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HomeMy WebLinkAbout150 VALLEY FORGE RD - Building Permits CITY OF COSTA MESA • • - o • A.F BUILDING DIVISION F asl 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us to, OPila . FOR INSPECTIONS CALL:(714)754.5626 !'''°"°4 PERMIT NUMBER: BC10-00246 PERMIT TYPE: B_COMBO STATUS: APPROVED Sub Type: POOLSPA DATE ISSUED: ISSUED BY: BE JOB ADDRESS: 150 VALLEY FORGE RD CM Suite/Unit: APN: TPN98078 Zoning: , , Vicinity: Primary Occ: Const Type: SQ. FT: 0 Valuation: $13,000.00 SCOPE OF WORK: REMODEL OF AN EXISTING IN-GROUND GUNITE SPA TO MAKE IT DEEPER.WORK TO INCLUDE NEW PLUMBING,NEW PUMPS,NEW FILTER. OWNER: MONTICELLO COMMUNITY ASSOC. Address: 150 VALLEY FORGE Unit: Phone: 714-355-7132 City/State/Zip: COSTA MESA,CA APPLICANT: DONALD TRIESCH Address: 6285 E SPRING ST Unit: :UNIT 410 Phone: 562-4214136 City/State/zZip: LONG BEACH,CA CONTRACTOR: PELICAN POOL AND SPA SERVICE License No. 842623 Phone: 562-421-4136 Address: 6285 E SPRING STUnit: UNIT 410 Cell: City/State: LONG BEACH,CA ZipCode 90808 ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: COMBINATION PERMIT FEE SUMMARY Building Plan Check: $145.11 Building Fees: $223.25 Electrical Fees: $73.00 Mechanical Fees: $0.00 Plumbing Fees: $84.25 SMIP Residential: $1.30 SMIP Commercial: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES: $527.91 ''Refer to fee receipts for all fees paid for project HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibited all hours-Sundays and the following Federal holidays: New Years Day,Memorial Day,Independence Day,Labor Day,Thanksgiving Day and Christmas Day NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. CODE P. INSPECTION TYPE, DATE INTmAL$ CODEX INSPECTION TYP$ DpaE IN¶TIAL$ 1616 I Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 7~140 6Z 208 Final Plumbing 'Fal rce-Noor _ 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 I WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. 0 Yes 0 No I hereby/ affirm under penalty of perjury one of the following declarations: Drivers License No. Expires: I7K1 have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 0 I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code, for the ged ance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My yn e s' comprnsaf Insurance carrier and policy ❑ I hereby certify that no excavation Me(5)or more feet in depth into which a number are: /, / person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding.falsework,a demolition Cartier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This mann need no,be sample 0g2-. o the permit is valuer'al one hundred doaars(31(10)ar kiss) 2,An 2,Sec.341,Title 8,California Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued.I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' ompensation provisions of Section 3700 of Applicants Signature Date the Labor Code,I hall fo t omply with these provisions. /wr��� G,-/7_/J Division of Industrial Safety Permit Number: of Apdi it's signature Da1e HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No (3100,000), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST.AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds.or a volume of 55 gallons.or 200 Cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code,and 2. Does or will the applicant or present or future building occupant need to file my license is�inn full force �and effect. a registration form for acutely hazardous materials? ❑Yes ElNo O Lic.# o 'T Z 6 22 Class# C S 3 (Section 25533 of the California Health and Safety Code, with some / exceptions, requires registration with the Costa Mesa Fire Department by �^� '/7'/V each business which at any one time has on hand a quantity of acutely rano(ssgnature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency-for the 3. Does or will the applicant or present or future building occupant need to performance of the work fa which this permit is issued.(Sec.3097,Civil Code), prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: '• hazardous materials)? ElYes ❑No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: ' Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No 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 (Sectionmln 65850.2 of the onCnlifornia Govemment Code requiresbuilding thnt thee requested License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished applications fa non-residential permits). Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If yes the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the properly, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder wilt have the burden of proving that he or she CERTfF(CATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a cattractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that El I am exempt under sec. the information given is correct. I agree to comply with.all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: 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' spection. gn e ?al r s)— Date Signature Date /-/72,4] 3057-46(3/07) And/44 Au honed Applicant r Date 410 MF CITY OF COSTA MESA 4 BUILDING DIVISION >:j ,1 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER F 1 at i PERMIT J IPA se 1P02-00028 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 • . PLUMBING PERMIT Job Address: 150 VALLEY FORGE RD Status: ISSUED Suite No Applied: 01/09/2002 Issued: 01/09/2002 Vicinity: CLUBHOUSE Parcel Nunmber: TPN98078 - - - ISSUED BY: 1 - Applicant: VELASCO, JULIO - - , ,-' Address: 526 S ROSS ST. . „7G ` Phone:_ 714-550-9185 / SANTA ANA,CA A.`-- - Zip: 92701- - / - -, -'i - - - - Owner: MONTICELLO.COMMUNITYASSOC. ` ,- Address 150 VALLEY.FORGE , - - / ,, / Phone: \�.y v. , COSTA MESA,CA Zip: 92626 ' v'v Contractor: VELASCO CONSTRUCTIONAND.DEVELOPMENT - , Address: 526 S ROSS ST _ - ' - Phone: 714-550-9185 _ ` �.� ' SANTA ANA' Zip: 92701 „ ' _ .i- License: 596135 . / Arch / Eng: " . . ._. - ., _ , Address: - Phone: v,' ' Zip: . _ , ' . _ License: . / - . . - SCOPE OF PERMIT •• REF:B02-00040.REMODEL CLUBHOUSE RESTROOMS.PLUMBING TO INCLUDE:CHANGE OUT 2 WASH BASINS,2 TOILETS, 1 URINAL,REMOVE TWO TOILETS AND CAP SEWER. , ' • " REVISED 3/20/02: RELOCATE 1 ADDITIONAL LAV AND 1.ADDITIONAL URINAL. /j% '. 9 FEE SUMMARY AMT OTY' AMT Q AMT TY 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 $19.60 2 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 $29.40 3 Dishwasher $0.00 0 - Sewer Cap for Demo, . . $19.60 2 - , 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) $19.60 2 Drain,Roof $0.00 0 Shower - - $0.00 0 Water Heater/vent $0.00 0 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: $111.70 NOTICE: The work authorized by this permit slGO� 16 alarcA #i 'UOMS 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)754-5628 2446-48(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: ilperpraffinn 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'compensation Insurance carrier and policy number are: Carrier: I Policy Number: (This section need not be completed ll the pe ' Is valued et one hundred dollars($100)or less.) ❑ I certify that in the ormance of the rk forwhich this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws California,end re 1 If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with t ase pr s. .1"17siguetDre: Ale....-0s, te- - 20-E)Z 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 COILARE(5100,000),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 provis on of apter 9(commencing with Section 7000)of Division 3 of the Busingsvnd Professions Code,and my license is In full once and effect.L;c— -� __ do - ;-41 rless.A-ts 470 ntractors.Signature: � 1 f0 o [tate:? .-S-LO-O2- 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 penally 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 properly,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 em exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Drivers 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(38)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: I 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 Fire Department by each business which at any one time hes 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). building nag..___ _ _ 3 0DoesYes will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? 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 al the applicant or present or future building occupant require for the work which is the subject of this application aPpermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residentlal building permits). 6 Will any part of the facility tri-be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 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 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 penally 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. nature OLLagew{mer(s) Data P!/ p / 'LES - 02, And1OrAuthorized ApplicantalE.YrDate_ -- - CODE I P45PEC110N TYPE PATE Pi. CODE( INSPECTIONTYPE PAIS ROIEIAL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing _. ,,f'_!C -a 2ar - 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 CITY OF COSTA MESA Fe) BUILDING DIVISION Fe DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT B02-00040 44.4•0Rmso di* (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesaBUI.ca.us NO PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 i Job Address: 150 VALLEY FORGE RD • ' - , ' Status: ISSUED Suite: Applied: 01/09/2002 Vicinity: CLUB HOUSE Issued: 01/09/2002 Parcel Number: TPN98078, Zoning: , Applicant: VELASCO,JULIO -- -. ISSUED BY: Address: 526 S ROSS ST - . "- _ "-Phone: 714-550-9185 - SANTA ANA- - Zip:, 92701 Owner MONTICELLO COMMUNITY ASSOC / ' Address /150 VALLEY FORGE - ; ' -" /N�,,',� �, -/ " "COSTA MESA,CA Zip: 92626 N'� �•� Contractor NVELASCO CONSTRUCTION AND DEVELOPMENT ,\� Address:, 526 S ROSSST N' >,,,V / ' ' Phone:- 714-550-9185 N ; SANTAANA \� Zip:-- '92701 ' License* 56135 596135 - .. Arch. t ` r �� Eng Address - t c "Phone:- - 'Zip: - - / License: - License: SCOPE OF PERMIT-- -_ •' UPGRADE INTERIOR OF EXIST:BATHROOMS TO COMPLY WITH 1998 ACCESSIBILITY REQUIEMENTS. FEE SUMMARY Plan Check: $287.46 ' ' " • , Calc Valuation: , $30,000.00 Permit $442.25 -/ T Claim Valuation: / - $30,000.00 f : DECLARATIONS 2 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 w for which this permit is issued. . h and will maintain workers'compensation insur ce,as required by section 3700 of.the Labor Code,for the performance of the work for which this permit is issued. wor e s'compensall n Insurance carrier and o>c umber are: , Carrier Policy Number: is ection need not be comple d if the permit i valued at one hundred dollars($100)or less.) - I certify that in the performance of th. ork for which this permit is iss I shall not employ any person in any manner sc as to become subject to the workers' compensation law • Calif°i la,en tree that if I shquld b=w s :ct to the workers'compensation provisions of Section 37 of the Labor Code,I shall forthwith comply with these p ^ / l /1 O `pplicant Sig t ,� . :ct _a Date: fl�I• WARNING:FAILURE TO SECUR. • . r'y-ENS' ION r.• -••GE• L r S ' 1 SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000), ' ADDITION To THE MAT OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS ,DEC1• -ATION: I hereby affirm that I am licensed 1 .er provisi.. s o :•t''(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic. a as Class# d Contractors Signa r:V i wl IP .0 Date: I- 9 .• Q 's. 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 mote 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,An 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: I 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 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 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 Califomia 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 appermit 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 0 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? 0 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 all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑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: 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. Weza7referie(s) I to :ArtrV Date? CODE C INSPECTION TYPE PETE !EMU CODE INSPECTION TYPE PATE Its • 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 SlocklRetaining Walt 212 Final Fire Prevention 202 Final Factory Fire Place-, . . . 220, Final Planning Approval , , 203 Final Sign _ 222 Final Site 204 Final Demolition, .. .. . . - - . p 250. Final Building/Occupancy _ 0 14/0 2— Bi/r p51' f CITY OF COSTA MESA bl� BUILDING DIVISION • ,,,,, �.�i arresis DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER Ft PERMIT IPPNI 602-01613 444•ro 't (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.UILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 150 VALLEY FORGE RD Status: ISSUED Suite: Applied: 10/03/2002 • Vicinity: CLUB HOUSE Issued: 10/03/2002 Parcel Number: TPN98078 Zoning: • Applicant: BLANKS, JERRY ISSUED BY: Address: Phone: 714-573-0155 Zip: Owner: MONTICELLO COMMUNITY ASSOC. Address 150 VALLEY FORGE Phone: COSTA MESA,CA Zip: 92626 , Contractor PREMIER ROOFING AND BUILDING CO INC • t )� ' Address: 17501 NORWOOD PARK PL - 4 ' �'1( ' #4 Phone: (714)573-0155 j TUSTIN,CA - � '- f Zip: 92780 ' - License: 634404 Arch : Eng: • Address: Address: Phone: • • Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING AND COVER WITH BUILT UP ROOFING.CLUB HOUSE FOR CONDOMINIUM COMPLEX. 'FEE SUMMARY Plan Check: $0.00 •Calc Valuation: 54,400.00 • Permit: $111.25 Claim Valuation: $4,400.00 SMIP Res: $0.50 - • SMIP Com: - $0.00 - — - - Other: $0.00 ' Inspection: $0.00 • • Total: • $111.75 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front ,0-0 - - Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front. 0-0 1`'Rear , 0-0. Left 0-0 Right 0-0 PARKING Existing: ' 0 - Required: 0 Proposed: 0 NOTES: • . • 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(6110) ls 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 wo or which this permit is issued. ave 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, y workers'compensation Insurance carrier end policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performanc• of the work for which this •? it Is Issued,I shall not employ any person in any manner so as o become subject to the workers' compensation laws of Califon a,and agrees= sho ecome subject to the workers'compensation provisions of Sectio 3700f the Labor Code,I shall forthwith comply w__—_se pron•. 0. /..--- rJ ri <�plicaal Signature:- = ' Date: I O -WARNING:FAILURE TO SECU- ' ORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(WA...0 N ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARAT ON: I hereby affirm that I am licensed under•rovislons of Chap' • (co , :-cing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# , /�/ is — Class# c 9Coo ct rs Signature:._ ���Sr.�i�_ Date: CONSTRUCTION LENDING Ac NCY: ❑ 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',civit penalty of not more than five hundred dollars($500).): b ❑ I,as owner of theorpropertrty,f 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 Cale: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 orlier 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,.therowner,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 end 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. `1 Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Drivers 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 Safely,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). IS 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑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 Califomia 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 Califomia Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require far the work which is the subject of this application ap_ermit for such construction or modification Irom the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 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? 0 Yes ❑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 all of the disclosures prescribed by Califomia Health and Safety Code 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: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• operty for inspection purposes ?agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. iry Of 7 ' LY,-- nd/OrAu horized Applicant -- , 3i D ate • CODE INSPECTION TYPE GATE llnELS SODEI INSPECTION TYPE GATE HUM 1618 Fixed System Final Fire Prevention 206 Final Mechanical 1268 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 L 204 Final Demolition 250 Final Building/Occupancy /, S-07 b/ kJ ,tj r 0501 MFS,p CITY OF COSTA MESA I ).4a BUILDING DIVISION F r """� ' DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT / E00-00099 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 150 VALLEY FORGE RD Status: ISSUED Suite No Applied: 02/08/2000 • Vicinity: Issued: 02/08/2000 Parcel Nunmber: TPN98078 �)�///� Applicant: LEWIS HINES ISSUED BY: �'i ./ r r Address: 1547 W.STRUCK ST#D Phone: (714)639-7330 ORANGE,CA- Zip: 92667 - , • Owner:, MONTICELLO COMMUNITY ASSOC. Address , -150 VALLEY FORGE-. - Phone: COSTA MESA,CA Zip: 92626 . 'Contractor: G &L COMMERCIAL POOL SERVICES INC. I Address: 1547 W.STRUCK ST#D ,. c - Phone: (714)639-7330 ORANGE,CA i ' . _ ' Zip: 92667 - License: 692210 • • • SCOPE OF PERMIT 2 1/2HP MOTORS FOR WADING POOL RETROFIT FOR COUNTY OF ORANGE HEALTH CARE AGENCY REQUIREMENTS. 2-1/2 HP MOTORS. I - . REF:M00-00068&P00-00079I"_ --- - Ii` - / FEE SUMMARY , Quantity _ ... Quantity ISSUE FEE . $23.50 - • Temp Dist System/Lighting t $0.00 0 Temp service test • $0.00 Busway/100 ft $0.00 - 0 Res.a/c package •$0.00 _ - Standing Section $0.00 0 • New Res(1-2 units) . • ,$0.00 0 Misc Electrical Equipment $0.00 0 New Res(34-units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0. up to 10 kva/kw $0.00 0 Lighting Fixts . $0.00 0 up to 50 kva/kw $0.00 ' 0 Recept Outlets . -• , $0.00 ' 0 up to 100 kva/kw $0.00 0 Switches $0.00 0 - over 100 kva/kw $0.00 0 Non Res Appl - $0.00 0 , Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc. Conduit $0.00 0 Service to 1000a $0.00 0 - Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1 hp $9.50 2 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand, $0.00 0 Motors to 50hp $0.00 0 .. Fireworks Stand-' -- $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 I 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 DECLARATJONSF 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 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. S\ My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be comple:• 'I the permit is valued at.. hundred dollars($100)or less.) O I certify that in the p: ormance he work for whic this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws .. Californi d agree that if I •uld become subject to the workers'compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these•revisions/ - Applicant Signature: i A� — Date: WARNING:FAILURE T•SEC - •RKERS'COMPENSA'01••VERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAR: L '4,000) ADDITION TO THE COST 0'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 licen�sed under provisions of C pter 9(commencing with Section 7000)of Division 3 of the Business and Profegsions Code,and my license is in full •( force and effect.Lic.# "t L Class N C° e (//c -3'S' Contractor's Signature: / %_32...-L Date: CONSTRUCTION LENdIt1F.A ENCY: O 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, 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 drivers license. ❑Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): I 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,Gm 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 ❑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 ❑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). o..... ur.. op ...re ogra... ey... _.mats.,.ls)?.. 3 Does or will the applicant or present or future building occupant needto prepare anRMPP(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 application apPermit 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 u No (Section 65850.2 of the Califomia Government Code requires that the requested information be furnished on applications for non-residential building permits). ........._, part . ..._._...be ct__"u' from the undoschool? s..__......_. _ fi Will any of the facility to constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Ves 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ......,._ t_._- ... ....m'--. - ..__.ion r.. _.which 7 If a permit from the South Coast Air Quality Management is or air pollution control district or agency is requiredYesfor 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 0 No __......- ac. of.,.. c' from-. o_..a ._._._ 8 (If"yes",attach certificate of compliance frthe 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. ��ignature•' egal Own: ate 02/840 fr— Aii.lA horized Applicant Date i CODE E. NSP T•N PE PATE INTMALS CODES INSPECTION TYPE LAM INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing �) 200 Final Re-Roof 210 Final Electrical 6/ii O7 •g it / - 201 Final Block/Retaining Wall 212 Final Fire Prevention o 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site _ 204 Final Demolition 250 Final Building/Occupancy 2446-46 mmEssuF RLmu, 150 VALLEY FORGE RD um: CITY OF COSTA MESA — BUILDING PERMIT 'WEFTS NAME IFKNOWN: MONTECELLO CONDO ASSOC PERM NO: B 080465 L ADDRESS: 150 VALLEY FORGE PERMIT NO: B 080465 PLAN CHECK NO; 04460-96 L •e . - = COSTA MESA, CA 92626 lAPPL.MtILn1G*mREs3 CONSTRUCTION TYPE: I PERMIT TYPE: STR PURPOSE: REP 4 ASCWRECTmminmROSS REIMER & ASSOCIATES UCIC: 27262 JOB DESCRIPTION 920FT BLOCK WALL/ 310FT RETAINING WALL SQ FT: 1 , 230 ARCNGRENG'SAOORE%: 1400 WEST LAMBERT om E BREA CA 92621 CLAIM VALUE: CALL—VALUE: 37, 000 .00 GROUP OCC; U— / CONTRACTORS NAME CONTRACTORS WRUNG COMMENTS : REPLACEMENT TO DAMAGED BLOCK WALLS/ RET WALLS ADDRESS: Lt IC: *******lE#3ffE1E1(-i(-#dE1E1f1klEfffEiEiE********IEiE1 *****iflElflE1(-1 ********lF1E�E1F#IE3 *** #fFiE1E***lE3ffElk*** wit ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under panty of perjury that I em licensed under provisions of CMOs 9 S E T B AC K S (commenting with Section 7000)of Division 3 of the Business end Professions Code.and my license win full face end effect. CRY LIC.NO.: L1C.CLASS: UC.NO.: EXP; • MAIN BUILDING ACCESSORY BUIL "NG FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN Date: Contractor: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN OWNER BUILDER DECLARATION:I hereby affirm under penal),Of penury that I ern same(from the Contractors License law for the • mowing reason(Section 7001.5 Business and PNesecns Code:Any city or county which requires a permit tomsbuc,after,improve PARKING RE : PROV: PARCEL : 00000000 ZNE: R3 REF NO; mofih,orrepatanystncmre,pr'atobe wauerce,awo repuirestheappfimnllsauchpermiltofweegnedetnenwdtlutMar5M PLANNING N TES> RECON ST 650 L/F, 6 FT . . HI BL WAL ON FAIRVW, 340 L/F ON S P/L, 3 .licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Denson 3 of the Business and Profession Code)Or that he or We is exempt therefrom and the basis for the alleged memptcn.Any violation of Section > 10 L/F 6FT HI RETAIN WAL& 240L/F BL/WL ON N PL 30LF ON E PL 7031,5 by any applicant for a permit subjects the applicant to a doll penalty of of nmore than live hundred dollen(S5:300. *******.7E{(..