE OF CONSTRUCTION INNEW�I--11❑ ADD ALTERATION U REPAIR - 7� - - _ Applicant's Mailing Address P..©. 130x 1049,1; A : BILLS 0 CONVERSION 0 DEMek1-1 0OOTHE LC, A.P.# // 47 -/57 - 0-C - ' Zone p "-_j Owner's Name r, �n " 3L7 tY33 DESCRIPTION OF WORK OA.)((fftaCe r _• I IVI r-t,/RT t-AA I I SI .Phone " j /33c? C�s ��n S Main Building: - Accessory Building: 1 Z' Address P.O. 6DX loop, REueRLy HILL% rA Da i3 E / % _ O CZ I 11 I'�r�f�t 1C--.C2,4 1I TYPE OF PERMIT Li GRADING IN FOUNDATION STRUCTURAL T Front // T qP ie,T�TVc ,N ) 'Arch/Eng. C LARK - IYI�`tIPI CK License NO. C-. 7 0 TENANT ® ELECTRICAL Y� PLUMBING ® MECHANICAL B Rear �J`n�A Y/7 N ,Address /1%9 (S��AN UtCCILJT'E ®U.IO., L �Q 4.9 0 OTHER • p�� A '+ / �/ _G S ,Contractor's Neme YI-IUL T�Rt '(...k PhoFd Ck+7D-'6��91 PROJECT DESCRIPTION SQ.?FT Ij�R OCCUPANCY-RW K RightZ9 L R Address(mailing/ i REPa LA' GRAnicre F.y.L[A.9rx1s C O N ST RUCTI ON TYPE /-tJ VALUATION$ /6.Soa. s Left /6 '•7 n Pµre 75//vJc • --7 E �, ZONE - GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ Z Q • City License No. 33r�7R 9 �y—�� / e .�� LICENSED CONTRACTOR DECLARATION U Remarks �� S0� _8�/� Parking Req./Provided Z— �.� 1. I hereby affirm that I am licensed under provisions of Charter (commencing f DQ jR with section 7000) of Division 3 of the Business and Professi eons Code, and Use of Building: gee; �7nA/!l6 ..E my license is in ful force and effect. ' , Licen a Class u 1 s • PLUMBING I FEES Planning'Notes: •M Date r Signature N ' WORKERS'COMPENSATION DECLARATION' ' —Bar Sink Showers HOLD con pr.Lr. "'� ,T I hereby affirm that I have a certificate of consent to self-insure or a certificate `J" vl ss! IILt(UIISL.�IClY tJ , of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preyenter_ • Service Sink. - S 3800, Lab. C.) ) 1 p Q (1�t,•TC n� •�-sv C Backflow Irrigation Sewer Cap - r- ELECTRICAL FEES:'r' Policy No. 56'713R-21f Company c11L1'G �IJMP 11tD.fU -J i Certified copy is hereby furnished. /f - �„ Bathtubs Sewer:Connection Lk to / Automatic Washer Transformer ❑ 15-50 KW / CO j[y Cerj fiey 4ppy1s(lied with the city ng D siyn./ • - - 0 50+KW l Date 11T PI Tea LL1 Applicant O(� alb �e'^�/�J�s Clarifiers ' ' - Solar,Collectors , Construction Pale Sub. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION/ (This section need not be completed If the permit is for one hundred ($100)or' / Dishwasher- `. ' / $Olaf Piping,eDOG// ONGyi S . Cooking Unit r t. Meter Iup to 100 amps - S. less). i. - I certify that in the performance of the work fsLwhlch this permit Is Issued, I ' Drinking Fountains Solar Tank -1 ' a : Dishwasher Meter Dover 100 amps -I I Op shall not employ,any person In any manner so as to become-subject to the Compensation Compensation Laws of California. Floor Drains Swimming Pool w/Spa ,I% Dryers AGas ❑Electric ` Sub Panel _ • (c)00 Date Signature 4 - NOTICE:If,after making this declaration,you should become subject to the - Floor Sinks Urinal • y Fan Motors 00-1 HP ❑1 X-B Workers' Compensation provisions of the Labor Code, you must forthwith00 ' •• -- I - J7 comply with such provisions or this permit shall be,deemed revoked. / Gas Service Outlets np Water CONSTRUCTION LENDING AGENCY, - aas/• Closet _ F.A.U. Inc.Solar 09-15 HP 016.15+ I. dO I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater; 19 Fixtures ' of the work for yyp(c is permit is Issued (Sect{gp 30 7 v. C.) /- `ZOO 3 Microwave 2(po Lender's Name l/tJry eR� ECS,STuK (ICI A(tF 1L�E f -0• / Kitchen Sink / Water Service - ' 00 _Device Boxes Pole Light -r� •• Lender's Address z}-J'!et A.ICALa,,A�I��UsILLACiF STP so Lavatories • OWNER BUILDER DECLARATION cj' eRANE , cif , 0' , . . - / (,t/AM 11109C-X/n/o - b CO 2cOutlets • Range DO ' I hereby affirm that I am exempt from the Contractor's License Law'fo"r-the p-Tra following reason (Section 7031.5 Business and Professional Code: Any city or p ' • • 19 Switches Sign 2j 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 or-repair — Drains pie - , Garbage Disposal • Standing Sections ( 00 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 - I - - • Division 3 of the Business and Professions Code) or that he/she is exempt Generator ❑0-5 KW ❑5-15 KW Trash Compactor 7031.51.5om anti the basiscfor the alleged txsmAey inofa Section y ,I �Y�_ Z ena t any applicant for a permit subjects the applicant to a civil Reinspection Fee- $ 3 VbOn.