*****.x..x.{!•.1t.N..N***I**********.IE************1E*****If****df If*****It*** ****if***** 1:3I.as owner of the property or my employees with wages as their sole compensation.will do the work,and the structure is not intended D E V E L O P M E N T SERVICES REQUIREMENTS or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does nol apply loan owner of property who buide or improves thereon,and who does such work himself or hone,or through he or her own employees,provided that such • improvements are red intended aoffered is eate.H,however.the buitlinporknpnnwment4sold within one year of completion,the ZONING APPROVED BY ' (L)Q DATE:1I=ft=lc. _ ,y owner-balder will have the burden of proving he or she did not build or improve for the purpose of sale). ❑ I.mowned ofthe MOM/G.am exct"iv°ycodmd ilvalh licensed Canoaclmsa Cantu"ctthepaisd(Sella"7044•Business and BUILDING APPROVED BY : DATE; Prof®aThenot n Code: Contractors License Law does apply to an owmer of. .. ..or improves thereon end who -- contracts for such projects with a mmra:1m )licensed pursuant to the Cont•-. o Iemexempt Section: B.AP.C. APPLICATION ISSUED BY: g DATE: _I— IC— -. 91 Date: � js<� ower: r• — • LEGALIZATION:N F E SUMMARYE - Y STRUCTURAL SEGMENT:Y I do hereby way that I am aware of and understand the req'- • of Gallants and Salaty Code Sections 25505.25539.and 25534.and that laany future building occupant Wl/leg not(circle one)need m•• • with esid awe moles and the requirements fa BLDG PMT PLUMBING ELECTRIC2--MECHANIC FIRE SMIP/RES GRADING •mama fercenstrudion or modGxmcchornthe Ay Quality Management District.- ,cel construction eppicmptm N ion as exemhuese ProvisioProvisions.oaots. I PERMIT 457 . 75 ;. - 3 . 70 Dale: Applicant: PLAN 297 . 54 SMIP/NON RES . WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following declarations: ISSUE FEE • - 1 ❑ I have and ail maintaii a certified.of consent to selbinsure for workers'compensation.SA PrOvided 10,bY Sedian MO al Ow Labcr BUILDING-DIV-> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code.for the pMomwcedthe work tor Mich this Fame wissued. TOTALS----> 461 . 45 0 . 00 • 297/. 54 758 . 99 758 . 99 . 00 o 1 I have and leg mawtaw workers'compensation insurance.as required by Sectcn 3700 of Me Labor Code,for parliaments of the • work tor www'°errir: issued.Mrwaienanpen.mon:aumnp.mdn.ndpo°ymmw..: REVENUE DIVISION TOTALS--> COLLECTED; . • 461 . 45 OVER/SHORT; . 00 Gone • Pricy Number: - • BLDG PMT PLUMBING ELECTRIC MECHANIC ' FIRE SMIP/TOT GRADING PLAN—CHECK albs section need not be completed I She perms is for one hundred dollars(5100/or Mon.) 457 , 75 . - 3 . 70 ❑ I eerily 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 wanton'Compensation laws of California. and spree that S I should berms alibied to The natters' ****************************************.*************************************** compensation provisions of Section 3700 o the Labor Code,I mall forthwith oompy with Mase provisions. INDIVIDUAL , F E-E BREAKDOWN Dae: Applicant: Warning:Failure to secure workers compensation coverage Is unbwnrl,and cell subject en employer to criminal pennies and TYPE QTY DESCRIPTION ,' ' UNIT COST TOTAL COST civil fines up to one hundred thousand dollen(S104000A In addition to the cost of compensation,damps as provided for In yt.; Section 3706oi@e Labor Code,Interest and attorneys lass. SFR 920 RES-CONCRETE BLOCK. ,WALL% •' ' / FT. 20 . 00 18, 400 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that!here is a construction lending agency for the SFR 310 RES—RETAIN WALLS UP TO 6, FT' ' / FT. 60 . 00 18 , 600 , 00 performance of the work for which this perms is issued(Soden 3097.Cie.C). .END OF FEESy LENDER'S NAME i LENDER'S ADDRESS: I certify that I have read this application and mate that Mn above information is coned.)agree to comply with all icy end cavy ordinances / / ,• stale end se laws relating to building conspudion end hereby authorize representatives of this icy to enter upon the above-mentioned property !,% fa inspection purposes.KAREN _7ILB ER ,'; /`" y 01 00219253-00219254 TOT 461.45 C�—_ i j DATE: 11/15/95 TIME: 11:40 . / oma: // ) / (5151.46,W P) White-Building A Sm, :Green-Re Caney-Appicam:Pink-Revenue:Goldenrod-Assessor L? , CONSTRUCTION AND PLANNING Por 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. - 1 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, 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 62. Backwash & Receptor-Final • 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains - t 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 1 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 OGas ❑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 PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED �J 33. Final Electric Notes:/Z,/,7 ( 9e,�/ hI/g, i s "eel ,t C/ , 34. Final Heating & Air ConditioningCN� r- /' 35. Final Gas Pipe-Test /N9� _c._Ds 36. Hood or CanOPY -IJ / 2�` 1 / C -- 37. Final Factory Fireplace ti /j��� 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43 Backflow Irrigation 44.E Landscape Irrigation System 454 Sound Attenuatign� 46.',Handicap Regulations t ` - 47. FINAL STRUCTURE & BUILDING i 48. ,`FINALPLANNING 1 49. Electric Release to Edison 50./Gas Release to Southern California Gas Co 51.10ERTIFICATE OF OCCUPANCY No ' Date CITY OF COSTA MESA , • BUILDING DIVISION >:� aiiii 1r DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER ti. PERMIT4 E02-00217 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 150 VALLEY FORGE RD Status: ISSUED Suite No Applied: 03/20/2002 Vicinity: Issued: 03/20/2002 Parcel Nunmber: TPN98078 cli--. Applicant: VELASCO, JULIO _- _. - - - - _ ISSUED BY: Address: 526 S ROSS ST j c i _- /C!�� - .Phone 714-5509185 :-''� \ SANTA ANA ! 7-. ` ', Zip: 92701 I i - A 7/G _ i 7 /���,„��>_ A / j AVA Owner:/ MONT.ICELLO COMMUNITY ASSOC.- - z ,,-:.. -1;j:7:-1-7-:::-.:. Address" /150 VALLEY FORGE ' /,' \ \ / ` \ Phone: - ' • COSTA MESA,CA Zip: 92626 ?-. Contractor: '' VELASCO CONSTRUCTION AND DEVELOPMENT Address: 526 S ROSS ST • • - - - v - ;iPhone: 714-550-9185/V ( ' SANTA ANA, /- -� \N Zip: 92701 -- - - . - - - i '- -V 2/A _ - License: 596135 - SCOPE OF PERMIT - ' / REF:802-00040;MODIFY MENS'BATHROOM:ELECTRICAL TO INCLUDE:33 LIGHT FIXURES,30 OUTLETS, 10 SWITCHES. - - - \--i./ - • _ , -' - - - - • - , ' 07/31/02 REVISED:ADD SERVICE TO 200 A(1),2 MISC.CONDUITS"AND 3 MISC.CONDUCTORS • (REWIRE 3 LIGHT STANDARDS). ,_ " FEE SUMMARY/ , - • • Quantity Quantity - - , / ISSUE FEE / $23.50 Temp Dist System/Lighting $0.00 -0 Temp service test' 50.00 ..„. . Busway/100 ft $0.00. ',0,- Res.a/c package' - 50.00 lStanding Section $0.00 ",1 0 - NewRes,( 1-2 units) ' •,$0.00 0 _ _ - Misc Electrical Equipment $0.00-%.'0 / ' - New Res(3+units) ,1 \,,$0.00 0 .." -.1- Transformers up tat kva/kw- $0.00'' ' 0/ - Pool/SpaAv" x$0.00v C-4-',-{ 0-' - ' ' / up to 10-kva/k'w `$0.00/ 0 ' , ' Lighting Fixts, i'$31.497>' , 33 - up to 50 kva/kw -$0.00,' 0 , ' ' Recept Outlets ' %$29.30":�y ,30 " : - up to 100 kva/kw' .',$0.00 ->, , 0. / - - Switches ,'i ' ;,' 511:00, ��'10��,,� over 100 kva/kw $0.00 ` % 0 ' / Non Res Appl " , , $0.00-1 , 0 - - . Low Voltage Equipment- ,- $0.00- - 0- / Res Appl $0.00 , , -; ,0 - - Low Volt Wiring System/Ckt $0.00 /0, , Service to 200a • $30:50 1 _ - Misc.Conduit y„$54:60," , 3 Service to 1000a - $0.00 0-, - Misc.Conductor' \ . $54.60 j3 Service over 1000a $0.00-- -. 0 I - / 'Circus(gen or ride)', ' ,$0.00/ 0 Motors to 1hp $0.00 .-, .- 0 "Circus(mech ride'or lights)_- $0.00 0 Motors to l0hp $0.00 \ - 0 _ - - A'Christmas Tree Stand j•/)/$0.00 0 Motors to 50hp $0.00 '- 0 = Fireworks Stand,,>' , - $0.00 0 Motors to 100hp $0.00 0 - - _ - ,.- - Other-Electrical Fee- ., $0.00 , Motors over 100hp $0.00 0 -- - Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $234.99 Interred Pole $0.00 0 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) ii EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or If work is suspended or abandoned I 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)7545626 2446-46(6/00) V DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm undgr 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 maintaij 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 are: Cartier: Policy Number: (This section need not be completed it the permit Is valued at one hundred dollars($100)or less.) ;�pcertity 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, agree that if I shout come subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with rhes 7 (Appit�n(Siorturl i.t .( 6 62 CO ate:_ l 7 — J�— 02 WARNING:FAILURE TO SECU E WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARE($100,000),IN ADDMON 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 afflrm.that.l-am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of.ihe•Businem and Profess) ns Code,and my license is in full forceaand•effecrLic-ate `pass N—L5 / S (G/ .3 S Contract gnaturer, ct�I_L'k. l I f C /IcJ✓� roar—, 7 - !J 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 to sale(Sec. 7044,Business and Professions Cale:The Contractors License Law does not apply to an owner of properly 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.). ❑ 1 am exempt under sac. - Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers 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 6,California AdministratIe 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 filo a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health end 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 application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency) Yes U 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? 0 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 _ e (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. Sig ur:Of Leval Owner(s) �? / Date - - 1r • dr T. .•App)-m crtate CODE I INSPECTION TYPE DAM gIDDAL9 g0DEE INSPECTION TYPE 211 gffiTALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing -. 200 Final Re-Roof 210 Final Electrical l"!': - Ila—OZ e> 201 Final Block/Retalning Well 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 • . • CITY OF COSTA MESA - o w - BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT ' PERMIT PERMIT NUMBER B99-00138 (714)754-5'73 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 150 VALLEY FORGE RD Status: ISSUED 47 Suite: Applied: 01/28/1999 Vicinity: Issued: 01/28/1999 Parcel Nunmber: TPN98078 Zoning: Applicant: KRAVITZ, KEN Address: Phone: Zip Owner MONTICELLO COMMUNITY ASSOC. Address 150 VALLEY FORGE Phone: COSTA MESA,CA Zip: 92626 Contractor CARASSO CONSTRUCTION SERVICES INC. Address: 22541 ASPAN UNIT C Phone: 949699-0145 LAKEFOREST,CA Zip: 92620 License: 697845 Arch : - Eng: Address: - Address: , Phone: Phone: Zip: License: • License: • SCOPE OF PERMIT • 322 LF OF 9'HIGH WROUGHT IRON FENCE AND 59 LF OF 3'HIGH WROUGHT IRON FENCE ABOVE EX. BLOCK WALL; ALL PERIMETER POOL/CLUBHOUSE FENCING. DEMO 287 LIN FT OF EXISTING 6'BLOCK WALL. • FEE SUMMARY ,' Plan Check: $256.59 Calc Valuation: $29,875.00 Permit: $394.75 Claim Valuation: $29,875.00 SMIP Res: $2.99 SMIP Corn: $0.00 Other $0.00 Inspection: . $0.00 Total: $654.33 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 NOTES: • 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 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 o1 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 are: Cartier: Policy Number. (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) • ❑ I certify that in the performance of the w• for which this permit is issued, I shall not employ any person in any manner so es to become subject to the workers' compensation laws of Califon'.,and a. 'e that it I should become subject to the workers'compensation provisions of Section 37Q0 of the Labor Code, I shall forthwith comply with these•ravislo• ,, Z _ / Applicant Signature: -_ Date: N{A w�fl S WARNING:FAILURE TO SE' RE WORKE-= COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI L PE LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000).IN ADDITION TO THE ansT 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 undo rovision Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.tic.N Class if Contractors 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.). ❑ 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 drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-properly 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 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 epplication apermit 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 L7 No (Section 65850.2 of the Califomia 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? 0 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 ar 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 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 COMPLIANCE AN UTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agr to comply with all to laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the ab,.."-de bed property:for in ection purposes.I agree not to occupy or allow occupancy of any building authonz by this per until final inspection. Signature Of Legal Owner(s) � � Date And/Or Authorized Applicant Date CQQEL INSPECTION TYPE Dam ltllflM COOEr IN$PECDQNTYPE DAM • IMMIEL6 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 ,/ p/_y 204 Final Demolition _ 250 Final Building/Occupancy (L'/1'— /! �L�� 2446-46 41 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. fly CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. CONSTRUCTION PERMIT • 6 - ' S .d • S%(o0 /6 /-/ii • / s2 I 1 '/I // -'- • Project Address / / 'L Z ,/(L TYPE OF CONSTRUCTION- ❑ NEW ❑ ADD ❑LJAqL ERAT ON REPAIR Applicant's Mailing /,,A/dddresss ��/// • ❑ CONVERSION ❑ DEMOLISH ® OTH`'ER _RG Ar Of/4/ A.p-# l Zone Owner's Name� c2 C/l/f//k/'/J 14/ Phone "�� DESCRIPTIONIPOF WOR /� ' '��L- ✓ /N/-' SAm_/ Alaip9L/ Rea tiI S Main Building: Accessory Building: Z Address G - 0 TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front N Arch/Eng. __ License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B - I Rear N Address. /A '/ ❑,OTHER A ,•L Contractor's Name4tLt€4A/NO 74341 a°i Phone 97V JO76 PROJECT DESCRIPTION SQ. FT. 7/dam - OCCUPANCY / C Right _ G g / / K R (I Address(mailingl�/.9T At/4,mi A/ at/me / @a'S CONST RUCTION TYPE VALUATION$ /O ODr S Left E `'/0 City License No. O26OF'S� ZONE GRADING CU.YDS. ACRES ping. Ref.# Park.Fees $ Q I LICENSED CONTRACTOR DECLARATION - Remarks: Parking Req./Provided . V I hereby affirm that I am licensed under provisions of Charter 9 (commencingR \ with section 7000) of Division 3 of the Business a --Professions Code,and Use of Building: E my license is in full for e and effect_ M I License Class e 0 .•�ii� LAY e No • - J - PLUMBING FEES Planning Notes: E � % •le - -'• Signature N \ JRKERS'COMPENSATION DEC Bar Sink Showers RATION '_ - T .nereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer • Service Sink S of Workers' Compensation Insurance, or a certified copy thereof (Section -- - \, 3800, Lab._C)) �i '/ /� // I' Backflow Irrigation Sewer Cap ELECTRICAL FEES JI Policy No. WP-o Z'I. 79.c Company/-1E40N/ Backflow - - , . •Certified copy is hereby furnished. Bathtubs Sewer ConnectionAutomatic Washer Transformer 0 15;50 KW Certified copy is filed with the city Buil n lision - D 50+KW Date /O'/'t-.51 Applicant ( Clarifiers Solar Collectors Construction Pole Sub. EXEMPTION FROM WORKERS'COMP NSATION DECLARATION Dishwasher - Solar Piping • (This section need not be completed If the permit Is for one hundred ($100)orP 9 - Cooking Unit Meter Sup to 100,amps - less). I certify that in the performance of the work 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 DElectric ,Sub Panel • Date Signature - - NOTICE:If,'after making this declaration,you should become subject to the Floor Sinks Urinal Fan Motors 1:10-1 HP Di''A-8 Workers' Compensation provisions of the Labor Code, you must forthwith - comply with such provisionsor this permit shall be deemed revoked. Gas Service Outlets Water Closet F.A.U. Inc.Solar ❑9-15 HP 016-15+ CONSTRUCTION LENDING AGENCY . - ' • I hereby affirm that there is a construction lending agency for the performance Interceptors , I ' Water Heater Fixtures Microwave of the work for which this permit is issued (Section 3097 Civ. C.), - Lender's Name - - _ _ Kitchen Sink ,Water Service - Device Boxes Pole Light Lender's Address - . OWNER BUILDERLDECLARATION Lavatories Outlets Range . I hereby affirm that I am exempt from the Contractor's License Law for the P-Trap reason (Section 7031.5 Business and Professional Code: Any city or p - - Switches Sign 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 file a signed statement that he/she Is licensed pursuant to the provisions of - - Contractor's License Law(Chapter 9(commencing with Section 7000) of Generator ❑0.5 KW ❑5-15 KW vision 3 of the Business and Professions Code) or that he/she is exempt Trash Compactor • 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 LJenalty of not more than five hundred dollars($500). 'Reinspection Fee $25 - Issue Fee $ 3 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 I for sale'(Secion 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 ❑ 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 0 • sale. If, however, the buildingor Improvement Is sold within oneyear of com- Duct-Under Ground P Application Approved By Date prone r h owner will have the burden of proving h¢/She did not build or im- - grove for for tthe purpose of sale). Duct-Structural Refrigeration System Application Issued By dte / . Date////7/�� U I,as owner of the property, am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044, Business and Professions Code: Duct-Ventilating - SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property whoC builds or Improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple LJ System Repair/Alteration BUILDING PERMIT $ 74 $MIP $ 5 tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ • PERMIT ❑'I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ ISSUANCE $ Date Owner Heating System&Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 BTL— ELECTRICAL $ 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- PLAN CHECK $ MICROFILM $senta inspection of this cit to enter poi. -e above-mentioned property for $ - TOTAL FEE $ 74-5-V inspection purpos • MECHANICAL Drivers' Date / �� Reinspection Fee Issue Fee' MINS 1 Drivers' License or SS Pe $25 $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - CONSTRUCTION AND PLANNING - P &SPA. Date Inspector ' - • Date Inspector APPROVALS Permit# - - - APPROVALS Permit#' . Y. 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 UF ER 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 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 Ceiling69. POOL/SPA SYSTEMS FINAL 19. Rough Heating &-Air Conditioning • FIRE DEPT. REQUIREMENT 20, •Rough Factory Fireplace APPROVALS Permit# . - 21. Ducts, in Structure I 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough &Test 72. Underground Flush • - 24'. Roof Framing ., • I 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 ' 'i I . 80. FOOD CERTIFICATE ISSUED 33. Final Electric i Notes: 34. Final Heating & Air Conditioning ' , _ r . 35. Final Gas Pipe-Test . r. 1 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 ' 1 48. Special Requirements Completed ' , ' I • 49. Electric,Release to Edison - ' - - I 50. Gas Release to Southern California Gal Co • ' 51. CERTIFICATE OF OCCUPANCY' _ _ - - _ • No. • - Date ' 1' ci.41;0Applicantto fill in all spaces except those within heavy border goes and sign all appropriate declarations. CITY OF COSTA MESA N PERMIT NO. TRACT NO. LOT NCI. , BLDG. NO. COP'RUCTION PERMIT '/B - 7OS . •j also 44-2-/40 9 Kr: Iv' //' ' Project Address 0 4LLL �A/1Mi'z6 - ' V4 TYPE OF CONSTRUC':7ON ❑ NEW ❑ ADO •L ERATION ❑ REPAIR Applicant's Mailing Addressesfry/r'� - ❑ CONVERSION ❑ DEMOLISH/IZ1 OTHER // iN• - A.P.# ' Zone Owner's Name/*l CECL/J /°1N4'•?S)y- Phone Stl°I��7 DESCRIPTION OF WORK C 5S 44" f76 . �Z ' S� l41i/0^4*r)24Q1,N S Main Building: Accessory Building: . O Address / G • TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION U STRUCTURAL T Front N Arch/Eng. ' License No. _ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear • Address ./ ❑ OTHER A • N Contractor's Nam.�/�fil ' 4 4/. D kef � Phone 4774 70740 PROJECT DESCRIPTION SQ. FT.112 _OCCUPANCY R I C Right . G Address(mailing)2l 7 '/3ArNd/4 ,0 t'�9NGE"t;/-/' c7.1-. i CONST RUCTION TYPE VALUATION$ GpS�O ' g Left - _ RE ZONE GRADING CU.YDS. ACRES 0 City License No. 4')-6 OE' Ping. Ref.# Park.Fees $ U LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided - I I hereby affirm that I am licensed under provisions of Charter.9 (commencing R with section 7000) of Division 3 of the Business a • Professions Code, and Use of Building: - E my license is in full Pore- and effect. License Class, Lie- se i �'- PLUMBING - FEES Planning Notes: M ate / "/ ' % Signature WLR 4_ A - E .ORKERS' COMPENSATION DE LARATION Bar Sink Showers - N T I hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink ' S of Workers' Compensation Insurance, or a-certified copy thereof (Section - - - - - - - ♦• 3800, Lab. C) n '/ �j / / Backflow Irrigation y /VP e92 compan y/^el/41 /NDL4 /7 g - Sewer Cap ELECTRICAL FEES Rol No. ❑ Certified copy Is hereby furnished : / Bathtubs - - Sewer Connection Automatic Washer Transformer 0 15-50 KW ' ➢.Q Certified copy died with the city : il•i•• aivisio•. -net" Date /n'/`] Applicant ' - _41 tR—a Clarifiers Solar Collectors Construction Pole Sub- ❑ SO+KW • EXEMPTION FROM WORKERS'COM'ENSATION DECLARATION Dishwasher' - - - Solar Piping CookingUhit - Meter Cup to 100 amps _ ' (This section need not be completed if the permit is for one hundred ($100)or - - , less). I certify'that in the performance of the work 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 ❑Electric Sub Panel Oate Signature — NOTICE:If,after making this declaration,you should become subject to the Floor Sinks Urinal Fan Motors 00-1 HP 01%-8 • 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 CONSTRUCTION LENDING AGENCY F.A.U. Inc.Solar ❑9-15 HP 016-15+ - I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures 'Microwave of the work for 'which this permit is issued_ (Section 3097 Clv. C.) Lender's Name - - Kitchen Sink Water Service Device Boxes Pole Light Lender's Address OWNER BUILDER DECLARATION Lavatories Outlets Range • . I I hereby affirm that I am exempt from the Cdntractor's License Law for the P—Tra - -p reason (Section 7031.5 Business and Professional Code: Any city or p Switches Sign county which requires a permit to construct,alter,Improve,demolish or repair -. ' -ny structure, prior to Its issuance, also requires the applicant for such permit Roof Drains ' _ ' ' _ _ Garbage Disposal - Standing Sections file a signed statement that he/she is licensed pursuant to the provisions of - ' ie Contractor's License Law(Chapter 9(commencing with Section 7000) of Generator ❑0-5 KW ❑5-15 KW Trash Com actor Oivision 3 of the Business and Professions Code) or that he/she is exempt - P 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 Reinspection Fee $ 3 enalty of not more than five hundred dollars($500). peI $25 Issue Fee • LII, as owner of the property or my employees with wages as their sole MECHANICAL • Reinspection Fee $25 Issue Fee • $ 3 compensation, will do the work,and the structure is not intended or offered 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 building or improvement is sold within one year of com- Duct-Under Ground Application Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- LJrove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By — Dat: �'� I,as owner of the property, am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMMAWSF FEES The Contractor's License Law does not apply to an owner of property who !BUILDING PERMIT $ �i (JJ SMIP $ - .�d builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK " $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. COO# PLUMBING $ ISSUANCE $ — Date Owner • Heating System& Ducting ' PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTU ELECTRICAL $ GRADING $ Information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize rep e- MICROFILM $ sentatives of. this ci to en a uporrrryyyy����the above-mentioned prop rty r PLAN CHECK $ inspection purposes-4..r.4` - �_' //, •/ MECHANICAL $ TOTAL FEE $ 9s/ 5V Signature Date �d Drivers' License or 5# / '• — 2 — Fee I $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - - \ 1 • • • VtCONSTRUCTION AND PLANNING ` ' • • . ' I & SPA Date ' Inspector • Date Inspector • . APPROVALS Permit# APPROVALS Permit# T: 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 Gtnd. 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 - 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' ,: 80.• FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating &•Air Conditioning , 35. Final Gas Pipe-Test • . 36. Hood or Canopy - • • 37. Final Factory Fireplace , 1 38. Final Plumbing , , 39. Water Service-Final - 40. Gas Service-Final 41. Solar Domestic-Final ' i ' ' . 42. Backflow Preventer , 43. Backflow Irrigation . 44. .Landscape Irrigation System . ' 45. Sound Attenuation - ! i • 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ' ' ' ' ' , 48. Special Requirements Completed • 49. Electric Release to Edison ' ' , -- - 1- - • :• - - - . • 50. Gas Release to Southern California Gag Co . 51. CERTIFICATE OF OCCUPANCY! , ' - - - _ __ - No. Date - , p Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations- ^+ 5 CITY OF COSTA MESA PER IT NO. TRACT NO. LOT NO. • BLDG. NO. CONS UCTION PERMIT p 7 RAject Address O ./ •L1/6 /C/ , 9Y/Y6 TYPE OF CONSTRUCTION NEW LJ ADD ❑ ALTERATION LI REPAIR Applicant's Mailing Address 5 941 '/ ❑ CONVERSION ❑ DEMOLISH W OTHER /?7464Fi4 A.P. # I Zone Owner's Name Arm/i/C reg £jft/ 1 disci Phone CYO-/047 DE CRIPTI N OFY�p RK G'L/jSS F%/1H<GG//ST G!/�A AA /7ll/fn/ T /COO,Pli S Main Building: Accessory Building: ZO Address .S/744 l E TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front N Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear Address �r l7' ///� /n! ❑ OTHER A N Contractor's NampfA,V 019/v/t1,9./CQ��a 'Phone - d PROJECT DESCRIPTION SQ. FT. �1sO� OCCUPANCY 2/ C Right - R Address(mailing) 2787Abilirmi l adia , 9.l.664-- CON ST RUCTION TYPE VALUATION$ 61/45-0D S Left _ E City License No. O2 O/J ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park,Fees $ Q U LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided I I hereby affirm that I am licensed under provisions of Charter 9 (commencing R with section 7000) of Division 3 of the Business and Professions Code,and Use of Building: E my license is in full force and effect. _ / iJ PLUMBING FEES Planning Notes: - M License Clas JG LI•-nse No. _ E ate h'• •1 Signature 0'P" i_ , /:a_ N /ORKERS'COMPENSATION DE ARATION Bar Sink Showers T I hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer • Service Sink• S of Workers' Compensation Insurance, or a certified copy thereof (Section • 3800, Lab. C-n �,,'/' / I` .I�f/ Backflow Irrigation Sewer Cap ELECTRICAL • FEES Policy No. Y-8L'1.S�7JB Company r/eeM224�/4/0,6a7i r Certified copy is hereby furnisheBathtubs Sewer Connection Automatic Washer • 'Transformer 0 15-50 KW Certified copyys lied with the city Iviisip+1/ ///J¢��� Date JD•isi-r# Applicantr,U��`-•t:•�`� Clarifiers Solar Collectors Construction Pole Sub. ❑ 50+KW EXEMPTION FROM WORKERS',COMPENSATION DECLARATION • Dishwasher Solar •Piping Cookin Unit Meter ❑u to 100 amps • (This section need not be completed if the permit is for one hundred ($100)or 9 P P • less). DrinkingFountains ' I certify that in the performance of the work for which this permit is issuetl, 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 ❑Electric Sub Panel Date Signature - I ' NOTICE: If,'after making this declaration,you should become subject to the Floor Sinks ' Urinal Fan •Motors ❑0.1 HP ❑1''4-8 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. . Inc.Solar 09.15 HP 016-15+ ' CONSTRUCTION LENDING 'AGENCY - I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures i Microwave of the work for which this permit, is issued (Section 3097 Civ. C.) Lender's Name - Kitchen Sink Water Service , Device Boxes Pole Light Lender's Address _ - ' - ' OWNER BUILDER DECLARATION - Lavatories • Outlets Range , • I hereby affirm that I am exempt from the Cdntractor's License Law for the P-Trap reason (Section 7031.5 Business and Professional Code; Any city or p - - Switches Sign county which requires a permit to construct,alter improve,demolish or-repair - - • "^`r�fileructure, prior to s signed statement thas t he/she alsorequires licensed pursuant to the ant prrosuvisionsnot Roof Drains - Garbage Disposal Standing Sections _1,.:rie Contractor's License Law(Chapter 9 (commencing with Section 7000) of Generator 00-5 KW O5-15 KW Trash Compactor 'Division 3 of the Business and Professions Code) or that he/she is exempt P • 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 Reinspection Fee 3 penalty of not more than five hundred dollars($500). P¢ ,$25 Issue Fee • $ 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 I 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 building or improvement Is sold within one year of com- Duct-Under Ground , Application Approved ByF1 Date� pletion, the owner will have the burden of proving he/she did not build or im- - - !b" /�' ve for the purpose of sale). • Duct-Structural Refrigeration System Application Issued By 171 - UroI,as owner of the property, am exclusively contracting with licensed con- : ❑0 100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: , Duct-Ventilating SUMMARY F FEES i _ 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 $ _9Jr /e SMIP •$ .,5 tractor(s) license pursuant to the Contractor's License Law). • PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# - PLUMBING $ ISSUANCE . $ Date Owner - • Heating System&Ducting • PLAN CHECK $— ENERGY P.C. $ • I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,00067E ELECTRICAL $ 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- - $ MICROFILM $ sentatives of this city to'enter •on t e above-mentioned pro ert for PLAN CHECK inspection purpos-, y p Signature .4 �. L'_. / /J--'• Date yP 7/� - MECHANICAL $ TOTAL FEE $ 7k5;(-5-�i Drivers' License or 9# « � - Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ f IMINfl CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink:Accounting;Goldenrod -Assessor • - - - - - - _ . - CQNSTRUCTION AND PLANNING. • •' :. • • - ,..- '; - 1 L&SPA Date Inspector Date Inspector APPROVALS ;Permit# APPROVALS Permit# e.. 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. s 55..Electrical Bonding . `5..Steel Reinforcement T - •- - - ; 56. Rough.P.lumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE . 7. Footings : _ - -. 58: Electrical.Conduit-Undrgrnd. • 8. Foundation • 59. Gas Pipe, D 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 • . ' - 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:j 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 , I • APPROVALS Permit# _ 21. Ducts, in Structure • - 70. Underground Hydro .22. Ducts, Ventilating - I , , 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 (S4ructural) & Monocoat 75Dry 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 " ' I 80. FOOD CERTIFICATE ISSUED 33. Final Electric '1 Notes: ' • • 34. Final Heating & Air Conditioning , 35. Final Gas Pipe-Test , , . . . • 36. Hood or Canopy H ' 37. Final Factory Fireplace ' 38. Final Plumbing • I I , ' , • 39. Water Service-Final - ' 40. Gas Service-Final 41. Solar Domestic-Final _ - 42. Backflow Preventer 43. Backflow Irrigation - , I , 44. ,Landscape Irrigation System 1 - • , 45. Sound Attenuation , ' 4 46. Handicap Regulations I , - ' . 47. FINAL STRUCTURE& BUILDING - - .- I , 48. Special Requirements Completed 49. ElectricRelease to Edison - - - - 50. Gas Release to Southern California Gas Co - I • , , . 51. CERTIFICATE OF OCCUPANCY - i. _ -- _ ; ' . , • No. - Date - •• . - . . A [ SV Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. �J CITY OF COSTA MESA- PE MIT NO. TRACT NO. LOT NO. BLDG. O. - 9"eco / 7/F•. 'r.r I I' CONSTRUCTION PERMIT 6 - 99S3 • s(G0 4a-4. /G - ProjectAd less 0 14I44�4�e FOR&6 /2I' 24)4 TYPE OF CONSTRUCTION U NEW U ADD ❑ ALT�RATII N I}'I REPAIR __ f/7n'I. ❑ CONVERSION ❑ DEMOLISH ® OTHER RE/CODa'/N0 •- Applicant'sMailingAddress: fir' ,/ / r A A.P.# Zone - Owner's Name Mdvl/T/CEwD C.oM�'"f��✓ Phoned-41a DESCRIPTION OF WORK CL/f�jf //fj (sLncc,(�Qtil/'+ 4c/Jr/447 ft ,//7U6 S Main Building: Accessory Building: Z Address SD/h/(. E - TYPE OF PERMIT GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front ON Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B - I • Rear N Address - ❑ A OTHER G S46/4NA/2iNDR40". 4971.30722 PROJECT DESCRIPTION SQ. FT. '9500 OCCUPANCY te/ C Right ' • Contractor's Nam�rqq O ,t/ A Hn PhoneO K • - R Address(mailing/A/87 AAA �DV/As COTnryDer`g• 9y4•6� CON STRUCTION TYPE VALUATION$ 6500+ S Left E ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ - Q City License No. 02.4 0 fq rU LICENSED CONTRACTOR DECLARATION Remarks: • Parking Req./Provided I I hereby affirm that I am licensed under provisions of Charter 9 (commencing R with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: E my license is in full force and effect. License CIas; , 39 _ ` Li "-- upas-+- _ • PLUMBING - FEES Planning Notes: E 'ate !2(/Q/T-1 Signature ' • -i' _ �� . _ ' A ' /ORKERS'COMPENSATION DECLARATION Bar Sink - Showers - • T T I hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink - S of Workers' Compensation Insurance, or-a certified copy thereof (Section - - 3800, Lab.,Cy) Sewer Cap ELECTRICAL ' FEES Policy No. JP'OZ 1/ 7S! Company/%CEMO�/rni/iN • icertified copy is hereby furnished. • �¢¢� Sewer Connection ■ 15-50 KW Certified opy is filed with the city Id'Id' wisipp n.� Date 14•I Y--P3 Applicant 6 '- Solar Collectors ■ 1 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION amps • (This section need not be completed if the permit is for one hundred ($100) or Solar Piping • IILW1 . .less). I certify that in the performance of the work for which this permit is;issued I Solar Tanka shall not employ any person in any manner so as to become subject to the Workers: Compensation Laws of California., •• / Swimming Pool w/Spa ■ ■ Date Signature • NOTICE:lf,'after making this declaration,you should become subject to the ' Floor Sinks ' Urinal _ Fan Motors 00-1 HP 011S-8 Workers' Compensation provisions of the Labor Code, youmustforthwith - comply with such provisions or this permit shall be deemed revoked. , - Gas Service ' Outlets •Water.Closet F.A.U. Inc.Solar 0945 HP 016-15+ CONSTRUCTION LENDING AGENCY, I hereby affirm that there is a construction lending agency for the performance Interceptors Water HeaterFixtures Microwave ' , of the work for which this permit is issued (Section 3097 Civ. C.) , • Lender's Name - Kitchen Sink • - - Water Service • Device Boxes Pole Light Lender's Address Lavatories OWNER BUILDER DECLARATION Outlets Range _ I hereby affirm that I am exempt from the Contractor's License Law for the P—Trap reason (Section"7031.5 Business and Professional Code: Any city or P Switches Sign county which requires a permit to construct,alter,Improve,demolish or repair - , 'fly structure, prior to its issuance, also requires the applicant for such permit Roof' Drains - Garbage Disposal Standing Sections file a signed statement that he/she Is licensed pursuant to the provisions of - ,e Contractor's License Law(Chapter 9(commencing with Section 7000)of Generator ❑0.5 KW ❑5-15 KW Trash Compactor Oivision 3 of the Business and Professions Code) or that he/she is exempt P 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 LImalty of not more than five hundred dollars($500). Reinspection Fee $25 Issue Fee I, as owner of the property or my employees with wages as their sole I 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 0 • sale- If, however, the building or improvement is sold within one year of com- Duct-Under Ground . Application Approved By Date pletion, the owner will have the burden of proving he/she did not build or Im- . �srove for the purpose of sale). Duct-Structural - Refrigeration System Application Issued By t ltii • Date //47/s- 3 LJ I,as owner of the property, am exclusively contracting with licensed con- • ❑6100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUUMMARY F FEES The Contractor's License Law does not apply to an owner of property who BUILDING PERMIT /.S/O SMTP - i SO builds or Improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration $ $ tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# PLUMBING $ ISSUANCE $ ' Date Owner- _ Heating System& Ducting • PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00-100,000 BTU 1:100,0008T ELECTRICAL $ GRADING $ Information is correct. I agree to comply with all city and county ordinances - - - - -- and state laws relating to building co struction,and hereby authorize re re- PLAN CHECK $ MICROFILM $ ' sentatives of this city • 'enter rn tryp)above-mentioned pro erty or e7 Inspection purposes.-� 7 • — J MECHANICAL $ TOTAL FEE $ 7S,-5-Signature �� - Date 4 Drivers' License or S5 - - — Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - - .. CONSTRUCTION AND PLANNING . - - I L &SPA APPROVALS` Permit# - • Date Inspector- APPROVALS Permit# Date Inspector 1't-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 r' • : . ' - + 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, 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 62. Backwash & Receptor-Final 12. Sewer Cap i . -63.7 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 I - _ - , -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# 27. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 25. 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' - 95.`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 I • HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat , ' - 79. FINAL INSPECTION • . 32. Electrical Power Meter-Final , ' 89. FOOD CERTIFICATE ISSUED 33. Final Electric i - • 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 i ' 40. Gas Service-Final 41. Solar Domestic-Final• ' ;, _ - _ -� 42. Backflow Preventer 43. Backflow Irrigation - - 44. :Landscape'Irrigation System ' , • ' • • ' 45. Sound Attenuation ' , - ' •i 46. Handicap Regulations - - , 47. FINAL STRUCTURE & BUILDING i . 48. Special Requirements Completed , i . , 49. Electric,Release to Edison - . - - .1 ' - . . . .- 50. Gas Release to Southern California Gas Co I . , 51. CERTIFICATE OF OCCUPANCY - ,-_ No. - • Date - ' . ' . ' r Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. IS..) CITY OF COSTA MESA PEg�'�IT NO. .) 4TRACT NO. LOT NO. BLDG.NO. 9E'.65 -1 I / ; //^-: CONSTRUCTION PERMIT ,L� - ?JoS,4 s-i6o lrr9-.2-17 .23 Project RYdress 0 •LL .,A % •yy4 TYPE OF CONSTRUCTION ' LI NEW��ttH ADD ❑ ALTERATION ❑ REPAIR Applicant's Mailing Address 7/y� ❑ CONVERSION ❑ DEMOLISH IN OTHER READOf//✓6, A p # Zone • - DESCRIPTION O WORK CLASS'A"r//f,LeRez.9SS C�Dti1A Owner's Name nID�CELLO L'O/11/fl ��y Phone S141/499 7 / S Main Building: - AccessoryBuilding: Z SA/i1E 504991L 7- t' Ud E 0 Address TYPE OF PERMIT GRADING ❑ FOUNDATION Ll STRUCTURAL T Front N Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear I Address . • - ❑ OTHER A N Contractor's Name594'/4!.44V2 �F a,/ • Phone97r'761729 �� PROJECT DESCRIPTION SQ. FT.�7r Q �/- OCCUPANCY C Right G p..� /s A,s K Left R Address(mailing) A is , /Ai' /I v/4j///44. q1'465 CONSTRUCTION TYPE VALUATION$ argil" $ E City License No. o z6 06s ZONE GRADING CU.YDS. ACRES ping. Ref.•/% Park.Fees $ • G LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided - I I hereby affirm that I am licensed under provisions of Charter 9(commencing R with section 7000) of Division 3 of the Business and P fessions Code,and Use of Building: E. my license is in full force and effect. _ �9 License Class ' ens o.�2" Z? PLUMBING - FEES Planning Notes: M . • 'ate G9•/`1'�'3 Signature " �'� a� N .ORKERS'COMPENSATION DEC • -ATION Bar Sink Showers N T 1 hereby affirm that I havatio a nre of consent to d self-insure or a f:(Section Backflow Preventer Service Sink S of Workers' Compensation Insurance, or a certified copy thereof (Section - - 3800, Lab. C.) f 4// Backflow Irrigation Sewer CapELECTRICAL 1 FEES Policy Novy 0'BZ-� OVS® company 'H/ ✓ bi 1. Certified copy Is hereby furnished. ir _ger /am, - Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW ' l Certifie gory.is filed with the city Bui • • e' Isior / Date / Pr4 Y3 - - v ���- Clarifiers 0 50+ KW C Applicant Solar Collectors Construction Pole Sub. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher - Solar Piping CookingUnit 'Meter ❑u to 100 amps (This section need not be completed if the permit's for one hundred ($100)or P P - less) I certif that in theperformancepersonof the work for which thispermit is issued,I Drinking Fountains Solar Tank Dover 100 amps• v' Dishwasher Meter 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 OGas ❑Electric Sub Panel ' Date Signature -NOTICE:lf,'after making this declaration, you should become subject to the Floor Sinks Urinal Fan Motors❑0-1 HP ❑1%-8 Workers'- Compensation provisions of the Labor Code, you must forthwith - comply with such provisions or this permit•shall be.deemed revoked. Gas Service Outlets - ' CONSTRUCTION LENDING AGENCY Water Closet F.A.U. Inc.Solar'❑9-15 HP ❑16-15+ I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures ;Microwave of the work for which this permit is issued -(Section .3097 Civ. C.) - Lender's Name - Kitchen Sink Water Service Device Boxes Pole Light Lender's Address - ' OWNER BUILDERDECLARATION • Lavatories Outlets Range I hereby affirm that I am exempt from the Ctintractor's License Law for the p-Tfa following reason (Section 7031.5 Business and Professional Code: Any city or p Switches Sign county which requires a permit to construct,alter,improve,demolish or repair - -my structure, prior to its issuance, also requires the applicant for such permit Roof Drains ' _ Garbage Disposal Standing Sections file a.signed statement that he/she Is licensed pursuant to the provisions of - • .e Contractor's License Law(Chapter 9(commencing with Section 7000)of - _ .Jivision 3 of the Business and Professions Code) or that he/she-is exempt - Generator O0-5 KW 05-15 KW Trash Compactor 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). Reinspection Fee $25 Issue Fee . $ 3 ' lJ I,-as owner of the property or my employees with wages as their soleReinspection Fee $25 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered I 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 ❑ thereon, and who does such work himself/herself or through his or her own Zoning Approved By nate employees, provided that such improvements are not Intended or offered for - Canopy Type II 0 - sale. If, however, the building or improvement is sold within one year of com- Duct- Under Ground Application Approved By Date 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 System i Application Issued By r r Date /(// /g-3 Li I,as owner of the property, am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: • Duct-Ventilating SUMMARY QF FEES The Contractor's License Law does not apply to an owner_ofproperty who (f builds or improves thereon,and who contracts for such projects with a con- ' Exhaust System ❑ Multiple laSystem Repair/Alteration BUILDING PERMIT $ �Sr $MIP $ ,.6-0 tractor(s) license pursuant to the Contractor's License Law). - PLAN CHECK $ PERMIT ❑ 1 am exempt under Section B.