� enalty of not more than five hundred dollars($500). Pe $25 I Issue Fee,. 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 ' L. ' '' MECHANICAL - FEES - for sale (Section 7044, Business and' Professional Code: The Contractor's ----- -- __ - -- - - -- _a----� REQUIREMENTS: License Law does not apply to an owner of a property,who builds or ImprovesPUBLIC SERVICES thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 ' w /�j employees, provided that such Improvements are not intended or offered for Canopy' Type II ❑ - Zoning Approved By Ph / Date / ( L{� sale. If, however, the building or improvement is sold within one year of com- ' Duct-Under Ground '_ Application Approved By Date u!////�s- pletlon, the owner will.have the burden of proving he/she did not build or im- , �q� grove for the purpose of sale). Duct-Structural ' / Refrigeration System I 4- M Application Issued By ` "1- " Date SY A� U I,as owner of the property,am exclusively contracting with licensed con- Rp1I0-100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating �4 The-Contractor's License Law does not apply to an owner of property who 2' '4 CQ SUMMARY..11OF FEES bulids or Improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ Y•CO SMIP • ! $ S' tractor(s) license pursuant to-the Contractor's License Law). . - - PLAN CHECK $ 23(. �o PERMIT ❑ i am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG#�j01 LI cc PLUMBING • $ 30.06 ISSUANCE $ Date Owner 1 Heating System& Ducting • PLAN CHECK $ - In•7 cc ENERGY P.C. $ I hereby certify that I have read this application and state that the above I go-loo 000 BTU 0100,000 BTU information is correct. I agree to comply with all city and county ordinances . - - -y--00 1 ELECTRICAL $ : 1-1'.`-(O GRADING $ and state laws resat to building construction, and hereby authorize repre- PLAN CHECK /5. 7n . MICROFILM $ sentatives of t u y to ter on the above-mentioned property 'for , $ . Inspection purp /,C/{� /� Signature t/ • Oate� • MECHANICAL $ I-11111-00 TOTAL FEE • $ 1(6 .�/ • Drivers' License or SS - Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ '-t-00 'CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - . CONSTRUCTION AND PLANNING POOL&SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector ' 1..Temporary Electrical Service or Pole_ 52. Pool & Equipment Location a • 2. Soil Pipe-Undrgrnd. 400r Qj.,�J� 53. Steel Reinforcement -. 3. Electrical Conduit Utility-Undrgrnd. : Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. TY F COSTA MESA CONSTRUCTION PERMIT PERMI�fdO. TRACT NO. LOT NO. UNIT NO. • 233o VAN(�UAttb 6L7ptj ri � � l3LO . G 6458 12/26/55 if b6 TL Project Address /t�� r t 9 SW. N -a�1vle !,4 .S t.i b Ma-S TYPE OF CONSTRUCTION U NEW LI ADD U ALTERATION U REPAIR Applicant's Mailing Address t �2.WtOC LANt710-b L-Th o e S7o-&7L; CI CONVERSION ❑ DEMOLISH CI OTHER _ _ A p # I Zone Owner's Nam�je DESCRIPTION OF WORK/USE OF BLDG. Address -1 SI5 CA)(1.SN t're IA (a£u,4-ixL 1_5 S Main Building: Accessory Building: C-1-4."Y 4-EDrii CI< Arch/Eng. License No. �} TYPE OF PERMIT U GRADING U FOUNDATION CI STRUCTURAL E Front o Address I I SS's 5p�1 Ct/incer iC e 1,4 . W LA QOO24C ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B _ N �,Q.L.. .F4Z ELF-�1'j'-/Lj C ho _Cr ❑ !OTHER A Rear I Contractor's Namp hone I � pROJEC7 DESCRIPTION SQ. F7. DCCUPANCv Address(mailing) 954 C Right N N. AIrvIEla.q CONSTRUCTION TYPE VALUATION$ K Left G D S City License No. 3 ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: �V Is E r _ Planning Notes: Q with section 7000) of Division 3 of the Business and Professions Code, and IM. M Lc license is in full force and effect.fect. it SOIS2p S T License Class('fie ] License No NZ Date I2,-2 ^ .