&P.C.for this reason ; Firepl/Fact.BIt. ICBG# ' PLUMBING $ ISSUANCE $ Date owner' Heating System&Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑o-100,000 BTU 0100,0006T GRADING $ information is correct. I agree-to comply withallcity and county ordinances - ELECTRICAL $ and state laws relating to building construction,and hereby authorize repre- PLAN CHECK MICROFILM $ Sentatives of this city t• 'enter upon the a' ve-mentioned property for $ inspection purposes o Signature /ssL_ - • t Date 0/ MECHANICAL $ TOTAL FEE $ • / S%c�•7 -"- TOTAL License or SS it / - • Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ CMF-0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - / all - -;;, - , F _ &SPA ' ,CONSTRUCTION AND PLANNING ' , , - - .' Date .Inspector_ - Date - Inspector .. APPROVALS ,Permit# APPROVALS ..Petmit# • .1. kerimporary 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..Rdugh Plumbing & Pressure Test. 6. Electrical UFER Grnd. . , ' . - 57. APPROVAL TO COVER-GUNITE - 7: Footings - . 58 r 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 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 - • 65. Electrical-Final ' • 15. Rough Electrical-Conduit : -' - - - -- ' , _ 166. Solar-System-Final - - - -: 16. Rough Electric Wiring ' , -I .67. Fencing & Access Approval.: - 17. Rough Wiring Sign , - 'I - - 68.-APPROVED-FOR PLASTERING - ' 18. 'Rou h Electrical-T Bar Ceilin - ' 9 9 '69. POOL/SPA SYSTEMS FINAL 19. 'Rough Heating 84-Air Conditioning • FIRE DEPT. REQUIREMENT iw20. :Rough Factory Fireplace • , APPROVALS , Permit# 21. Ducts', in Structure ' 70. Underground Hydro . 22. Ducts', Ventilating. , , 71. Product Piping E Gas .❑Oil 23; Gas Pipe-Rough & Test- , ,• i ; 72. Underground Flush 24. Roof Framing ,� . 73. Undergrnd,Storage Tank 0 Gas 17 Oil ' 25: _Roof Sheathing i H i - 74. Overhead Hydro - - 26. T-Bar Ceiling (Structural) & Monocoat • ' 75., Dry,Chemical - 27. Frame and Flashing 76. Dry Standpipe ' 28. .Lathing & Siding I 77. FIXED SYSTEM FINAL . t 29. insulations • ; 78. FIRE PREV. FINAL • ' 30. Drywall Nailing' 4 t . HEALTH DEPT. REQUIREMENT ' ; 31. Plaster Brown Coat : ! 79. FINAL'INSPECTION 32. ,Electical Power Meter-Anal _ ' ' ' , - 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' • Notes: 34. Final Heating & AirCoriditioning ; • ' , 35. Final Gas Pipe-Test . . - - 36. Hood or, Canopy ' - . : • , � - ' - • i 37. Final Factory Fireplace • ' , 38. Final Plumbing ' ; .. • ' • . 39. Water Service-Final - I 40. Gas Service-Final ' • - ' 41. Solar Domestic-Final . ' I_- t_ ' "I - - ' - 42. Backflow Preventer - _ _ I • 43. Backflow Irrigation . - - - - , 44. ,Landscape Irrigation System , . . . . ' 45. Sound 'Attenuation ' I • ' , ' - 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING T ,, I - , 48. Special Requirements Completed • ,- I ` 49. Electric Release to Edison - -- - - - -• - • - 50. Gas Release toiSouthern Kalifornia Gas Co ` i • i , i 51. CERTIFICATE OF OCCUPANCY _ _ - . . - . No. - rt Date � - 50 I Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. �L�(+ I I / n 112/CITY OF COSTA MESA • - PE IT NO. TRACT NO. LOT NO. BLDG.NO. - . - CONSTRUCTION PERMIT — 9� 2.. 516 era 12 1 - 128' • 2 r Prc{wrr'ladd_ess 150 -VaLLey Fohg e, Cob to M e4 a. TYPE OF CONSTRUCTION ❑ NEWp87''IlLi ADD ❑ ALTERATION ❑ REPAIR Applicant's Mailing Address Same - ❑ CONVERSION ❑ DEMOLISH XII OTHER • • • s I . / . . 1. A.P.# I Zone • Owner's Name Mon,ti.eelIo Comm AAAn Phone 540-1097 DESCRIPTION OF WORK F.f.6ehgLa44 , amp, A4p a '.t KOO g • g S Main Building: Accessory Building: Z• Z Address 150 Valley Fnn^p Rd CnAta Mona - / J r TYPE OF PERMIT ❑ GRADING FOUNDATION ❑ STRUCTURAL T Front N , Arch/Eng. - License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear I • Address ❑OTHER Rut oos A N Contractor's Names an Max-Lno Roo£ CO Phone • 974-3070 PROJECT DESCRIPTION SQ. FT. 7100OCCUPANCY R-1 K Right _ R Address(mailing) 2187 M BaZaVLQ, Ohange 92663 CONSTRUCTION TYPE S-N _ VALUATION$ 6500 S Left • - E City License No. 026085 ZONE GRADING CU.YDS. ACRES ping. Ref.# - Park.Fees $ Q U LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided - I I hereby affirm that I am licensed under provisions of Charter 9 (commenting - • R with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: E my license is in full fs r5�e and effect. License Class CS Y41.. icen No?4 9 5 9 PLUMBING FEES Planning Notes: M Dat4 I /16 Signature .!1/ E WORKERS' COMPENSATION DELL ATI Bar Sink Showers N R I hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink S of Workers' Compensation- Insurance, or a certified copy thereof (Section -- 3800, Lab.�.l. 82 '150458 Fhemon.t Indemnity Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. Y Company y . ❑ Certified copy Is hereby furnished. ------7- Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW *J CerSi(J'e 9opy,Ix tiled with the city Isla y.¢--�. Date I 1 1 6/d 3 . Applicant � • -.le Clarifiers Solar Collectors Construction Pole Sub. 0 50+ KW EXEMPTION FROM WORKERS'COMPENSAT ON DECLARATION Dishwasher ' Solar Piping - — Cooking'Unit Meter ❑up to 100 amps '— ' (This section need not be completed if the permit is for one hundred ($100)or , less). ' I certify that in the performance of the work for which this permit Is issued, I Drinking Fountains Solar Tank Dishwasher i 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' ❑Electric Sub Panel r Date Signature NOTICE:If,after making this declaration,you should become subject to the Floor Sinks . 4 Urinal ' Fan • Motors❑0-1 HP ❑1 t4-8 • 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. Inc.Solar 09-15 HP 016.15+ CONSTRUCTION LENDING AGENCY - _ I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures :Microwave of the work for which this permit is issued (Section.3097 Clv. C.) _ Lender's Name - . Kitchen Sink • - Water Service '- Device Boxes Pole.Light • Lender's Address Lavatories OWNER BUILDER DECLARATION - - Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the P—Trap reason (Section'7031.5 Business and Professional Code: Any city or p . . ' Switches Sign . 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 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 - Generator ❑05 KW ❑5-15 KW Trash Compactor ')ivision 3 of the Business and Professions Code) or that he/she is exempt - om P ierefrom and the basis for the alleged exemption'. Any violation of Section .- 031.5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee $ 3 Lienalty of not more than five hundred dollars($500). Pe $25, Issue Fee I, as owner of the property or my employees with wages as their sole MECHANICAL • Reinspection Fee $25 Issue Fee $'3 compensation, will do the work,and the structure is not Intended or offered . 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 ❑ ' thereon, and who does such work himself/herself or through his or her own Zoning Approved By - nate employees, provided that such Improvements are not intended or offered for - -- Canopy Type II 0 sale. If, however, the building or improvement is sold within one year of com- . Duct-Under Ground Application Approved By Date pletlon, the owner will have the burden of proving he/she did not build or int- f� rove for the purpose of sale). Duct-Structural Refrigeration System -Application Issued By 7 '� Date 11/7/��� U I, as owner of the property, am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU _ tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property who _ $ Q builds or Improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ 7�r oD SM IP • S tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ ISSUANCE $ Date Owner • Heating System&Ducting • PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 0o-ioo,000 BTU ❑100,000BTLELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances - and-state laws relating to building construction,a d hereby authorize repre- MICROFILM $ • sentatives of this city to'enter upon ab ntionetl property for PLAN CHECK $ inspection pur�.es.REI LLV `SR Date 11718` !3 MECHANICAL $ TOTAL FEE $ 7/•.�n Signature l• Reinspection Fee Drivers' License or SS# CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - . -- CONSTRUCTION AND PLANNING. : m _ .; '' . POO. SPA APPROVALS `Permit# 4 y - Date...- ate✓ Inspector APPROVALS Permit# Date Inspector 1. temporary Electrical Service or Pols- - • 52. Pool & Equipment Location • )J - co • .> :Z r•' - ' 2. Soil Pipe Undrgrnd. `. 53. Steel Reinforcement ''� JM1 ✓ 3^ElectricalConduittiltilR't-Undrgrnd. �'. wl - . 54. Forms . . • - - cc -4_Elect sal conduit_lfridrgrnd. � - 55. Electrical Bonding `"' 5.QSt QI<Re forcem4t�s a . - 56. Rough Plumbing & Pressure Test ,-.1-, 6.:Electnca) UF•ER ,Grod. x : 57. APPROVALTOCOVER:GUNITE o- 7>cFooti�ys6+ o - • 58.-ElectricalConduit-Undrgrnd. � S.:Foundat o`n G c - rr. - 59. Gas Pipe, 0 Undrgrnd., Test . 9. Water-Pipe-Undrgrnd? ci • - - 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10.itructura'J',Floor Sysfym o . 61.'APPROVAL TODECK ' G 11.;QropertyiSewer Linec& House Connection H. 62.-backwash & Receptor-Final • 12_Sewer Ca o` ^' z 63` Heater & Vent-Final 13.'. ,.-rams An E 64.'Plumbing.System - Final 4 ' [U .O - we 14. Rough Plumbing' `['. •-rh'r 65f Electrical-Final -. »o •15. Rough Electricaltonduit -- - 66. Solar System-Final w 16; Rough Electric Wiring • .- - i ,67." Fencing & Access Approval ._ • ' - . 17. Rough Wiring Sign - • 68. APPROVED FOR PLASTERING 18. Rough Electricil-T Bar Ceiling ' - - ' 69:POOL/SPA SYSTEMS FINAL ' 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough Factoryf ireplace ' • APPROVALS Permit# • 21. Ducts, in Structure ' 70. Underground Hydro 22. DucA,'Ventilating ' . 71. Product Piping0Gas 0 Oil • _ 23. Gas Pipe-Rough&Test 1 72. Underground Flush I-- , 24. Roof4Eraming o 73. Undergrnd.Storage Tank D Gas 0 Oil 25. Roof Sheathing _ - 74. Overhead Hydro ¢. TUBar Ceiling (Structural) & Monocoat ' 75.-Dry Chemical 27. Freme and Flashing 76. Dry Standpipe 28. .Lat-i g &.Siding; I 1 77. FIXED SYSTEM FINAL . 29. Insulation 1' , - 78. FIRE PREV. FINAL ...-•.CI 30. Der�ywall Nailing rt, 1 HEALTH DEPT. REQUIREMENT 31. Pla-ster Brown Coat° ' 79. FINAL INSPECTION 32. Electrical Power.kieter-Final 1 80. FOOD CERTIFICATE ISSUED ' 33. Final Electric � Notes: 34. Final Heating & Air Conditions ig , 35. Final Gas Pipe-Test _ I ' - , . • - • 36. Hood or Canopy ' _ , 1 . I 37. Final Factory Fireplace I - , - , - - 38. Final Plumbing ' , 39. Water Service-Final , . - ' - ' 40. Gas Service-Final 1 ' , 41. Solar Domestic-Final I _ _ ' - . • - 42. Backflow Preventer ' 43. Backflow Irrigation '• - I - - 44. .Landscape Irrigation Systemi , • • 45. Sound Attenuation I - 46. Handicap Regulations , ' . " • 47. FINAL STRUCTURE & BUILDING ' 48. Special Requirements Completed 49. Electric Release to Edison • 1 - : -- - - - ' - - i 50. Gas Release to Southern California Gas Co'. [ : : 51. CERTIFICATE,OF OCCUPANCY' _ - _ -_ - • No. Date -- - - • _ cApplicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. O�` CITY OF COSTA MESA PERMIT NO. TRACT NO„ II .LOT NO. BLDG. NO. - - CONSTRUCTION PERMIT 6 - 76 7 6 516 I o9-120 • 3"_'- j Project Address 150 UaZLty FOd. e Rd C.M. QL J Sane. na g TYPE OF CONSTRUCTION UNEWG�1yh�� ADD ALTERATION REPAIR 4. Applicant's Mailing Address £a.RlG CI CONVERSION 111 DEMOLISH Iag.IkOTHER RCA00b , C.QQeb A. A.P.# Zone ' Owner's Name Mon.ti_e e_Uo Comm Aeon Phone 540-1097 DESCRIPTION OF WORKS 4,beAg lasso , Comp, A6phaZt - S Main Building: • Accessory Building: Z Address Ca mP - A • I E - 0 TYPE OF PERMIT . GRADI S'FOUNDATION I♦ STRUCTURAL T Front • N Arch/Eng. License No. El TENANT El ELECTRICAL El PLUMBING ❑ MECHANICAL B Rear Address © BOTHER Reno06 A - ' -. N Contractor's Name Sian Maki-no R006 Co Phone 974-3070 PROJECT DESCRIPTION SQ. FT.10, 700 OCCUPAyyNrrCYy�1ygy�1- 1 C Right G CONSTRUCTION TYPE - VALUATION _6500. s Left R Address(mailing) 2187 N. RaRv.i a, lJnnngo, CA. 5-NE City License No. 026085 ZONE - —'GRADING CU.YDS._ ACRES Ping. Ref.# Park.Fees $ Q U LICENSED CONTRACTOR DECLARATION Remarks: ' Parking Req./Provided • • I I hereby affirm that I am licensed under provisions of Charter 9(commencing R with section 7000) of Division 3 of the Business and/• ofesslons Code, and Use of Building: • E • rite my license is in f II f. e and effect. - PlanningNotes: M License las Lice. a• Ne.249: 9 PLUMBING FEES ate ISIS Signature -��� •i .�%"— - _• N WORKERS'COMPENSATION DECLARATI•N Bar Sink Showers T • I hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink S of Workers' Compensation insurance, or a certified copy thereof (Section - - - . - 3800, Lab. L,1,. 82 150458 Fn-emon•t InC�em n.C.t --Backflow Irrigation • Sewer Cap ELECTRICAL FEES Policy No. W Y Company ® Certified copy is hereby furnishetl, Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW C r((if yy my 10 iled with the city Bu �g [�t41s'on ❑ 50+KW Date 1 ( 1�J 8 3 Applicant f"--�( -e Clarifiers Solar Collectors • Construction Pole Sub. . EXEMPTION FROM WORKERS'COM ENSATION DECLARATION - Dishwasher Solar Pi in(This section need not be completed if the permit is for one hundred ($100)or Piping, - Cooking Unit - Meter ❑up to 100 amps less). - I certify that in the performance of the work 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' OE teethe Sub Panel Date Signature - _ NOTICE:If,'after making this declaration,you should become subject to the Floor Sinks Urinal • . Fan Motors 00-1 HP 01%-8 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. ' Inc.Solar 09-15 HP 016-15+ CONSTRUCTION LENDING AGENCY - I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures 'Microwave of the •work for which this permit-is issued (Section 3097 Clv. C.). - - - Lender's Name _ - ' Kitchen Sink - Water Service Device Boxes Pole Light ' Lender's Address , OWNER BUILDER DECLARATION Lavatories • Outlets ' Range I hereby affirm that I am exempt from the Contractor's License Law for the ' p-Trap following reason (Section 7031.5 Business and Professional Code: Any city or p. . - . . Switches Sign county which requires a permit to construct,alter,improve,demolish or repair , _ - ny structure, prior to its issuance, also requires the applicant for such permit Roof Drains - - • . • Garbage Disposal Standing-Sections file a signed statement that he/she Is licensed pursuant to the provisions of , - - he Contractor's License Law (Chapter 9-(commencing with Section 7000)of Generator ❑05 KW ❑5-15 KW Trash Compactor Division 3 of the Business and Professions Code) or that he/she is exempt P 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). Reinspection Fee $25 , Issue Fee $ 3 U 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 nate employees, provided that such improvements are not Intended or offered for Canopy Type II ❑ sale, If, however,the building or improvement is sold within oneyear of com- Duct-Under Ground p Application Approved By Date Pletion,,the owner e have the burden of proving he/she did not build or im- LJrove for thepurposeof sale). Duct-Structural • Refrigeration System • Application Issued By �. Of r Date te �r/ I,'as owner of the property,am exclusively contracting with licensed con- ❑0100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating , SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property who BUILDING,PERMIT f07. OY> SMIP 5-0 builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple ❑ System Repair/Alteration $ $ tractor(s) license pursuant to the Contractor's License Law). - PLAN CHECK $ _ _ PERMIT ' ❑ am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# _ PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ 1 hereby certify that I have read this appli ation and state that the above ❑0100,000 BTU D100,000 BT ELECTRICAL $ GRADING $ information is correct. I agree to comply wit all city and county ordinances and state laws relating to building constr on,and ereby authorize repre- - - - ' PLAN CHECK $ MICROFILM $ - -- sentatives of this city to enter ubo abov ned property for /D7 SU inspection gurpyse's. • MECHANICAL $ TOTAL FEE • $ f Signature LTJ • REILLY S Date_11 /16/83 - Drivers' License or SS# Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 - White-Buildin 9;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor • - CONSTRUCTION AND PLANNING. ' ss - - JL &SPA Date .Inspector - - Date Inspector • APPROVALS' 2Permit# APPROVALS Perm- it# tt. Temporary Electrical Seryle.ice or Po - - . • 52: Pool & Equipment Location - : tsr 42. Soil PlpelUndrgrnd. • ° tr '� - • 53: Steel Reinforcement , •._, V 1 ¢v ryJ vl _ 3.`Electrical Conduit Utility-Undrgmd:-, o+ t • , 54. Forms, - a '4.Electit¢al Conduit't'd nd. �� - 55. Electrical Bonding . - 5:(St ekReinforcemehtt YJ - - 4-. .` C. i - 56.;Rough.Plumbing & Pressure Test y���,, • 6.: lect cal UFER'Gr . nO - 57. APPROVAL TO COVER-GUNITE c): •- ._ I^ U 7. Footips R . 58. Electrical Conduit-Undrgrnd. a•• 8.`s^Fountfration g -G - ..59. Gas Pipe,'0�Undrgrnd.;Test • N 9.'Water'Pi e-Undr rndh In P 9 60. Backwash Lines,P.-Trap, 0 Undrgrnd. 10 tructural'Floor S"Ysj^"em o •, _ 61: AI'PROVAL,TO-DECK 11. Property Sewer Linec& House Connection 4-' ' . 62: Backwash & Receptor-Final (-) 12:._Sewe'rr'Cap �' n •_ ti F - .63.`Heater &-Vent-Final _ 13. Roof Drains ' 1 ` w E .'64. Plumbing,System - Final (,o • U: 14. Rough Plumbing 65. Electrical-Final ^O ' 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:At-Air-Conditioning - -• FIRE DEPT. REQUIREMENT s. • ' 20. Rough FactotFireplace APPROVALS 1, Permit# 21. Ducts, in Structure - 70. Underground Hydro -ole. _. ' 22. Ducts t(gntilating = 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe?Rough &,Test 72. Underground Flush , _ 24: RoofFrarning ' 73. Undergrnd.Storage Tank-0 Gas 0 Oil 425. Roof-Sheathing '' 74. Overhead Hydro 2,6. T:Bat.,Ceiling (Structural) & Monocoat 75. Dry Chemical 27•. Frame and Flashing 76. Dry Standpipe n +: 48•. Lathing &'Siding ' ' 77. FIXED SYSTEM FINAL . 29: I^ura�ion mac. _ 78. FIRE PREV. FINAL 30. d W4ll Nailing y°a,., HEALTH DEPT. REQUIREMENT 31. Pla'�te} Brown Coag t i '79. FINAL INSPECTION 32. Electrical Power Mejr-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test _ . 36. Hood or Canopy • ' . I " ; •• 37. Final Factory Fireplace . ' . _ 38. Final Plumbing 39. Water Service-Final • i• 40. Gas Service-Final .. . . 41. Solar Domestic-Final , , _ I _ - • 42. Backflow Preventer ' 43. Backflow Irrigation - ' 44. Landscape Irrigation System . , • • • ' 45. Sound Attenuation - -- 1 , 46. Handicap Regulations • I . 47. FINAL STRUCTURE & BUILDING I I - 48. Special Requirements,Completed ' 49. Electric Release to Edison I .-- - . - • ' 50. Gas Release to'Southern California Gas Co , r ' i ' 51. CERTIFICATE OF OCCUPANCY' ' - ; _ ' ' _;, - - • - . No. Date 40 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. lb` CITY OF COSTA MESA P MIT NO. - TRACT NO. LOT NO. BLDG.NO. CONSTRUCTION PERMIT 8 - 94 '7,� / y-No S/la0 * Z � 4 Vic:' / I I.Project Address / 7 /i/.�� COSTA MEA 'e�/J• TYPE OF CONSTRUCTION LI NEW IJ ADD ALTERATION Ll REPAIR Applicant's Mailing Address. ail ❑ CONVERSION ❑ DEMpLISH ❑ OTHER R.E4B0/e/A/Ci dZ4/$S '//" lLLO / AJ / JffO.fl/&T/i�GofiA/G / A.P. Zone Owner's NameM6N//CG asentat Me Phone<A4/297 DESCRIPTION OF WORK /"/���i9SS CAMP / . S Main Building: Accessory Building: 2 Address 72ndO TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front N Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICALB Rear - I Address /� �f / ❑ 'OTHER A N Contractor's Name 5%t/MB/1/A/o AO/ A .• Phone f71-,3710 PROJECT DESCRIPTION SQ. FT. (D(>a0 OCCUPANT, R-I C Right G Address(mailing)2/re7 AAis7;J!///J/o,Plt/G.f,61- �1) 5 CON ST RUCTION TYPE VALUATION$ °Soo . $ Left • R E 2 ZONE GRADING CU.YDS. ACRES Ref.# Perk.Fees $ 0 City License No. Q 6oAS Ping. U LICENSED CONTRACTOR DECLARATION Remarks: • Parking Req./Provided I I hereby affirm that I am licensed under provisions of Charter 9 (commencing - - R with section 7000) of Division 3 of the Business and Professions Code,and Use of Building: • E my license Is in full force and effect. License C .s5 C3' V Lice. e No. _.-.. _ PLUMBING FEES Planning •Notes: M IE ;=ate Signature Ire 4 - Ate' Bar Sink Showers • N 1-'WORKERS'COMPENSATION DEC • RATI•N T I 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 S 3800, Lab. C.)," / -�/ Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. frit- 43+ /stIC8 Company ❑ Certified copyis herebyfurnished Bathtubs Sewer Connection �l ' Automatic Washer Transformer 0 15-50 KW Certified copy is filed with the city, ltriivi io 0 50+KW Date Applicant' Clarifiers • Solar Collectors Construction_Pole Sub. EXEMPTION FROM WORKERS'COMPENSATT6N DECLA ATION - Dishwasher Solar Piping (This section need not be completed if the permit IS for one hundred($100)or P 9 Cooking Unit Meter Dup to 100 amps less). [kinking Fountains certify that in the performance of the work for which this permit is issued, I 9 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 OGas ❑Electric Sub Panel Date Signature NOTICE: If,'after making this declaration,you should become subjett to the Floor SinksUrinal Fan Workers' Compensation provisions of the Labor Code, you must forthwith Motors 00-1 HP 011/2-8 comply with such.provisions or this permit shall be deemed revoked. Gas Service Outlets - Water Closet CONSTRUCTION LENDING AGENCY F.A.U. Inc Solar 09.15 HP'016-15+ - I hereby affirm that there is a construction lending agency for the performance Interceptors - Water Heater Fixtures Microwave • of the work for which this permit is,issued (Section 3097 Civ. C.) _ Lender's Name Kitchen Sink Water Service Device Boxes Pole Light Lender's Address Lavatories OWNER BUILDER DECLARATION • Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the p—Tra following reason (Section 7031.5'Business and Professional Code: Any city or p Switches Sign county which requires a permit to construct,alter,improve,demolish or repair ny structure, prior to Its issuance, also requires the applicant for such permit Roof Drains • Garbe a Disposal J file a signed statement that he/she is licensed pursuant to the provisions of - g P Standing Sections • .she 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 - Generator 00-5 KW 05-15 KW Trash Compactor 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 Reinspection Fee 3 LJenalty of not more than five hundred dollars($500). pe $25 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 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 nate employees, provided that such improvements are not intended or offered for Canopy Type II ❑ sale. If, however, the building or Improvement Is sold within one year of corn- Duct-Under Ground pletion, the owner will have the burden of proving he/she did not build or im- Application Approved By //�� _i//�/� Date rove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By ./i Date///) g3 r/ 0 I, as owner of the property,am exclusively contracting with licensed con- ❑0100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property who , CO builds or Improves thereon,and who contracts for such projects with acon- Exhaust System 0 Multiple 0 System Repair/Alteration • BUILDING PERMIT $ /07,/1"0 • SMIP $ tractor(s) license pursuant to the Contractor's License Law). - PLAN CHECK $ PERMIT 0 I am exempt under Section — B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ PERMIT ISSUANCE $ Date _ Owner Heating System&Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTU-- GRADING $ Information Is correct. I agree to comply with all city and county ordinances _ - ELECTRICAL $ and state laws relating to building onstruttion;and hereby authorize repre- PLAN CHECK MICROFILM $ inspection fives of this city • ent- ,�.on Vler above-mentioned pro ert for . $ inspection purposes. _� ' /J,t - S�gnature Date / / 3 MECHANICAL $ TOTAL FEE $ /07•Co Drivers' License or SS$ Reinspection Fee I .$25 Issue Fee $ 3 PLAN CHECK $ i CMF 0865-46 rev. 7/83 White-Building:Canary-Applicant:Pink-Accounting:Goldenrod-Assessor - CONSTRUCTION AND PLANNING - - iL & 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. Footingsc 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 ' 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 • . 1 • 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 - I71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 1 • 73. Undergrnd.Storage Tank 0 Gas n Oil 2'E. 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 3t Plaster Brown Coat ' 79. FINAL INSPECTION . 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: . •34. Final Heating & Air Conditioning ' 35. Final Gas Pipe-Test . 36. Hood or Cahopy - - 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 I 1 . 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 ' ED + Applicant to fill in all spaces except those within hea. 'border lines and sign all appropriatep p Pg declarations. CP::] / , v\ , CITY OF COSItA MESA - PERMIT NO. NC LOT NO. - BLDG.NO. - - - CONSTRUCTION PERMIT • B — ?4 2 Tt ' TRACT'60 39 1 Project Address ISO Uotiey FAAOP - rOAtR MP6a - TYPE OF CONSTRUCTION- LINEW-I-J ADD ALTERATION LLREPAIR - Applicant's Mailing Address SamP CI CONVERSION ❑ DEMOLISH ® OTHER RPAAO/� r!aAA kw A.P.# Zone Owner's Name MontLee.tto Comm A64n Phone 540- 1097 DESCRIPTION OF WORKFJ h01/ paAtl a romp Xaphne.t ga0in,. _ Roobd.l�[ S Main Building: Accessory Building: Z Address Same TYPE OF PERMIT • ❑ GRADING u FOUNDATION ❑ STRUCTURAL E Front N Arch/Eng. License No. �I❑ TENANT CI ELECTRICAL ❑ PLUMBING CI MECHANICAL B Rear N Address' X6tJ OTHER ' Renoc6 Contractor's Name San MaxLno Rood Co Phone 974-3070 PROJECT DESCRIPTION SQ. FT. 9500 OCCUPANCY R- 1 C Right ' G Address(mailing/ 2 181 N. BatavLa. ' Ohange. 92663 CON ST RUCTION TYPE S—N VALUATION$ 6500 g Left - R E 026085 ZONE GRADING CU.YDS. 'ACRES City License No. Ping. Ref.# Park.Fees $ Q U LICENSED CONTRACTOR DECLARATION Remarks: . Parking Req./Provided I I hereby affirm that I am licensed under provisions of Charter 9(commencing - R with section 7000) of Division 3 of the Business and Professions Code,and Use of Building: - E my license is in fyjl f r e and effec License Class ' /��� Lice Nate PLUMBING FEES Planning Notes: M Date 11 /16/83 signature Y tet// a/'$""'V E WORKERS'COMPENSATION DECLARATION Bar Sink Showers N 'hereby affirm that I have a certificate of consent to self-insure or a certificate - T Compensation Insurance, or a certified copyBackflow Preventer Service Sink - S if Workers' thereof (Section 3800, Lab. �1. 82 150458 Fhemo * Indemn.itu Backflow Irrigation Sewer Cap ELECTRICAL - FEES Policy No. Company ❑ Certified copy Is hereby furnished. Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW b(J Crr if-ref filed with the city B tl' g w ion 0 50+ KW Date i / ' genet Applicant s Clarifiers Solar Collectors Construction Pole Sub. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION- Dishwasher - Solar Piping - ' (This section need not be completed if the permit is for one hundred ($100) orP 9 _ • Cooking Unit' - .Meter ❑up to 100 amps' ' I certify that in the performance of the work for which this permit is issued, I Drinking Fountains Solar Tank I 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, I Swimming Pool w/Spa Dryers ❑Gas- ❑Electric Sub Panel Date Signature - — NOTICE: If,after making this declaration,you should become subject to the Floor Sinks • Urinal FanMotors❑0-1 HP ❑1%-8 ' 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. Inc. olar S-15 HP 016-15+ CONSTRUCTION LENDING AGENCY ❑ - I hereby affirm that there is a construction lending agency for the performance ' , Interceptors • Water Heater Fixtures :Microwave of the work for which this permit is issued (Section 3097 Civ. C.) - Lender's Name ' _ Kitchen Sink Water Service Device Boxes Pole Light Lender's Address OWNER BUILDER DECLARATION " " " , Lavatories Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the p—Trap following reason (Section 7031.5 Business and Professional Code: Any city or P Switches Sign 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 StandingSections 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 'vision 3 of the Business and Professions Code) or that he/she is exempt . • Generator 00-5 KW 05-15 KW Trash Compactor • arefrom and the basis for the alleged exemption. Any violation of Section J31.5 by any applicant for a permit subjects the applicant to a civil p!nalty of not more than five hundred dollars($500). Reinspection Fee $25 Issue Fee $'3 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 I for sale (Secion 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 Elthereon, and who does such work himself/herself or through his or her own Zoning Approved By nate employees, provided that such improvements are not intended or offered for Canopy Type II ❑ sale. If, however,the building or improvement is sold within one year of con- . Duct-Under Ground Application Approved By Date pletion, the owner'will have the burden of proving he/she did not build or im- t2 drove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By , «i flare//��+'(/4� LJ I, as owner of the property, am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU tracors to construct the project (Section 7044,Business and Professions Code: ' Duct-Ventilating SUMMARY 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 $ 445',82) SMTP $ ' .5 (J tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT ❑ l am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ 'ISSUANCE $ Date Owner • Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑O-100,000 BTU 0100,000 BTU— GRADING $ 'information is correct.:) agree to comply with all city and county ordinances - ' ' ' ' ELECTRICAL $and state laws relating to building construe"on, and hereby authorize repre- MICROFILM $ sentatives of this city to enter upon /ab mentioned property for PLAN CHECK $ Inspection qurppses. MECHANICAL $ TOTAL FEE $ gcs.7/ Signature g .J .• Re,r II$ 4Date 1 1 16/$3 - Drivers' License or55 _� Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 ' White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - - - . . • 'CONSTRUCTION'AND PLANNING ? 4 • - - -POC SPA _ Date,_ Inspector- " Date Inspector APPROVALS- Permit# APPROVALS Permit# • 1. Temporar.y Electrical Service or Polo-1 . ,. 52. Pool & Equipment Location _ .-1 > 2. Soil Pipe Undrgrnd. ���.' ,;< . i 53, Steel Reinforcement - �� _ ": 3:rElectrical Conduit•Utilitt-Undrgrnds) G1 7 ' " , 54: Forms' ' - n .4:-Elect'al Conduiai dfFrnd. " ` N -55.; Electrical,Bonding • •h :;5.<Steel-Reinforcement.t� - - ' 56.- Rough.Plumbing•& Pressure Test `s 6. ltFical UFER-&rnI. _ iO - 57._APPROVAL TO COVER-GUNITE -on) 7.rFootings 58' Electrical Conduit-Undrgrnd. , • - c,I 8. Foundation ° . " • - :59. Gas Pipe, 0 Undrgrnd., Test 9. Wateripe-Undrgrnd � - .• 60.•Backwash Lines, P-Trap, 0 Undrgrnd. a, 10-Structural Floor S'ys?em - 61.' APPROVAL TO DECK • 11:.1Property Sewer Line:& House Connection i - - 62. Backwash & Receptor-Final ' c -a . 12.-Sewe'r,tap •a a a• • .' 63. Heater & Vent-Final ' .13.-Roof'Drains I e --- a 64. Plumbing System - Final ,. R •.•-- , 14.; RouCli Plumbing'' - - `65. Electrical-Final v 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 ' , i 69. POOL/SPA SYSTEMS FINAL • 19: Rough Heating &'Air Conditioning ; i . FIRE DEPT. REQUIREMENT X20: Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure • , 70. Underground Hydro rrK n •22. Ducts`gentilating ri , 71. Product Piping 0 Gas 0 Oil ' 2'3. Gas Pipe-Rough &Test- ; - 72. Underground Flush td. •Rbof.Freming ' • 73. Undergrnd.Storage Tank 0 Gas 0 Oil • • 25.R 6heathing - 1 .." , 74. Overhead Hydro 26. TEBa,Ceiling (Structural) & Monocoat • - , 75. Dry Chemical 27. Frame•and Flashing 76. Dry Standpipe • ' 2$. Laihing & Siding , I 77. FIXED SYSTEM FINAL - • 29. Insulation � 78. FIRE PREV. FINAL • 30. D',ry'vvall Nailing ;� HEALTH DEPT. REQUIREMENT ' • 31'. Platter Brown Coato " 79. FINAL INSPECTION 32. Electrical Power Meter-Final •' ' 80. FOOD CERTIFICATE ISSUED • 33. Final Electric I- . Notes: , 34. Final Heating & Air Conditioning I 35. Final Gas Pipe-Test ' ' I _ '. , , - _ 36. Hood ori Canopy ' - I i ' - 37. Final'Factory Fireplace , ' - I . . " • 38. Final'Plumbing - l , • 39. Water Servide-Final ' 40. Gas Service-Final ' • - 41. Solar Domestic-Final 42. Backflow Preventer • 43. Backflow Irrigation I - .. - • - 44. ,Landscape Irrigation System - . 45. Sound Attenuation ' • - 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING - . - • 48. Special Requirements Completed i - I 49. Electric Release to Edison - _, - 50. Gas Release to Southern California Gas Co - ' 51. CERTIFICATE OF OCCUPANCY' - ' No. - Date' - l I . • Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. IIIIIIIKCOSTAAMESA :iron-NO. "TRACT NO. LOT NO. BLDG. NO. 96220 I I/1-72r- tlQort` i n0 . CONSTRUCTION PERMIT • - ?241 7- .•r511160 - 2 - 25 18 • • Project Address 150 Valley Forge, Costa Mesa TYPE OF CONSTRUCTION LI NEW Li ADD Li ALTERATION Li REPAIR ❑ CONVERSION ❑ DEMOLISH ]� OTHEFRPrnnf (`1 aqq sr A^ Applicant's Mailing Address same A.P.# I Zone Owner's Nam Ph^no=d n-0 /s0'r DESCRIPTION OF WORK Fiberglass, Cnmp,Asphalt- Owner's Comm Assn .r4p 1097 Roo n S Main Building: Accessory Building: 2Z Address SWUC TYPE OF PERMIT ❑ GRADING FOUNDATION ❑ STRUCTURAL - E Front N Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BRear A • N 1 Address OTHER Reroofing C Right G PROJECT DESCRIPTION SQ. FT. OCCUPANCY - Contractor's Name San Marino Roof C(�hone 5'74 J070 — R^1 K Left - R g 187 N Batavia, R Ylge 92665 CONSTRUCTION TYPE VALUATION$f rjQn S Address(mailing) n E City License No. p76QR5 ZONE - GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ Q U LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided I I hereby affirm that I am licensed under provisions of Charter 9(commencing - R with lection 7000) of Division 3 of the Business an• Professions Code, and Use of Building: - E my license is in full force and effect. / _ Planning Notes: M License Class — • -• ice se N. - PLUMBING FEES • Date Signature •. .% - " s` E 'ORKERS'COMPENSATION DECLARATION - Bar Sink Showers N T • .hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink S of Workers' Compensation Insurance, or a certified copy thereof (Section - 3800, Lab. C.) Backflow Irrigation Sewer Cap ELECTRICAL . FEES Policy No. lei R-x_82 1504-58 Companyj'LI•CIR t In C It y ��IIII certified copy is hereby furnished. Bathtubs Sewer Connection I Automatic Washer Transformer 0 15-50 KW :frit Certified copy is filed with the city I g ivisi - • Clarifiers Solar Collectors Construction Pole Sub. ❑ 50+KW i Datil-18 $ Applicant _ EXEMPTION FROM WORKERS'CO PENSATION DECLARATION Dishwasher Solar Piping CookingUnit Meter ❑u to 100 amps (This section need not be Completed if the permit Is for one hundred ($100)or ' PP less): DrinkingFountains I certify that in the performance of the work for which this permit is Issued,I 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, ❑Electric Sub Panel Date Signature . . , — NOTICE:If,atter making this declaration, you should become subject to the Floor Sinks ' Urinal Fan Motors❑0.1 HP ❑1'/z-8 I 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. • 'Inc.Solar09-15 HP 016-15+ CONSTRUCTION LENDING AGENCY , I I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater : _ Fixtures -i Microwave . of the work for which this permit is issued (Section 3097 Civ. C.) •Lender's Name Kitchen Sink Water Service Device Boxes Pale Light Lender's Address' - Lavatories ' - OWNER BUILDER DECLARATION - - ' Outlets - Range . • 1 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 - - Switches Sign 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 ` • - ' - • . I - Garbage Disposal Standing Sections n file a signed statement that he/she is licensed pursuant to the provisions of e Contractor's License Law(Chapter 9 (commencing with Section 7000) of . Generator ❑0.5 KW ❑5-15 KW Trash Compactor vision 3 of the Business and Professions Code) or that he/she is exempt p , • 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 civilr . • penalty of not more than five hundred dollars($500). 'Reinspection Fee $25 - Issue Fee $ 3 • LJ I, as,owner of the property for 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 I FEES for sale (Secion 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 ❑ thereon, and who•does such work himself/herself or through his or her own Zoning Approved By Rate employees, provided that such Improvements are not intended or offered for Canopy Type II. 0 sale. If, however, the building or improvement is sold within one year of com- Duct-Under Ground Application Approved By Date - pletion, the owner will have the burden of proving he/she did not build or im- / rove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By A)! Data //� / � LJ 1,as owner of the property, am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES The Contractor's License Law does.not apply to.an owner of property who BUILDING PERMITU builds or improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple 0 System Repair/Alteration $ �i SMIP $ ' tractor(s) license pursuant to the Contractor's License Law). • PLAN CHECK $ PERMIT 0 l am exempt under Section • B.& P.C.for this reason Firepl/Fact.aft. ICBG# PLUMBING $ ISSUANCE $ Date Owner —. Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00.100,000 BTU ❑100,000BTL' • GRADING $ Information Is correct. I agree to comply with all city and county ordinances - - ELECTRICAL $ and state laws relating to building cons ction,and her y authorize repre- - PLAN CHECK -MICROFILM $ sentatives of this city to enter u•• e ab�- a oned property for $ !Q/.50 I iginat ro Grp s. MECHANICAL $ ' TOTAL FEE $ Sspectire"1°• °�• Reilly / - Datell-18-.83 Drivers' License or SS# 095 Fee $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - • CONSTRUCTION AND PLANNING Pt & SPA - - Date ..i Inspector_ Date Inspector APPROVALS -:Permit#p, - ,R 'APPROVALS Permit# 1.. Temporary Electrical.Service or Pole • -I 52. Pool & Equipment Location y .2. Aoil P@eslndr rnd. ' tit9 oP 53.2„Steel Reinforcement - t .. J •23. ElectricUlr€onduit Utility-Undrgrnd. - 54. Forms - . ' 4. E)ectri l Conduit-_Qndrgirid. - ° U I ! 55. Electrical Bonding - .y ''5. Steel Reinforcemen7J•-• 56. Rough•Plumbing-& Pressure Test `-i0 . 6. dectrisal UFER Gu. ' w 757. APPROVAL TO COVER-GUNITE .J 7. Footings O W 58._ Electrical Conduit-Undrgrnd. ' Yr 8. Fp undation 'L .N - 59.-Gas Pipe, D Undrgrnd., Test 9. Water 5i e-Undr rnd. 0v n ,�P 9 60. Backwash Lines, P-Trap, D Undrgrnd. 10. S,l:ructural Floor S`yaiein - • 61. APPROVAL TO DECK 11. Property Sewer Line 8i'House Connection -' 62. Backwash Receptor-Final. • `v t. 12. Seweraap t^,-,,� r 63. Heater & Vent-Final - LA 13: Roof Drains �I •o i. - ' 64. Plumbing System : Final ?, C3 J r., rr 14. RoughTPlumbing V ru .i 65. Electrical-Final . r ` • coo 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 Factoryy:Fireplace , , APPROVALS Permit# • 21. Ducts, in Structure : t 70. Underground Hydro 2.. Ducts„ rentilatiing . 71. Product Piping 0 Gas 0 Oil ' 23. Gasjp jRougFQ&g est : , . 72. Underground Flush 24. Roof Fring o 173. Undergrnd.Storage Tank,D Gas El Oil 25. RoofiSrieathing 74. Overhead Hydro 26. T-vqa?JCeiling (Structural) & Morioco'at' 75. 'Dry Chemical 27. Frame and'Flashing 76. Dry Standpipe • - • 28. Latlii,g & Siding . • • 77. FIXED SYSTEM FINAL. ' 29. Insulation - ' . 78. FIRE PREY. FINAL - 1 -: •- 3.9. DtwaII NailingI , HEALTH DEPT. REQUIREMENT ' 31- Plaster Brown Co ' ag • ' 79. FINAL INSPECTION . 32. Electrical Power Meter-Final, ' 80. FOOD CERTIFICATE ISSUED ' 33. Final Electric Notes: , 34. Final Heating & Air Conditioning • , 35. Final Gas Pipe-Test I - • - - - 36. Hood or Canopy - - - • . 37. Final Factory Fireplace - • - • • • 38. Final Plumbing ' .. , .• I 39. Water Service-Final i ' - 40. Gas Service-Final ' 41. Solar Domestic-Final ' - - . 42. Backflow Preventer t • ' , 43. Backflow Irrigation - - - - • 44. Landscape Irrigation System • • 45. Sound Attenuation - - ' '' ' i 46. Handicap Regulations • I , • 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 - - • - SD Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 9L;E I I ,I '. ./ - - aD% CITY O6COSTA MESA - PERMIT NO. TRACT NO. LOT NO. BLDG. NO. - - CONSTRUCTION PERMIT - 974/ r. 5160 264th 30 BS- 19 ' Project Address150 Valley Forge, L.osca mesa TYPE OF CONSTRUCTION U NEW U ADD LI ALTERATION U REPAIR 1 • .j' Applicant's Mailing Addressxili same ❑ CONVERSION ❑ DEMOLISH OTHER $eroof Class 1,8" A.P.# I Zone ( Owner's Name MOn*irell O rnmm (� DESCRIPTION OF WORK - _ _ _ Assn Phow540-1 97 �� Q S Main Building: Accessory Building: O Address same TYPE OF PERMIT GRADING IS FOUNDATION, ❑ STRUCTURAL ' E Front N Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Address ®OTHER Reroofing A Contractor's Nam¢ Phon PROJECT •DESCRIPTION SQ. FT. 4000 OCCUPANCY R-1 C Right Q San Marino Roof Co. 979-3070 K R Address(mailing) - _ _ , __ _ • _ - _ CONSTRUCTION TYPE 5—u` 'VALUATION 6500 S Left E ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park $ Q City License No. 026085 U LICENSED CONTRACTOR DECLARATION Remarks: • Parking Req./Provided I I hereby affirm that I am licensed under provisions of Charter 9(commencing - R with section 7000) of Division 3 of the Business and Professions Code,and Use of Building: . E my license is in full or[p Apnd effect. 'icense Class -37 oma..—vLic se N 4 55.^� - PLUMBING - FEES Planning Notes: M ate Signature i( •-d—I/ /id E WORKERS'COMPENSATION DECLARATION Bar Sink Showers • T I hereby affirm that I have a certificate of consent to self-Insure or a certificate Backflow Preventer , Service Sink' S of Workers' Compensation-Insurance, or a certified copy thereof (Section - - - - - 3800, Lab C.) Backflow Irrigation Sewer Cap ELECTRICAL ' , FEES Policy J 82 150458 ' Company Fremont Indemnity s kjCertified copy is hereby furnished. ' Bathtubs Sewer Connection Automatic Washer ' 'Transformer 0 15-50 KW Certified copy is filed with the ci n ivi on. ❑ 50+KW Da��ee'�I1 77 $$��_5$��''�j Applicant Ifs Clarifiers Solar Collectors Construction Pole Sub. -EXLr RIP14&.4 FitDM WORKERS'COMPENSATION DECLARATION Dishwasher - " Solar Piping - ' -- (This section need not be completed if the permit Is for one hundred ($100) or P 9 Cooking Unit Meter ❑up to 100amps less), - I certifythat in the permitDrinkingFountainsamps performance of the work for which this islissued,"I Solar Tank Dishwasher Meter Dover 100 am s 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 ❑Eleen ic Sub Panel Date Signature I NOTICE:If,'after making this declaration,you should become subject to the Floor Sinks Urinal Fan Motors 00-1 HP 01'/a-8 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. Inc.Solar 09-15 HP 016-15+ CONSTRUCTION LENDING AGENCY, I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures ' - Microwave • of the work for which this permit is issued (Section 3097 Civ. 'C.) . Lender's Name • Kitchen Sink Water Service - Device Boxes Pole Light Lender's Address - OWNER BUILDER DECLARATION - LavatoriesOutlets Range I hereby affirm that I am exempt from the,Contractor's License Law for the P—Trap . following reason (Section 7031.5 Business and Professional Code: Any city or - Switches Sign . ^.ounty which requires a permit to construct,alter,improve,demolish or repair ' ,,.erny structure, prior to Its issuance,also requires the applicant for such permit ' . - Roof Drains , - Garbage Disposal Standing Sections } .o 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 Generator 00-5 KW 05-15 KW Trash Compactor Division 3 of the Business and Professions Code)_or that he/she is exempt • - - P 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 Reinspection Fee $ 3 enalty of not more than five hundred dollars($500). Pe $25 Issue Fee • Li I, as owner of the property my employees-with wages as their sole MECHANICAL Reinspection Fee $25 Issue Fee • $ 3 compensation, will do the work, and the structure is not intended or offered . - . 