> Signature its- G4_(=� PLUMBING FEES A,. WORKERS'COMPENSATION DECLAR ION / r I hereby affirm that I have a certificate of consent to self-Insure or a certificate Bar Sink Showers ELECTRICAL FEES \ .f Workers' Compensation Insurance, or a certified copy thereof (Section i — Backflow Preventer Service Sink Automatic Washer Transformer ❑ 15.50 KW - ( 3800, Lab. CC..) O " IC4R.S YCG Di ti P Construction Pole Sub. \ Policy No. Company Backflow Irrigation Sewer Ca 0 50+KW Certified copy is hereby furnished. _ /� Certifiedcopy is filled with the city Buil•'ng Divisi• . ' Bathtubs Sewer Connection L Cooking Unit I Meter pp to 100 amps 5 W Data__-- Applicant alvni.—_ar - EXEMPTION FROM WORKERS'COMPENS• ION D'CLARATION • Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the per It is for one hundred($100) ,r less). Dishwasher Solar Piping Dryers OGas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is Issue• I - shall not employ any person in any manner so as to become subject to he Drinking Fountains Solar Tank • Fan Motors 00-1 HP 01%-8 Workers' ompe n Laws of Califor - Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ 'NOTICE: f,a er making this declaration, yo houltl b me subject to the — Workers' Compensation provisions of the La r Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. - Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance - Pole Light ' of the work for uIe utlS= �m t is issued � -0n 3097 Civ. C.) )(r Lender's Name e �r 0aW6P- Interceptors Water Heater Outlets Range Lender's Address 9"J 9 U LJCOLN V tt-La6'E Dot. Ststrit I ENT0 Kitchen Sink Water Service - Switches - OWNER BUILDER DECLARATION CAL Si n I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash GarbageDisposal following reason (Section 7031.5 Business and Professional Code: Any city or - P ;Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator ❑0-5 KW ❑5-15 KW any structure, prior to Its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains 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 ' 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 LIpenalty of not more than five hundred dollars($500). •I _ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered - Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's • MECHANICAL 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 ❑ Zoning Approved By Date pletlon, the owner will have tho burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date prove for the purpose of sale). 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By W Dat /) 2 S tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 0o-100,000 BTU 0100,000 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). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ ' proof oftheir Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO# Fire Dampers PLUMBING $ • PERMIT ISSUANCE $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ 't I • ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑0.100,000 BTU ID 100,000 BTL - W7.R !_t� GRADING $- information Is correct: I agree to comply with all city and county ordinances ELECTRICAL $ i and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ c2.S• MICROFILM $ / sentatives of this city tO,enter upon e above-mentioned property for inspection purposes. Cr----- /� Drivers'Signature /ZL al Date MECHANICAL $ TOTAL FEE $ /, ^ License or SS - � / Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ • �S \ CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor - CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector • 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrnd. • 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE • 7. Footings . - • 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System j 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 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 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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32..Electrical Power Meter-Final //iris R/ ) 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' 1�v 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. Backf low 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