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 whodoessuch 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 D sale. If, however,the building or improvement is sold within one year of corn- Duct-Under Ground Application Approved By Date /� '/8.3 p T grove the owner will have the burden of proving he/she did not build or Im- flatei/ /8`3 rave for the purpose of sale). Duct-Structural Refrigeration System Application Issued By �/ tiff • U I, as'owner of the property, am exclusively contracting with licensed con- • ❑0-100,000 BTU 0100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: . Duct-VentilatingSUMMARY OF FEES The Contractor's License Law does not apply to an owner of property who yos pp , Co builds or improves thereon, and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ _ SMTP $ tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT 0 t am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG* . • PLUMBING $ ISSUANCE $ Date owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑4100,000 BTU 0100,000BTU GRADING $ information Is correct. I agree to comply with all city and county ordinances ' r ELECTRICAL- , - $ and state laws relating to building con ,ruction, • d hereby authorize repre- PLAN CHECK $ MICROFILM $ sentatives of this city to-enter up j$1.5 the . f-m-'Boned property for inspection purposes. yJ / _ _ MECHANICAL . $ - TOTAL FEE $ /iL 6icSa Signatur- - •St -i - Dat . Drivers'.License or SS ' - ��1$— l Reinspection Fee I $25 Issue Fee $ 3 PLAN CHECK $ ' CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - ,,t CONSTRUCTION AND PLANNINta )1 - - JL &SPA APPROVALS Permit#' - Date -1 Inspector- APPROVALS - Permit# - Date Inspector I !,.'.• 1: Temporary Electrical Service or Pole •' •' 52. Pool & Equipment Location 2. __Soil P•'Ipenyndrgrnd. - - u , CO 53. Steel Reinforcement hi - '3._Electrrca lEGonduihUti lityt Undrgrnd. • ti - 54. Forms - - w •4.4ElectrAal Conduit-Urldrg?nd. :fl; 2- ' 55. Electrical Bonding- -` 5.ateel U1 -. .J ,Reinforcemeprt - ao - - 56. Rough Plumbing & Pressure Test - v. m .1f `6.>Eltictncal'UF ER trig. • • 57.- APPROVAL-TO COVER-GUNITE 7,food ys .K ',,q - - 58. Electrical Conduit:Undrgrnd. O/ 8.EFoundation O0 •'1 M 59. Gas Pipe, O Undrgrnd.,Test ti w ri 9. Waterleipe-Undrggd.- - (1) - ;60. Backwash Lines, P-Trap, O Undrgrnd. a. 10 1tructural'Floor SystPn C61. APPROVAL TO DECK N 11.0Property Sewer Line&House Coijnection " , ' .'62. Backwash & Receptor-Final ^ "\ - _ y 12:-$ewer=Cap t-- 'l.) C - I o G. r � ,7 63. Heater &Vent-Final - ti 13..Roof&rains I .-I : y - Lt l' ..Roof tJ _D 64. Plumbing System - Final Il 14. Rougt'Plumbing 1 iI ;h - 65. Electrical-Final - w h Electrical-Conduit - - 'A 15. Rough 66. Solar System-Final 16. Rough Electriceiring ! , - 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 Factor'cqFiieplace APPROVALS Permit# • 21. Ducts, in StruFlure 70. Underground Hydro N Y r -22: Duct ntilaiing. 71. Product Piping 0 Gas ❑Oil 21. Gas I;ape4Rougly& Test I 72. Underground Flush 24. Roof frirning - 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roofj heathing � - 74. Overhead Hydro 26. T-Bar lCeiling (Structural) & Monocoat' - 75. Dry Chemical - Frame and Flashing • 76. Dry Standpipe 21 L Thing & Siding i 77. FIXED SYSTEM FINAL • 29. Insulation 78. FIRE PREY. FINAL • M. Dr;�wall Nailing, j , ' HEALTH DEPT. REQUIREMENT• ' Cl/ ill 311. Plastee Brown Cos • 79. FINAL INSPECTION _t I 32. Electrical Power'Meter-Final 80. FOOD CERTIFICATE ISSUED • 33. Final Electric Notes: 34. Final Heating & Air Conditioning- - 35. Final Gas Pipe-Test , , I ' 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 { SU Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. C_C I / / ^ '\ 1,,i' CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. CONSTRUCTION PERMIT B - 9 ? 4' 9 ' 5160 11-1520 .Project�Addresz 15-0 X11 ey Forgo , Costa MPsa TYPE OF CONSTRUCTION LI NEW U ADD U ALTERATION 3 REPAIR It. - 0 Applicant's Mailing Address same CONVERSION El DEMOLISH OTHER n ^ A,P.# 1 Zone Owner's NameMOAtiCe 110 Comm Ae.sn Phone 540-1119 DESCRIPTION OF WORIFlbe rg ass, COIDD_ a Asp d BOOP i Aq S Main Building: Accessory Building: Z Address L7 E 0 sante TYPE OF PERMIT L GRADING FOUNDATION ❑ STRUCTURAL T Front N Arch/Eng. License No. 0 TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear - N Address y(OTHER RPrOnfirg C Right G Contractor's Name San Marino Roof COPhone974-3070 PROJECT DESCRIPTION SQ. FT. 4000 OCCUPANCY Address lmaiiing12187 N. Batavia. Orange 92665 CONSTRUCTION TYPE 5—N VALUATION$ 6p1OU-1 $ Left E 026085 ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ 0 City License No. U LICENSED CONTRACTOR DECLARATION Remarks: - Parking Req./Provided I I hereby affirm that I am licensed under provisions of Charter 9 (commencing R with section 7000) of Division 3 of the Business an• Professions Code, and Use of Building: E my license is In full fora and effect. Planning Notes: • License Class Lir se No. M — :�� "Z PLUMBING FEES DD41-18-83 Signature sr. , WORKERS'COMPENSATION DECLARATION Bar Sink Showers N ' T I hereby affirm that I have a certificate of consent to self-Insure ora certificate Backflow Preventer Service Sink S if Workers' Compensation Insurance, or a-certified copy thereof (Section • • • 3800, Lab. C�.i Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. WP 82 ] 50458companv nt Tndeninitl 0 15-50 KW ❑ Certified copy is hereby furnished— / Bathtubs Sewer Connection , Da CO,Ified copy is flied with the city =Tn• ei isi• �sAutomatic Washer Transformer Date —1 R-83 Applicant i .04.� Clarifiers Solar Collectors Construction Pole Sub. 0 50+KW EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher • Solar Piping (This section need not be completed If the permit:is for one hundred ($100)or P 9 Cooking Unit - Meter Owlto 100 amps less). DrinkingFountains I certify that In the performance of Ihd work for which this-permit couIs t tot I Solar Tank , Dishwasher Meter Clover 100 amps shall not employ any person In any manner so;as to become subject the Workers' Compensation Laws of California Floor Drains Swimming Pool w/Spa, • Dryers ❑Gas ❑Electric Sub Panel Date Signature • - NOTICE:If,'after Making this declaration, you should become subject to the ' Floor Sinks Urinal Fan Motors❑0-1 HP 01%-8 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. Inc.Solar ❑9-15 HP ❑16-15+ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance ' Interceptors . Water Heater Fixtures of the work for which this permit is issued (Section 3097 Civ. C.) Microwave Lender's Name Kitchen Sink Water Service Device Boxes Pole Light Lender's Address OWNER BUILDER DECLARATION Lavatories - Outlets - Range I hereby affirm that I am exempt from the Contractor's License Law for the P—Trap reason (Section 7031.5 Business and Professional Code: Any city or p - Switches ' Sign • 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 - arGbo a Disposal Standing Sections to file a signed statement that he/she is licensed pursuant to the provisions of g tan9 the Contractor's License Law(Chapter 9(commencing with Section 7000)of 'vision. 3 of the Business and Professions Code) or that he/she is exempt - Generator 00.5 KW ID 5-15 KW Trash Compactor :refrain'and the basis for the alleged exemption. Any violation of Section - 131.5 by any applicant for a permit subjects the applicant to a civil rnalty of not more than five hundred dollars($500). Reinspection Fee $25 Issue Fee $ 3 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 ❑ 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 building or improvement is sold within one year of com- Duct-Under Ground Application Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- ' rove for the purpose of sale). - Duct-Structural Refrigeration System Application Issued By r w// • / Date /./.x."1/2.3 I, as owner of the property, am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES t 7O The Contractor's License Law does noapply 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 BUI LDING PERMIT $ I£d SMIP $ /-rte tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.alt. ICBG# PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑0.100,000 BTU 0100,000 BTL GRADING $ information Is correct. I agree to comply w h a0 city and county ordinancesELECTRICAL $ ' and state laws relating to building constr . ion, a•• h eby authorize repre- - PLAN CHECK $ MICROFILM $ sentatives of this city to enter upon r ab, fm tioned property for ' inspection purposes. j i/� MECHANICAL $ TOTAL FEE $ 41°'`5 D inspection po• J. Reill Date 11-18-83 Drivers' License or SS# - • Reinspection Fee .1 $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 White- • • - - N / Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - • CONSTRUCTION AND PLANNING - POO SPA Date, liispector • Date Inspector APPROVALS Permit# ~ . -i APPROVALS Permit# . r I .0 _ 1. Temporary Electrical Service or Polej y 52. Pool & Equipment Location I ' y 2. Soil Pipe-I ndrgrnd. O b' - .I 53. Steel Reinforcement • M ll �''- N W n, 3. ,E lectrtcgalcConduitjUtjlity -Undrgr`gd. . ci cu 54. Forms. ' - P -. 4. llectr�Cal ConduiP-Undigrnd. ci . 55. Electrical.Bonding • 5.Sieel Htinforcemeit " a, A 56. Rough Plumbing & Pressure Test • 11 6. Ele6t5ycal•UFER'Qrn21. - . 57: APPROVAL-TO COVER-GUNITE `"'I „C1 -n 7. Footings `D 9 ' 58. Electrical Conduit-Undrgrnd. -J 8- founda4 tion O tr. , - " 59. Gas Pipe, 0 Undrgrnd., Test `� 9. Water ipe-Undryrndy ' N . • •.60. Backwash Lines, P-Trap, 0 Undrgrnd. a, A. n 10: $tructural Floor $ystm - C , 61. APPROVAL TO DECK cit of 11.' operty Sewer Line House Coif°iection ri 62..Backwash &-Receptor-Final C./ C, I 1 _ i....( 12. SewenCap - v nv ,J C I 63. Heater & Vent-Final `� 13. oof Drains tj m v 64. Plumbing System - Final I 14. Rough:Plumbingi- '`I F 65. Electrical-Final . ' w 15. Rough-Electrical-Conduit -,- • 66. SOlar System-Final ' 16. Rough Electric Wiring ,' - 67. Fencing & Access Approval 17. Rough Wiring Sign68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL }9. Rough Heating& Air Conditioning - FIRE DEPT. REQUIREMENT 20. Rough FactoryjFireplace APPROVALS Permit# 21. Ducts, is.(:Structure - 70. Underground Hydro , w a i 't 23. Ducty, ¢entilattng 71. Product Piping 0 Gas 0 Oil 23. Gas Pip4Rough Wriest 72. Underground Flush 24. RoofaFraming u' 73. Undergrnd.Storage Tank OGas ❑Oil J 25. Roof$heathing - ' . - 74. Overhead Hydro 26. T-Bar)Ceiling (Structural) & Monocoat - 75. Dry Chemical 17 - 2 .i. FrO¢,and Hashing 76. Dry Standpipe 28. LaBiin.g & Siding 77. FIXED SYSTEM FINAL 29. Ins4tion , 78. FIRE PREV. FINAL 30. Dr vC/ II Nailing :J ' 1 HEALTH DEPT. REQUIREMENT a•^ • 31,. Plai ' Brown Coar . ' 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test _ ' 36. Hood or Canopy _ ' 37. Final'Factory Fireplace , , , - , , . ' 38. Final Plumbing - 39. Water Service-Final • ' • 40. Gas Service-Final r 47. 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 , , • i51. CERTIFICATE OF OCCUPANCY_ No. Date r. ` 64° Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 962_ I / : I'I'o` 4° ` CITY OF COSTA MESA PERMIT NO TRACT NO. LOT NO. BLDG.NO. CONSTRUCTION PERMIT R - 9,73-0 5160 LI 16-20 4x11 -P7oject Address _ a - • • • - - u - c - TYPE OF CONSTRUCTION U NEW�lLi ADD LJ ALTERATION LJ REPAIR 1 Applicant's Mailing Address Same El CONVERSION II] DEMOLISH 8J OTHERRPTnnf Claes "A" A.P.als I Zone Owner's Name Mnnti CP alp Comm z1CS*?rphon{ad0-10-97 DESCRIPTION OF WORif'.l .-r lass, Comp , Achalt , Roo t • p S Main Building: Accessory Building: Z 0 Address same TYPE OF PERMIT . GRADING = FOUNDATION STRUCTURAL E Front N Arch/Eng. License No. _ Cl�7l TENANT El ELECTRICAL El PLUMBING El MECHANICAL B Rear Address Jr�.l OTHER _ A N Contractor's Name San Marino Roof COhone 974-3070 PROJECT DESCRIPTION SO FT.40 e 0 OCCUPANCY R-1 C Right G Address(mailing) 2187 N. Batavia, Orange 92665 CON ST RUCTION TYPE - 5-N VALUATION$ 6500 S Left E A City License No. 026085 ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ Q U LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided I I hereby affirm that I am licensed under provisions of Charter 9 (commencing R with section 7000) of Division 3 of the Business and Professions Code,and - Use of Building: -• E my license is in 11)1,1 fgm and effect. License Class 1. 37 LI se N PLUMBING FEES Planning Notes: M Date 11-1te-111 Signature 41 - E _-_ /YORKERS'COMPENSATION DECLARATION Bar Sink Showers T I hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink S of Workers' Compensation Insurance, or a certified copy thereof (Section - 3800, Lab. 141p82 150458 Fremo t Indemnity Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. Company 1' • Certified copy is hereby furnished. Bathtubs Sewer Connection Automatic Washer Transformer 0 15.50 KW Cgrtlfie9 Gppy i filed with the city it Di si ❑ 50+KW Date II 11 tt-8 Applicant - - Clarifiers Solar Collectors Construction Pole Sub. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION was Dishher - - (This section need not be completed if the permit is for one hundred($100) or Solar Piping - Cooking Unit Meter ❑up to 100 amps less) - I certify that in the performance of the work 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 te Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa' Dryers ❑Gas ❑Electric Sub Panel ' Date Signature — ' NOTICE:If,'af ter making this declaration,you should become subject to the • Floor Sinks Urinal ' Fan Motors❑3-1 HP 01K-8 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. Inc. ❑9-15 HP ❑16-15+ CONSTRUCTION LENDING AGENCY - . - • I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures of the work for which this permit Is issued (Section 3097 Civ. C.) • Microwave • Lender's Name - Kitchen Sink Water Service • Device Boxes Pole Light • Lender's Address Lavatories . ' OWNER BUILDER DECLARATION Outlets Range I hereby affirm that 1 am exempt from the Cdntractor's License Law for the P-Trap reason (Section 7031.5 Business and Professional.Code: Any city or p Switches Sign county which requires a permit to construct,alter,Improve,demolish or repair _ 'ny structure, prior to Its issuance, also requires the applicant for such permit Roof Drains Garbage Disposal Standing Sections ) file a signed statement that he/she is licensed pursuant to the provisions of ne 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 •- Generator ❑0-5 KW ❑5-15 KW Trash Compactor 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 Reinspection Fee LJenalty of not more than five hundred dollars($500). Pe $25 Issue Fee $ 3 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 L 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 0 ' sale. If, however, the building or improvement is sold within one year of com- Duct-Under Ground Application Approved By Date pletion, the owner will have She burden of proving he/she did not build or im- - - g,ove for the purpose of sale). Duct-Structural ' Refrigeration System Application Issued By 1) ,' y nate/y/T•Z/83 LJ I,as owner of the property, am exclusively contracting with licensed con- ❑4100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARYRO OF FEES ` f� The Contractor's License Law does not apply to an owner of property who - �/d J • builds or improves thereon, and who contracts for such projects with a con- Exhaust System 0 Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT 0 I am exempt under Section B.&P.C.for this reason Firepl/Fact.Blt. ICBG# PLUMBING $ ISSUANCE $ Date owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑3-100,000 BTU 0100,000 BTL GRADING $ Information is correct. I agree to comply wi h all city and county ordinances ELECTRICAL $ -- and state laws relating to building constr tion,an• hereby authorize repre- - MICROFILM $ sentatives of this city to'enter upon/ e ab 7` e ,toned property ,for . PLAN CHECK $ inspection purposes. r ' . 11-18-83 . - MECHANICAL $ TOTAL FEE $ 40'15 a Signature L. J. ReillyDate Drivers' License or SS le - Reinspection Fee $25 Issue Fee $ 3 I PLAN CHECK $ • T CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor 1 -1 INSTRUCTION AND PLANNING - ti ' ' - ,L&SPA •APPROVALS 'Permit# - Dated ' Inspector APPROVALS Permit Date Inspector A. Teme` porary Electrical Service or Pols - ' y 52. Pool & Equipment Location 1-1 • 2:L§oil Pipe-Undrgrnd. -� _ .5 I I - - 53. Steel Reinforcement v 3 w it I l m - 3. •ElectacaliConduit Utility-Undrgrrjdt - n . 54.•Forms,- 1 - J 4. 4)ectrj4al Conduit3Intlfgrnd. - - 55. .Electrical Bonding _l$ -5. Steel ROinforcemetitt b - a - • 56..Rough Plumbing & Pressure Test `t LA 6. 51Atrical UFER d'rr . - to 57. APPROVAL TO COVER-GUNITE n 7. Footirt-ys •`O a 58. Electrical Conduit-Undrgrnd. • 8. ,6undetion 'T 5. 59. Gas Pipe, 0 Undrgrnd.,Test .a 9: Waterh8ipe-Undrgmd7 N _ - 60., Backwash Lines, P-Trap; 0 Undrgrnd. • ?I 10. &tructrfral Floor S�ysthm 61. APPROVAL TO DECK Ca 11.,Property Sewer Line`& House Co`tection r F_ 62.•Backwash & Receptor-Final ti •--1 12. ewerCap of :i c, :1 0 63. Heater & Vent-Final 1 o tw v 13: Roof-Oains �1 po - °'' T.112 - • - 64. m Plumbing-Syste - Final 4.1:i 1 14. Roug?Plumbing. rJ '4 - 65. Electrical-Final j 15. Rough Electricalldonduit PA - -66.-Solar System-Final 1'6D Rough Electric Wiring •67. Fencing & Access Approval 117. Rough Wiring Sign :. 68. APPROVED FOR PLASTERING 61•8: Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL '13. Rough Heating &,Air.Conditioning ' , FIRE DEPT. REQUIREMENT • 120. Rough Factory Fireplace _ APPROVALS Permit# 21. Ducts, in Structs re 70. Underground Hydro 22. Ducts?entilatung- 1 • 71. Product Piping 0Gas 0 Oil 57:- ' f. .e r. Gas R pc-Roughrys7r_•tn oot • 72. Underground Flush 24. Rf aming tuo--' . 73. Undergrnd.Storage Tank 0 Gas 0 Oil , 25. RooffSheathing 74. Overhead Hydro 2g. Tygar-Ceiling (Structural) & Monocoat 75. Dry Chemical 27i. Frafn¢ nd Flashing • 76. Dry Standpipe C-) . . 28. LRCf,,hirig & Siding - 77. FIXED SYSTEM FINAL 29. Insjle{ion 78. FIRE PREV. FINAL 1 30. Drtywl Nailing HEALTH DEPT. REQUIREMENT J 1 31.. PlastertBrown Coit 79. FINAL INSPECTION • 32. Electrical Power Meter-Final ' 80. FOOD CERTIFICATE ISSUED 33. Final ElectricNotes: 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 I • _ ' . 42. Backflow Preventer , . . • 43. Backf low Irrigation , . • i , • • 1 44. ,Landscape Irrigation System - 45. Sound Attenuation • • • 46. Handicap Regulations' ' , - . 47. FINAL STRUCTURE & BUILDING • • H ' 48. Special Requirements Completed • - • 49. Electric Release to Edison ' ' . . ' - - 50. Gas Release,to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - i , . . . _ . No. - Date ° Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. c\cs77 CITY OF COSTA-MESA PE MIT NO. TRACT NO. LOT NO. BLDG.NO. - CON.T,3 CTION PERMIT 9624 I / . '/ ' • �I 776 5160 Z-10 22 ....r Project Address 190 Val ley Forge , Costa MPRH TYPE OF CONSTRUCTION Li NEW- ❑ ADD L ALTERATION Li REPAIR Applicant's Mailing Address sAMP - . ' ❑ CONVERSION ❑ DEMOLISH ® OTHER Reroof Class "A" A.P.# 1 Zone Owner's NamMnntire11n rnmm Aaan Phone C40-10(47 DESCRIPTION OF WORK •- - - - - - ,,.- Roof E Main Building: Accessory Building: ZO Address -same TYPE OF PERMIT ❑ GRADING LJ FOUNDATION ❑ STRUCTURAL T Front N Arch/Eng. License No. 0 TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL B I Address` OTHER A Rear N n ' Reroofing Contractor's Nam hone 974-3070 PROJECT DESCRIPTION SQ. FT. SOO OCCUPANCY C Right G Address(mailing) r - • _- c _ CONSTRUCTION TYPE-N VALUATION$ 6C00R-1 s Left R ZONE GRADING CU.YDS. ACRESPing. Ref.# Park.Fees $ U City License No. 0260-R$ LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided 1 I hereby affirm that I em licensed under provisions of Charter 9(commencing R with section 7000) of Division 3 of the Business rid Professions Code, and • Use of Building: - E my licenie is in fuL.:- and effect. I� License Class "— � ansa 59 - PLUMBING FEE$ Planning Notes: M Date 11-1 FS—53 Signature E YORKERS'COMPENSATION DECLARATION' Bar Sink Showers N - .hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink S of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab._C.) 82 150458 Fremont IndemnF- Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No.WY Company y 3lr,.l1 Certified copy is hereby furnish° Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW ALJ Certified copy is filed with the cit Di isi - 0 50+ KW Date ,) 7� 77 pR_({���� Applicant Clarifiers Solar Collectors • Construction Pole Sub. • .EXEMPTIOIOYRQTY WORKERS'CO 'PENSATION DECLARATION Dishwasher - (This section need not be completed if the permit is for one hundred($100)or _ - Solar Piping Cooking Unit Meter ❑up to 100 amps less). DrinkingFountains I certify that in the performance of the work for which this permit is issued, I Solar Tank Dishwasher Meter Dover 100 amps shall not employ any person In any manner so as to become subject to te . Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa• Dryers ❑Gas DElectric Sub Panel Date Signature - NOTICE: If.after making this declaration,you should become subject to the Floor Sinks Urinal Fan Motors 001 HP 01 K-8 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 CONSTRUCTION LENDING AGENCY - F.A.U. IAC.Solar 09-15 HP 015-15+ I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures ' t Microwave of the work for which this permit is issued.-(Section 3097 Civ. C.) _ Lender's Name Kitchen Sink Water Service - Device Boxes Pole Light Lender's Address• Lavatories BUILDER DECLARATION - Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the P—Trap reason (Section-7031.5 Business and Professional Code: Any city or p . Switches Sign 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 '- file a signed statement that he/she Is licensed pursuant to the provisions of - e 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 Generator 00.5 KW 05-15 KW Trash Compactor r herefrom 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). Reinspection Fee $25' Issue Fee $ 3 0I, as owner of the property or my employees with wages as their soleReinspection Fee $25 Issue Fee - $ 3 compensation will do the work,and the structure is not intended or offered MECHANICAL FEES for sale (SectI ion 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 IDthereon, 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 buildingor improvement is sold within oneyear of com- Duct-Under Ground • P Application Approved By Date pterion, the owner will have the burden of proving he/she did not build or Im- rve for the purpose of sale). Duct-Structural Refrigeration System Application Issued By A ). /�f Date/1/4)/8'' /� oI, as owner of the property, am exclusively contracting with licensed con- ❑4100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY 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 $ _ y 'f7U SMTP $ V tractors) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG 4 PLUMBING $ ISSUANCE • $ Date owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑o-100,000 BTU 0100,00067E GRADING $ Information Is correct. I agree to comply with all city and county-ordinances - ELECTRICAL $ and state laws relating to building construction, a d hereby authorize repro- PLAN CHECK MICROFILM $ sentatives of this city to enter upon a ab v mentioned property for $ inspectio n_pu rpo),es. _ Signatures.' J . Reilly. Date11-1R—Rq - MECHANICAL $ - TOTAL FEE $ 9S,S Drivers' License or SS Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink- - Accountln9:Goldenrod-Assessor 1 `CONSTRUCTION AND PLANNING X - - P. &SPA .. (APPROVALS Permit# - Date Inspector- - 'APPROVALS Permit# Date Inspector 1y - l 1. Temporary Electrical Service or Pole '`ti •I. - 52.- Pool & Equipment Location -� x - . x - 2. Soil PjpeaQndrgrnd. . 1 • ,1 - 1 . 53. Steel Reinforcement 3. Elects�al'Conduitayti(ity-Undrgrtf dt) ' `'I w: 54: Forms _ ' . 4.:Electrical ConduittUndrgrnd. • `� ru55. Electrical Bonding .� • 1 - - - "I 5.`Steel'geinforceme�hit • x r .. 56: Rough Plumbing & Pressure Test - - Hr 6. jElco Qr " ' m 57. APPROVAL TO COVE a' ''_. al UF �rnd.•u - - � 7.c ootiiigs O cd • - _ - 58. Electrical Conduit-Undrgrnd. y 8. jl oundatiOn p u7 - • = ' 59. Gas Pipe, 0 Undrgrnd.,Test n =l 9. Watercv ipe-UndrgTrhd., _ „ -60. Backwash Lines, P-Trap, 0 Undrgrnd. .a =l 10.i$tructural Floor System K - 61. APPROVAL TO•DECK -- :J a 11.property Sewer Line a&House Co ection .62. Backwash & Receptor-Final u 12. Sewer apcad • `' `J cF t' w v •'63.;Heater & Vent-Final I 13. 10- oof Drains ,� d •� - ,64. Plumbing System - Final x en 1 14. Rougi Plumbing i 11 `•' 65: Electrical-Final ` _ w - 15. Rough-Electrical-Conduit - >a -i ' 66. Solar System-Final - 16. Rough Electric,Wiring , - • - 67. Fencing & Access Approval 17. Rough Wiring Sign . , 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling - ' 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating_& Air Conditioning FIRE DEPT. REQUIREMENT •20. Rough Factoryireplace APPROVALS Permit# 21. Ducts, in Strucpire 70. Underground Hydro ,,a .. 2�. DucE V�ntilattg :'' 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe Rough±$p Test 72. Underground Flush ti .•I - 24. Rootframing ' . 73. Undergrnd.Storage Tank ❑Gas ❑Oil 25. Rootbheathing 74. Overhead Hydro .1 216. T-garteiling (Structural) & Monocoat' - 75. Dry Chemical 2'/. Filth-14 and Flashing 76. Dry Standpipe 28. Lghipg & Siding, - 77. FIXED SYSTEM FINAL 29. Insulation - i 78. FIRE PREY. FINAL y 30. Drjv24Jl Nailing 'ou HEALTH DEPT. REQUIREMENT 31. Plastet Brown Coad 79. FINAL INSPECTION . 32. Etecvlcal Power Nltter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric 1 , ' Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test -• I . 36. Hood or Canopy I . • - 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 Recjuirements Completed • 49. Electric'Release to Edison ' • • - - - 50. Gas Release to Southern California Gas Co . 51. CERTIFICATE OF OCCUPANCY _ __ - No. - - - Date • • - - I ' ' l V Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. „r=_ly I i :off fl;,' lDs 777 CITY OF COSTA MESA • ' P,,EE,,RMIT NO. _ TRACT NO. LOT NO. BLDG.NO. _CONSTRUCTION PERMIT CS — 925 160 312-316 26 ' . • Project Address 150 Val 1ey Fnrge,Cnsta Mesa TYPE OF CONSTRUCTION NEW L�❑ ADD LI ALTERATION LI ,p REPAIR Applicant's Mailing Address SamP ❑ CONVERSION ❑ DEMOLISH I][I OTHER Beronf Class "An A.P.# - , I Zone Owner's Name Monti rel In (num Aaan PhonA40-1097 DESCRIPTION OF WORK Fiberglass, ramp; AMFbalt • BO n S Main Building: Accessory Building: Z E Address _same TYPE OF PERMIT ❑ GRADING LJ FOUNDATION ❑ STRUCTURAL T Front' . N • Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B - I A Rear N Address ®OTHER Rernnf i ng C Right G Contractor's Name San Marino Roof CO Phone 974-3070 PROJECT DESCRIPTION SQ. FT- 4000 OCCUPANCY R-1 K R CON STRUCTION TYPE S—N VALUATION 6500 S Left Address)mailing) 2l$aN08 $ataVld, Orange 92665 E • ZONE GRADING CU.YDS. ACRES Ping. Ref. # Park.Fees $ U City License No. 026085 LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided - I I hereby affirm that 1 am licensed under provisions of Charter 9 (commencing - R with section 7000) of Division 3 of the Business and rofessions Code,and Use of Building: E my license is in full force d effect. License Class — ce No. 59 • PLUMBING FEES Planning Notes: M - `Date 11-18-83 Signature E NORKERS'COMPENSATION DECLARATION Bar Sink Showers Ig I hereby affirm that I have a certificate of consent to self-Insure or a certificateI S of Workers' Compensation Insurance, or a certified-copy thereof (Section Backflow Preventer - Service Sink S 3800, Lab. C.1� Backflow irrigation Sewer Cap ELECTRICAL - FEES Policy No. WY 82 15045,ompanyFremo t Indemnity Certified copy is hereby furnished. Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW car ifie op I filed with the cit g iv'sio . ❑ 50+KW Dat l�— — Applicant - Clarifiers Solar Collectors Construction_Pole Sub. EXEMPTION FROM WORKERS'CO PENSATI ON DECLARATION Dishwasher - I in Solar Pi (This section need not be completed if the permit Is for one hundred ($100)or Piping Cooking Unit - Meter pup to 100 amps less): • • Drinkin Fountains - Icertify that in the performance of the work for which this permit is issued I 9 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 _i_ Dryers ❑Gas ❑Electric Sub Panel Date Signature NOTICE: If,'after making this declaration,you should become subject to the Floor Sinks Urinal Fan, • Motors❑0-1 HP ❑1'/2-8 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. • Ina Solar ❑9-15 HP 016-15+ CONSTRUCTION LENDING AGENCY ' I hereby affirm that there is a construction lending agency for the performance Interceptors - Water Heater Fixtures .Microwave of the work for which this permit is issued (Section 3097 Civ. CJ Lender's Name Kitchen Sink Water ServiceDevice Boxes Pole Light Lender's Address ' Lavatories OWNER BUILDER DECLARATION - - - Outlets , Range I hereby affirm that I am exempt from the Contractor's License Law for the P—Tra •p reason (Section 7031.5 Business and Professional Code: Any city or p Switches Sign 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 • ) file a signed statement that he/she is licensed pursuant tothe provisions of _ • le Contractor's License Law(Chapter 9(commencing with Section 7000) of Generator ❑0-5 KW ❑5-15 KW Trash Compactor Jivision 3 of the Business and professions Code) or that he/she is exempt P 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 Reinspection Fee $25 Issue Fee - $ 3 LJenalty of not more than five hundred dollars($500). Pe I, as owner of the property or my employees'with wages as their sole MECHANICAL Reinspection Fee $25 Issue Fee $ 3 ' compensation will do the work, and the structure is not Intended or offered - 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 ❑ 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 11 ❑ sale. If, however, the building or improvement Is sold within one year of com- Duct-Under Ground Application Approved By Date '_ pletlon, the owner will have the burden of proving he/she did not build or'im • - LJrove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By . art nate///s,-/g5 I, as owner of the property, am exclusively contracting with licensed con- - ❑0.100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUM ARY OF FEES The Contractor's License Law does not apply to an owner of property who - rU builds or improves thereon,and who contracts for such projects with a con- Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ �'�Q SMIP . $ ' tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT D 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# PLUMBING $ ISSUANCE $ Date Owner Heating System&Ducting PLAN CHECK $ ENERGY P.C. $ ' I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL GRADING $ ELECTRICAL information is correct. I agree'to-comply with all city and county ordinances ' - - $ and state laws relating to building construct) and hereby authorize repre- MICROFILM $ sentatives of this city to-enter upon t abov ent oned property for PLAN CHECK $ , Inspection pu oses Signature �+• �• Reilly - %ate))-1 >Z—RR - MECHANICAL $ TOTAL FEE $ 4Q'sd Drivers' License or SS# Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ - SUM IL CMF 0865-46 rev. 7/g3 White-Building;canary Applicant;Pink - - - - / y- Accounting;Goldenrod-Assessor - • tONSTRUCTION AND PLANNING k• ; : - I. ,•, F _ & SPA - APPROVALS. Permit# - Date,,H Inspector APPROVALS Permit# Date -Inspector H H • . 1. Temporary Electrical Service or Pole' - •-i - 52. Pool & Equipment Location , '. 2. Soil P.ipeCUndrgrnd. - - I tr' - -0 - 53.:Steel Reinforcement 1 4 ..t W 3.,Electr�carConduiY.'Utility,-Undrgrn"rL,t co - 54..Forms • _ p 4.-Elec4a) ConduitfhJndrggnd. w y _ 55. Electrical Bonding m '5.'•Steel'Reinforcement • co, '56. Rough Plumbing & Pressure:Test -14 'y u, u H .-.r• - - "I 6: ! ectrScaI.UFER 1{nd1. rrU . 57.- APPROVAL TO COVER-GUNITE ' 7.:Footiri s al 58. Electrical Conduit-Undrgrnd. 8. 'foundation 0 '� C" - 59.-Gas Pipe, 0 Undrgrnd.,Test w 9. Water^n Pipe-Undrgrnd. 60. Backwash Lines,.P-Trap, 0 Undrgrnd. a• es n 10. 'thtructural Floor,Syst m . . C - , ;61. APPROVAL TO DECK y 11. ;Property Sewer Line&.House Conhection T 62..Backwash & Receptor-Final 12.' ewerj ap L: 01w - •.63. Heater & Vent-Final I I • -1 .. - .o of m13. ,Roof'Drains 1 (0 • : 64:-Plumbing System - Final ,I z, I 14. Rough'Plumbing ") :� 65. Electrical-Final vi 15. Rough Electrical-Cenduit • '� - - 9 66. Solar System-Final • 16. Rough Electric,.Wiring - 1 ' 67..Fencing & Access Approval - - 17. Rough Wiring Sigri - 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling . - 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating;& Air Conditioning - FIRE DEPT. REQUIREMENT , 20. Rougii FactoryyFirep-lace APPROVALS Permit# ' 21. Ducts, in Structure ' , 70. Underground Hydro • 22. Ducts,Ventilating rti 71. Product Piping 0 Gas ❑Oil 23. Gas•Pip®Rough &Jest 72. Underground Flush m d-, 24. Roo ifr;aming '=; - . 73. Undergrnd.Storage Tank 0 Gas ❑Oil' r 25. RooftSheathing 74. Overhead Hydro 26. T-BarlCeiling•(Structural) & Monocoat , • I • .- 75. Dry Chemical - ' tur . FrBme and Flashing- _ 76. Dry Standpipe • n n 28. -Lp'Fii'ng & Siding 77. FIXED SYSTEM FINAL ' 29. In3ulation ' ' 78. FIRE PREV. FINAL 30. •Drigll Nailing ' '? ' ' I , • HEALTH DEPT. REQUIREMENT 3I. Plastei Brown Coat 79. FINAL INSPECTION 32. Electmcal Power Meter-Final, , 80. FOOD CERTIFICATE ISSUED •33. Final Electric Notes: 34. Final Heating &'Air Conditioning $ ' 35. Final Gas Pipe-Test . • ' 36. Hood or,Canopy _ I 37. Final Factory Fireplace . - - - • 38. Final Plumbing ' - 39. Water Service-Final , . 40. Gas Service-Final • . ' ' • I 41. Solar Domestic-Final • - 42. Backflow Preventer i ' 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 i• - t — ' F r Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA �J�t C� P MIT NO. _ TRACT NO. LOT NO. BLDG.NO. S CONSTRUCTION PERMIT I j— 2775 60 28/9 - 288 3 760 13_e ' \1 Project Address 111W -•fr„o,F Innen TYPE OF CONSTRUCTION \ LYNEW ❑ ADD Li ALTERATION REPAIR Applicant's Mailing Address I. sI ' ❑ CONVERSION"-❑ DEti1OLISH ❑ OTHER R eh.0 op bt-ng A p #, (Zone Owner's Name on ti rap ('nmm AAA n T n alone 540-1097 DESCRIPTION OF WORK 0117 A6 Is ASI Fcbeh 59/444 , COmr- M to S Main Building: Accessory Building: ZO AAp aft Rnn� in� Address Sam() TYPE TYPE OF PERMIT U GRADING FOUNDATION LJ STRUCTURAL T Front _ N Arch/Eng. License No. ❑ TENANT CIELECTRICAL ❑ PLUMBING CIMECHANICAL B Rear __ I Address ❑ OTHER A - N C Right G Contractor's Name San Mart.in0 R006 CO Phone974-3070 PROJECT DESCRIPTION SQ. FT- 1380040 OCCUPANCY R-I K R Address&nailing) 2.187 N. Batavia , Oxang e. 92 665 C ON ST RUCTION TYPE VALUATION$ 6500. S Left • E City.License No. 026085 ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ u LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided I I hereby affirm that I am licensed under provisions of Charter 9(commencing R with section 7000) of Division 3 of the Business an Professions Code, and Use of Building: E my license is in full force and effect. / - •License Class C3 9 Lk Se N 4 S� . PLUMBING • FEES Planning Notes: • E Date 9-2 9-k 3 Signature _ -� Bar Sink Showers - N WORKERS'COMPENSATION DEC ARATION T 'hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink • • S Workers' Compensation Insurance, or a certified copy thereof (Section j". Lab.Lab. `Di P 8 2 1 50458Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. CompanikaMO indemnity - )}''yl Certified copy is hereby furnished. . Bathtubs , Sewer Connection Automatic Washer ' • Transformer 0 15-50 KW R1 Cert((}}legq,,cppy//'s1 lied with the city g MR jou, 50+KW Date Y--L Y-d S Applicant �(�Jrr''�%��• e d� Clarifiers Solar Collectors Construction_Pole Sub. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Solar Piping ' (This section need not be completed If the permit Is for one hundred ($100) orP 9 Cooking Unit Meter ❑up to 100 amps less). DrinkingFountains I certify that in the performance of the work for which this permit is issued, I Solar Tank Dishwasher Meter Dover 100 amps shall not employ any person in any manner so as to become subject to te - I Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers OGas DElectric Sub Panel ' Date Signature _ - -. — NOTICE:If;after making this declaration,you should become subject to the Floor Sinks • Urinal Fan Motors 0o-1 HP 01%-8 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. Inc.Solar 09.15 HP 016-15+ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance Interceptors • Water Heater Fixtures ;Microwave • of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Kitchen Sink Water Service• _ Device Boxes Pole Light Lender's Address Lavatories OWNER BUILDER DECLARATION - Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the P-Trap reason (Section 7031.5 Business and Professional Code: Any city or p _ Switches Sign 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 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 Generator 00-5 KW 05-15 KW Trash Compactor nivision 3 of the Business and Professions Code) or that he/she is exempt • - P yet rpm 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 . natty of not more than five hundred dollars(5500). Reinspection Fee $25 Issue Fee $ 3 '❑ I, as owner of the property or my employees with wages as their sole MECHANICAL Reinspection Fee $25 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered - FEES for sale (Section 7044, Business and Professional Code: The Contractor's - PUBLIC SERVICES REQUIREMENTS: j 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 nate employees, provided that such improvements are not Intended or offered for Canopy Type II ❑ sale. If, however, the building or improvement Is sold within one year of corn- Duct-Under Ground Application Approved By Date pletion, the owner will have the burden of proving he/she did not build or Im- — C, o% R prove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By /�/ Date/ / LJ I,as owner of the property,am exclusively contracting with licensed con- ❑x100,000 BTU ❑100,000 BTU tractors to construct the project(Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES SO The Contractor's License Law does not apply to an owner of property who BUILDING PERMIT �3�s fro -fa builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration $ SMIP $ tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT ❑ 1 am exempt under Section B. &P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting • PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above El 0-100,000 BTU 0100.000 BTL ELECTRICAL $ GRADING $ information Is correct. I agree to comply with all city and county ordinances • and state laws relating to building construction, and hereby authorize repro- - PLAN CHECK $ MICROFILM $ sentatives of this city to enter upon the above-mentioned property for • Inspection p rpo es. MECHANICAL $ TOTAL FEE $ l38,S0i Signature L..�, REI L L V SR Date 9-29-83 Drivers' License or ss le Reinspection Fee I $25 Issue Fee $ 3 PLAN CHECK $ a. 'CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - . • CONSTRUCTION AND PLANNING . 7. - POOL PA - APPROVALS "Permit# - Date Inspector APPROVALS Permit# • Date Inspector 1. Temporary Electrical Service or Pole`, - . r 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. r r " 53. Steel Reinforcement , 3. Electrical-Conduit,Utility-Undrgrnd.) - - 54. Forms - , 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel ReinforcemeQt-; ' . • , , - - 56. Rough Plumbing & Pressure-Test • 6. ElectricalUFERdrnd. .57.-APPROVALTOCOVER-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 - c 61. APPROVAL TO DECK" 11. Property Sewer Line & House Connection r 62. Backwash & Receptor-Final • 12. Sewer Cap i- 63. Heater & Vent-Final 13. Roof'Drains r - "' - 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 - .1 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling • 69.'"POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. ,R3ugh Factory Fireplace, ' APPROVALS Permit# ' • 21. JJ'uCts, in Structure , 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough &Test ' • i - 72. Underground Flush 24. Roof Framing • • i 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 I 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' • ' Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test - 36. Hood or Canopy - - 37. Final Factory Fireplace 38. Final Plumbing ' 39. Water Service-Final , ' 40. Gas Service-Final ' 41. Solar Domestic-Final . ' • 42. Backflow Preventer • - 43. Backflow Irrigation - • 44. Landscape Irrigation System I 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. - 7 Date • - • /0 Apollcant to fill in all spaces except those wit, nes and sign all appropriate declarations. CITY OF COSTA MESA �0� - P MIT NO. / TRACT LOT NO. BLDG.'NO. 7G01 ID/EG/G: 60...," :. CONSTRUCTION PERMIT 8- 7/ 7 w IA() f 1 86-190 37 - Project Address 1 5 0 V¢Il P y FOh lg P RcL, 'C- M_ TYPE OF CONSTRUCTION LI NEW L I ADD IJD ALTERATION LI REPAIR Applicant's Mailing Address Cif m 0 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ? kOQ[p tll9 A.P.# I Zone Owner's Name MQNTICE LLQ COMM ASSN Phone 540-1097 DESCRIPTION OF WORK Cta6.6 "AII FA0011g (A/s, romp_ , Aa 112't P o^£ 6N S Main Building: Accessory Building: O Address Same TYPE OF PERMIT U GRADING ❑ FOUNDATION ❑ STRUCTURAL - T Front N Arch/Eng.. License No. • ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL .B Rear Address ❑ OTHER A - - N Contractor's NamaSanMlartino Roo r0_ PhonA743070 PROJECT DESCRIPTION. SQ. FT. 15000 OCCUPANCY R-1 C Right - G Address(mailing) 91R7 N Batavia Ohnn3P , CA 921565 CONSTRUCTION TYPE .-- VALUATION $ 3950_ s Left E City License No. 0?15085 ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ Q LICENSED CONTRACTOR DECLARATION Remarks: • I Parking Req./Provided - U I hereby affirm that I am licensed under provisions of Charter 9 (commencing R with section 7000) of Division 3 of the Business a Professions Code,and • Use of Building: E my license is in full forse age/ ffect. •— Datense Class —•� LI se No. 49559 PLUMBING I FE• ES Planning Notes: E Date 1 Q—1 -83 Signature — WORKERS'COMPENSATION DE RATION Bar Sink Showers _ _ N T • hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink - S ' Workers' Compensation Insurance, or a certified:copy thereof (Section - - - • - a800, Lab. C. Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. 1uP82 150458 CompanyFhemon.t IndemnLty certified copy is hereby furnisheBathtubs Sewer Connection I Automatic Washer Transformer 0 15-50 KW C,erxlfi¢{1 copx is filed with the city wi io ❑ 50+ KW Date/ U -83 Applicant Clarifiers Solar Collectors Construction_Pole Sub. ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION .DishwasherSolar Piping - (This section need not be completed if the permit is for one hundred ($100) or P 9 Cooking Unit - - _ ,Meter Duo to 100 amps' less). - - • I certify that in the performance of the work 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 DElectric Sub Panel Date Signature — - NOTICE:If;after making this declaration,you should become subject to the Floor Sinks - Urinal Fan ' Motors 00.1 HP 0114-8 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. Inc.Solar 09-15 HP 016-15+ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures 'Microwave of the work for which this permit is issued' (Section 3097 Civ. C.) - Lender's Name - - Kitchen Sink Water Service Device Boxes Pole Light Lender's Address Lavatories OWNER BUILDER DECLARATION - -• Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the p—Tra • following reason (Section 7031.5 Business and Professional Code: Any city or p - . - Switches Sign ' 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 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 livision 3 of the Business and Professions Code) or that he/she is exempt - Generator ❑0-5 KW ❑5-15 KW Trash Compactor lerefrom and the basis for the alleged exemption. Any violation of Section 031.5 by any applicant for a permit subjects the applicant to a civil - uf.nalty of not more than five hundred dollars($500). Reinspection Fee, 1 $25 Issue Fee 3$ ' 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: J 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 ter -- Canopy Type II ❑ ' sale. If, however,the building or improvement is sold within one year of com- Duct-Under Ground Application Approved By Date pletlon, the owner will have the burden of proving he/she did not build orim- pLove for the purpose of sale). - Duct-Structural Refrigeration System Application Issued By /0/ /frf / Date //2/7-0/7 - LJ I, as owner of the property, am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY 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 $ (90'&O SMIP $ t So _ tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBO# PLUMBING $ ISSUANCE $ - Date Owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 0o-100,000 BTU 0100,000 BTU GRADING $ information is correct. I agree to comply with all city and county ordinances - ELECTRICAL $ and state laws relating to building construction, and hereby authorize repre- MICROFILM $ sentatives of this city to enter upon the above-mentioned property for PLAN CHECK $ inspectionpurposes. bOrSQ Signature . EI LLY SR Date 111-1 -x3 MECHANICAL $ TOTAL FEE $ Drivers' License or 55# Reinspection Fee ' $25 Issue Fee $ 3 PLAN CHECK $ a CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - CONSTRUCTION AND PLANNING - POO. 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: ElectricalConduit:U0,10-Undrgrnd. - " ' • 54. Forms' 4. Electriilal ConduigUndrgind. , `j 55. Electrical Bonding --1 5. Steel Reinforcement ' - --� . 56. Rough Plumbing & Pressure Test 6:,Electrical UFER Grnd. . . ' . _ , ..57. APPROVAL TO COVER-GUNITE - 7.,.Footings o _ . 58. Electrical Conduit-Undrgrnd. 8. Foundation n - - n_ 59. Gas Pipe, 0 Undrgrnd.,Test• , ' 9. Water Pipe-Undrgrnd'• li . . W. Backwash Lines, P-Trap, 0 Undrgrnd. (> • 10. Structural Floor System - o ,- 61. APPROVAL TO DECK ' 11..P.roperty Sewer Line & House Connection `62. Backwash & Receptor-Final 12.. ewer Cap `: 4 63: Heater& Vent-Final '• 1 131 Roof Drains ., c : lt' = 64..Plumbing System Final 1 14. Rough-:Plumbing' ,.; ;1 ' 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-I 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&Testpe 4. Roof'Fra ming 72. Underground Flush _ 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof'.Sheathing - 74. Overhead Hydro 26 T-Bar Ceiling (Structural) & Monocoat' I 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lething & Siding' 77. FIXED SYSTEM FINAL • 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing , `,Q, HEALTH DEPT. REQUIREMENT ' 31. Plaster Brown Coat > • 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' . . , ' Notes: 34. Final Heating'& Air Conditioning , 35. Final Gas Pipe-Test . . . I 36. Hood or Canopy 37. Final Factory Fireplace 1 ' ' 38. Final Plumbing • 39. Water Service-Final ' ' 40. Gas Service-Final i 41. Solar Domestic-Final ' • 42. Backflow Preventer • 43. Backflow Irrigation1 ' • 44. ,Landscape Irrigation System ' • - ' _ - ' 45. Sound' Attenuation 46. Handicap Regulations - . - . 47. FINAL STRUCTURE & BUILDING • , 48. Special Requirements Completed ' . 49. Electric Release to Edison - 4 - - - - - 50. Gas Release to,Southern California-Gas Co ' 51. CERTIFICATE.OF OCCUPANCY_ 1 _ _ No. ' Date /o Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. I spy CITY OF COSTA MESA PE MIT NO. TRACT NO. LOT NO. • BLDG.NO. li CONSTRUCTION PERMIT — 9/7 7 5160 231 -236 38 7 0c 17/'= :/-2 r' „';. T' Project Address 1 5 a Unify y FOAg q r r M • TYPE OF CONSTRUCTION - U NEW LJ ADD .H ALTERATION H REPAIR - t ' Applicant's Mailing Address nSnMe ❑ CONVERSION ❑ OL4o, ISH"❑ OTHER Rpnq 0 Ang A.P.o - IZone Owner's NameM 01,1 tin 2QC0 Comm A44 V1 Phonec4 0-1097 DESCRIPTION OF WORKC•PCAA If Ass F.Cbehg Pp/DIA 4 . Comp. S Main Building: Accessory Building: 2 Address .Sam e TV ET GRAINC El FOUNDATION ❑ STRUCTURAL ET Front , 0N Arch/Eng. - License No 1 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICALB Rear - Address • CIOTHER A • N Contractor's Nam SAPhone540-1097 PROJECT DESCRIPTION SG. FT. A600 OCCUPANCY R-7 C Right G N MARTNO ROOF ('0 Address(mailing) 91117 N Rat au.iaOnan9P 99665 CONSTRUCTION TYPE 5-N VALUATION$ 4550_ g Left R ZONE GRADING CU.YDS. ACRES Ping. Ref.4 Park.Fees $ Q City License No. n 9 A n x 5 U LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided - I I hereby affirm that I am licensed under provisions of Charter 9 (commencing - R with section 7000) of Division 3 of the Business an Professions Code, and Use of Building:• E my license is in full force And t ct. M DeClass' L. 3re se N • 4 PLUMBING •FEES Planning Notes: E Date! n-1 -83 Signature Bar Sink Showers N WORKERS'COMPENSATION DE RA ION - T hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink - • S ' Workers' Compensation Insurance, or a certified copy thereof (Section - - -. - .800, Lab. C,Ip82 150458 Fhemcn•t Indem n.ity Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. W Compan - I Certified copy is hereby furnished �i Bathtubs Sewer Connection Automatic Washer ' Transformer 0 15-50 KW ' Z Certified copy is filed with the city i g wiz on • - ❑ 50+ KW Date/ 0-1 -X - Clarifiers 3 Applicant Solar Collectors Construction Pole Sub. -EXEMPTION FROM WORKERS'COMPENSATION-DECLARATION Dishwasher Solar Piping' - - (This section need not be completed if the permit is for one hundred ($100)or 9 • Cooking Unit Meter ❑Up to 100 amps , less). - - • I certify that in the performance of the work 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 ❑Electric Sub Panel Date Signature — - - NOTICE: if,'after making this declaration, you should become subject to the Floor Sinks Urinal Fan Motors 00-1 HP 01/-8 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. Inc.Solar 09-15 HP 016-15+ CONSTRUCTION LENDING AGENCY - I hereby affirm that there is a construction lending agency for the performance Interceptors' - Water Heater Fixtures Microwave of the work for which this permit is issued (Section 3097 Civ. C.) ' Lender's Name - Kitchen Sink Water Service - Device Boxes Pole Light Lender's Address Lavatories OWNER BUILDER DECLARATION Outlets Range • I hereby affirm that I am exempt from the Contractor's License Law for the . p-Tra following reason (Section 7031.5 Business and Professional Code:-Any city or P - - - Switches Sign 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 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 - ivlsion 3 of the Business and Professions Code) or that he/she is exempt - - - Generator 00.5 KW 05-15 KW Trash Compactor r _ -;•erefrom and the basis for the alleged exemption. Any violation of Section - • . - `031.5 by, any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). Reinspection Fee I $25 Issue Fee $ 3 • 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 ❑ 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 buildingor improvement is sold within oneyear of com- Duct-Under Ground • - P Application Approved By Date _ prove , the owner will have the burden of proving he/she did not build or im- '/y grove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By - r �"r Z. Date ��/��/g • LJ I, as owner of the property,am exclusively contracting with licensed con- ❑p.100,000 BTU ❑100,000 BTU ' tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SU/ry_1/ry.1ARVy1OF FEES [� The Contractor's License Law does not apply to an owner of property who BUILDING PERMIT IY$ IP lBU SMTP • $ ' y- builds or improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple❑ System Repair/Alteration tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT ❑ I am exempt under Section • B.& P.C.for this reason Firepl/Fact.Bit. ICBG 4 ' • • PLUMBING $ ISSUANCE $ Date Owner' Heating System& Ducting 1 PLAN CHECK $ ENERGY P.C. $ ' •I hereby certify that I have read this application and state that the above 0o-100,000 BTU 0100,000 BTU • GRADING $ information is correct. I agree to comply with all city and county ordinances - - - - ELECTRICAL $ and state laws relating-to building construction, and hereby authorize repre- - MICROFILM $ PLAN CHECK sentatives of this city to enter- upon the above-mentioned property for $ inspection purposes., MECHANICAL $ TOTAL FEE $ 66 so 4...fk Signature L.J . ey SA Dahl O-1 -83 Drivers' License or SS Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor -- - • w .POO. SPA CONSTRUCTION AND PLANNING 7, - y - - - APPROVALS- Permit Date _ 'Inspector`" APPROVALS Permit# Date Inspector • 1. Temporary Electrical Service or Polgt . ,_ 52. Pool.& Equipment Location 2. Soil Pipe-Undrgrnd. `� 53.: Steel'Reinforcement . . • 3.rElectrical.Conduiialkility-Undrgrnd. .^ . 54. Forms; - - - • 4. _Electrical;,Conduit-Undrgjnd. .? • r'i . • 55.. Electrical Bonding . ' 5.'Steel Reinforcement o - - r✓ - 56..Rough Plumbing & Pressure Test _ ' 7 6. `Electiical'UF ER Grndc _ _. 57.-APPROVAL TO COVER-GUNITE • t.....• . • -,; 7.tFootings - 58.'Electrical Conduit-Undrgrnd. - .- 8. ;Foundation - rr • 59_Gas Pipe, 0 Undrgrnd.,Test 9. Water:Pipe-Undrgrnd;; . _ .. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10rStructural Floor,System . 61. APPROVALTO DECK , . 11. Property Sewer Line& House Connection - 62.. Backwash & Receptor-Final 12. Sewer. Cap • • �t ' 63. Heater & Vent-Final • a 0.. ^�, _ c") ' - _ ..- 13! Roof.brains . „ - y . 64..Plumbing System - Final �1 • 14. Roug Plumbingc cc : . - 4 - : 65.-Electrical-Final • 15. Rough Electrical-Conduit -66. Solar System:Final, 16. Rough Electric Wiring ' ' 67. Fencing &Access Approval - 17. Rough Wiring Sign 68. A,PPROVED:FOR PLASTERING ' 18. Rough Eiectrical-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 00iI it- ;23. :23. G/s Pipe-Rough&_Test _ 72. Underground Flush 2'4. Rodf,Framing . - • 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - 74. Overhead Hydro • 26. T-Ba?Ceiling (Structural) & Monocoat75. Dry Chemical . 27. Frame and Flashing 76. Dry Standpipe ,g8. .Laitiing & Siding 77. FIXED SYSTEM FINAL ' 29. Insulation - 78. FIRE PREV. FINAL • 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT -- •31. Plaster Brown Coat'• 79. FINAL INSPECTION 32. Electrical Power Meter-Final , 80. FOOD CERTIFICATE ISSUED 33. Final Electric , , Notes: 34. Final Heating& Air 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 ' ' i - , i 44. Landscape Irrigation System ; - . 45. Sound Attenuation . - I 46. Handicap Regulations _ . - • 47. FINAL STRUCTURE & BUILDING - ' 48. Special Requirements Completedi 49. Electric Release to Edison , , - • - --- - 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY, ' .._ _ i-- No. - Date - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF-COSTA MESA PERMIT N99. TRACT NO. 'LOT NO. BLDG.NO. - - • - - • - . . . - CONSTRUCTION PERMIT Q !pO ga :# cil.6-n A - N • . • P C. Address 1 50 Valley Forge. r.M. • IY2E OF CONSTRUCTION • :alzfr I /I H/ 1 I .:o_'tl 'n ' 0 ner - Phon' I D NEW D ADD D ALTERATION-- • - - - _ D REPAIR ID CONVERSION ODEMOLISH . 0 OTHER Reroof ZONING REGULATIONS ' - DESC RIPTION OF WORK and. Story Tar & Ap _ • . •'• ��''aavg ZONE • PLNTGp. REF.# • _ _ . •• •• • ; TYPE OF PERMIT Cl - ' - • BUILDING - ROBP I INC - - AddresSETBACK C LST. ERTV LINE _ e • . • 0-GRADING ' D FOUNDATION- 0-STRUCTURAL- SIDFE YARD LICENS D •O -A • - D L. I•N - 0 TENANT D ELECTRICAL-❑PLUMBING OMECHANICA SIEEDEVAR• - - . I hereby affirm that I am licensed under provisions of Charter 9(corn- - • - RIGHT .. . mencing-with- section 7000) of-Divisl• • if a -Business and. 0 OTHER . Professions Code, and my license •II orce and effect. REAR YARIJ(TO P/L) - '- PROJECT DESCRIPTIONn License Class • • e No. • ! ( - . . PKG.SPACE REQ. PROVIDED - - Date _ RR Signature // / . • .- 'Sq. FT. )�iU '1� WORKERS'CI JPENSATION D • ,1 •OCCUPANCY C�ONSTRUCTIONyTYPE STREET WIDTH PARK FEE$ , I hereby affirm that I have a certifi..te of consent to self-insure or a ) ZONE ZONING APPROVED BY -- DATE certificate of Workers' Compensa '•n Insurance, orr-a certified copy VALUATION U•- thereof(Section 3800 Lab.C.). GRADING CU.YDS. ACRES SPECIAL-CONDITIONS: ' - ' . ' ` -- -•icy No. 4R7RJO-R2aompan$t Pomp- Tns Fund - - • - _ - .. . . - Certified copy is hereby furnished. _ . ' REMARKS: ' - _ _ - - ' . ' - Certified copy is filed with the city Building Division. - • - .. EMPTION FROM WORKERS' COMPENSATION DECLARATION - - - ' ' - - - - • (This section need not be completed if the permit Is for one hundred ' ($100) or less). "" ' - - ' - - -- - certify that In the performance"of the work for which this permit is Issued, I shall not employ any person in any mannerso as to become PLUMBING . PLAN CHECK ' .. ELECTRICAL .. - PLAN CHECK - - subject.to the Workers'Compensation,Laws of California. _ „UWELLINb-_ GARAGE Date Signature BATHTUBS • SHOWERS' ' " • - ' • - • -^ NOTICE: If after making this declaration, you should become subject TOILETS, URINALS - •- -GENERATOR- - 0-1 KW_1-10 KW -- - - to the Workers' Compensation provisions of the Labor Code,you must - TRANSFORMER -- forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS' APPLIANCE -' 10-50 KW=50+KW. . . ., -. '- KIT.'SINKS -'- ' DISHWASHERS -MOTORS- •- -- 0-1-HP HP CONSTRUCTION LENDING AGENCY - "" -"' I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS . SUMPS - - ----- (INC.SOLAR) - .10-50 HP +HP ' formance of the work for which this permit is issued (Section 3097 -• .. FLOOR`SINKS -" 'FLOOR'DRAINS' FI%TYRES -OUTLETS - SWITCHES- - - --- - ---- Lender's Name_ " ` - --- - - --DRINKING'FOUNTAINS • - - -- - - GAS TUBE SIGNS - Lender's Address - - - • - OWNER BUILDER DECLARATION ' INTERCEPTORS _ CLARIFIERS - POLE LIGHTS - -- - - - - -• - - I hereby affirm that I am exempt from the Contractor's License Law for the following reason-(Section-7031.5 Business and Professions Code:. - SWIMMING POOL - -P TRAP- -- LUNS I RUL l ION - - • - Any city or county which requires a permit to construct, alter, POLES' METERED - SUB - - improve, demolish orrepairany-structure, prior to its-issuance,also-re- -WATER SERVICE - ALTERATION ' • PANELS- - MAIN- - - SUB --- - quires the applicant for such permit to file a signed statement that he - • is'licensed pursuant to the-provisions-of the Contractor's License--Law GAS SERVICE ' - --OUTLETS - - - - - - - -- - (Chapter 9 (commencing with Section 7000) of Division 3 of the .. SERVICE AMP Business and-Professions-Code)exe Code) or that he is exempt therefrom and the- WATER HEATERS - • BTU OUTPUT -- ---- - - - •- •- -- - -- basis for the -foxed exemption. Any violation of Section 7031.5 by - vIapplicant-for-a-permit•e) or the applicant-to a civil penalty ER'CO ECTIONS- ••' ^- - - -• - • • • - -- - - - - - • not more than five hundred dollars ($500). - - J I,'as owner-of the property; or my employees with wages as'their' SOLAR TANK _. ..._ sole compensation, will do the work, and the structure is not intended - . ' or offered for sale. (Section 7044,`Business and Professions Code:'The ' SOLAR PIPING SYS. ' - ISSUE FEE- • - -- - - - • - Contractor's"License Law does not_apply,to an owner of a property pLIGATOAPPROVED BV who builds or improves thereon, and whodoes such'work himself-or- " - ISSUE FEE ' ' _. - -. ` -^ - through his own employees, provided that such improvements are not Intended or offered for sale. If, however, the building orimprovement- MECHANICALPLAN CHECK -is sold within-one year of completion, the owner will have the burden SUMMARY DFFEES, ; •of poving he did not build or improve for the purpose of sale): BUILDING -- / nA•D 1, as owner -of -the property, am exCluSively contracting with HEATING SYSTEM 0-100000 BTUPERMIT $ f3' ' SMIP. . , ' fcalicensed contractors to construct the project (Section 7044, Business ANDDUCTING• 100,000 +BTU �'PLAN CHECK $ PERMINand caner of pro erty The Contractors provese Law tloes no[applyto. • _ . . ISSUANCE $' an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTUPLUMBING $ _ tracts--from--such-.projects with a contractor(s).licesned.pursuantto- SYSTEM. - . - - GRADING $the Contractor's License Law). 100,000+'BTU ' PLAN CHECK $ �"'-D Iam exempt under Section' ----- - - B:& P.C:for this gOILERS - BTV _ ELECTRICAL" $ $.reason- _. _ MICROFILM $ • Dale. Owner SYSTEM REPAIR,ALTERATION PLANCHECK -$ - ' - ,. • TOTAL FEE$) I hereby certify that I h •e r-b s application and state that the above EXHAUST SYSTEM MULTIPLEMECHANICAL $ - - - - information is c• e . I�„gig to'comply with all city and'county' _- PLAN CHECK g VANCE PC $ --- ordinances and a 'w el • ng to construction,and hereby authorize 'representative •ff, hi/ i . ' upon the above' mentioned -- • ' property to nr•., _• S Dat /K/f �`' (''J� Signature / e� �S FINAL FEE $ /`-' 'J LJ Drivers'Licen - or - S. - ' - -- - - . - . . . CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting;-Goldenrod-Assessor / -- CONSTRUCTION AND PLANNINGn r (.8 u a+ r POOL&SPI : - Date Inspector .iz,+ Date Inspector APPROVALS Permit# APPROVALS . . • Permit#,} ,3 73g 1,--[1.6V[jbV U21 .. 43. Pool & Equipment`L•ocatioillc :4tegq )c -2(02=`Ebs i'T r 1. TemporaryElectrical Service or Pole , k '. _ 2. _Soil.Pipe-Undrgrn ' . - - - 34.1bY§Wel Reinforcement •1^_•J A ysvf -Epoi )DIIOO1'Y \.L ES:,t • 3. Electrical Conduit Utility-Undrgrn - _ .. .c --E'.• v nit i)CS 45. Forms - - . 4. . Electrical Conduit-Undrgrn . _ _ _ - "46rcrEleetrical Bonding • - 5. Steel Reinforce 47. Rough Plumbing et - - palIoofi .6-157-sea " . 6. -ElectricalUFERGrn 48. APPROVAL TO COVER-GUNPFEt!D! -�"XOgr! )! cE .3$ E eVE " .7. - Footings _ _ - _ 49. Electrical Conduit-Undrgrn •- .. - 8. Foundation - - _ _ _ 50. Gas Pipe, E Undrqrn,Test�-y . . . ' 9. -Water Pipe-Undrgrn _ - - 51. Backwash Lines;P-TrapY Lt Lin'digrn - - - • e L-'.J 10. Structural Flobr System 52. -APPROVAL TO DECK _ .- ' - C8-E-.E • 11.. Property Sewer Line & House Connection - - . _ " - -. . 53. Backwash & Receptor-Final -. - 12.- Street Sewer Connection. _ , _ -_ ___ -__ • 54; Heater &Vent-Final. r,:;. & 1T •j, o.„-) _ „',, vS+, +•Y • 13.- Rough Plumbing. -_ _ _ . . . _ - _ 55. Plumbing SvstAm'- Final 14. Rough Electric-Conduit - -'-- ' __ - - 56. Electrical-Final - 15. Rough Electric-Wiring - - - - --- -57. Solar System-Final - 16: Rough Heating &Air Conditioning- - - - - - - - - 58. Fencing&Access Approval • - 17: -Ducts,in Structure , - - - - -- ! _- - _ 59._ APPROVED'FOR PLASTERING ' ,. 18. -Ducts, Ventilating- - - - . -. • . - - - - - _ - _- _ - - _ , - - , 19. Gas Pipe=Rough &Test - " . r ._ __ _- 60. POOL/SPA•SYSTEMS FINAL ' •, • • ' ' -- 20. --Roof Framing ------ - - - ' - 21. Roof Sheathing . --- - - - - - --- - -- - - : - ... • 22. -Frame and Flashing NOTES; __- . 23:--Insulation - - - " -- . - - - -- - - - - - - -- - .. - - .. _ . . . ' t 24 Lathing-&-Siding _ _ -- _ . _ _ - - -- • - - . " _ __ _ - - ._ - ---- _ _ 25. Drywall Nailing - - . --- -- - " -- -- - - -- - - - - .. - -• . , • • . . • 26. Plaster Brown Coat - - - - - -" - - -. . .. _ 27. Electrical Power Meter-Final- " - -- --- - - - - - " .. . _ -- 28:- Final Electric - - - • - - - - - -- - - - - 29. Final-Heating & Air Conditioning- - - - - - - - -• -- • - - - - 30. Final Gas Pipe-Test - - - --"-- "-- - . . __ _ ' . - - -31. -Final Plumbing _ -- - - - _ •32. -_Water Service-Final -- - - - " - "' 33.- Gas Service-Final . _- ... _ - • 34. Solar Domestic-Final - •1. . - ''35:' ' Landscape Sprinkling System-, • - 36. Sound Attenuation _ _ - - - - 37. Handicap Regulations - . 38. FINAL STRUCTURE & BUILDING - ._ _-_ _. . _ - 39. Special Requirements Completed - 40. Electric Release to Edison - - ' 41. Gas Release to Southern California Gas Co. _ • 42. CERTIFICATE OF OCCUPANCY -- - - - "No Date ""� Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. - CITY OF COSTA MESA PERMIT NO, - TRACT NO. LOT NO. -BLDG.NO. - - CONSTRUCTION PERMIT g -- 6045 ; 5160 88 10 Projec rens 1 50 Val 1 ey Forge. CM TYPE OF CONSTRUCTION • 1 O er Phone 0 NEW 0 ADD 0 ALTERATION )-.SII I / 1 :7- ' °' ` TL L_ Mersky & E. Morrow12/ I Ad 339 ThOndar-oga Way, C M 0 REPAIR 0 CONVERSION 0 DEMOLISH ZONING REGULATIONS _ _ Arch/Eng. License NO. 0 OTHER Reroof DESCRIPTION OF WORK A.P.St Address 2nd _Story Tar & (� Gravel ZONE PLNG. REF.� Lpy, Contractor - Ferrara Rnnfin roPhone642 R9q g 3TVPE OF PERMIT BUILDING SETBACK C/L ST. p PROBPtEIRTVNIJNE • - _• Address - 1. .. s ❑GRADING ❑ FOUNDATION ❑ STRUCTURAL SIDE YARD LEFT , LICENSED CONTRACTOR D CLARA 01. 0 TENANT 0 ELECTRICAL ❑PLUMBING ❑MECHANICAL/ SIDE YARD I hereby affirm that I am licensed under provisions of Charter 9 (corn- RIGHT mcncing-with section-7000) of Division 34 o t - Business and 0 OTHER Professions Code, and my license Is In f• ce and effect. PROJECT DESCRIPT19N REAR'YARD(TO P/L) - License Class •• / i•.'. N.. • _ • e f • PKG-SPACE REQ. PROVIDED •Date 1 -1-R1 "' Signature i SQ. FT. 36 i STREET WIDTH PARK FEE$ WORKERS'COMPENSATION D C • OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certlf ate of consent to self-Insure oraUU ZONE VALUATION - ZONING APPROVED BY. I DATE certificate of Workers' Compens- on Insurance, or a certified copy thereof(Section 3800 Lab.C.). GRADING CU.YDS. ACRES SPECIAL CONDITIONS: Onlicy No. 4R7R911-R 9Company_G} . romp Tnc Fnr-1 - - - .. certified copy.is hereby furnished. REMARKS: •• - - - _ _ Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - . - - ' • ' .(This section need not be completed if the permit is for one hundred ($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 PLUMBING - ' PLAN CHECK ELECTRICAL • - PLAN CHECK - - subjecttothe Workers'Compensation Laws of California. UW ELLINO GARAGE Date - O Signature BATHTUBS SHOWERS _ SO FT SFT • - -- - ---- NOTICE: If after making this declaration, you should become,subject TOILETS URINALS - • • GENERATOR 0-1 KW_• 1-10 KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW_SO+KW revoked. CONSTRUCTION LENDING AGENCY - KIT.SINKS ' ' DISHWASHERS- 1- - MOTORS 0-1 HP_1-10 HP - - • I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS - • SUMPS -- - - . . (INC.SOLAR)_-_ 10-50 HP 50+HP' • ' formance of the work for which this permit is issued (Section 3097 -- ' Civ: C.). - - - - -- - - FLOOR SINKS - -FLOOR DRAINS- FIXTURES - OUTLETS SWITCHES" - Lender's Na_m_e _ - - ' " ' DRINKING FOUNTAINS" ' - - - -- - •• - GAS TUBE SIGNS - - Lender's Address - - ' ' OWNER'BUILDER-DECLARATION - - -' - INTERCEPTORS - CLARIFIERS - - - - ' ' - POLE LIGHTS - - ' . . • ' I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5-Business and Professions Code: SWIMMING POOL - - P-TRAP- • - - .- LUNSI NUC I IUN • Any city or county which requires a permit to construct, alter, POLES METERED'- - 'SUB ' improve,'demolish or repair any structure,-prior to its Issuance,also re- WATER SERVICE ALTERATION --- -- PANELS MAIN SOB --. - quires the applicant for such permit to file a signed statement that he is licensed pursuant-to the provisions of the Contractor's License-Law -GAS SERVICE " OUTLETS - SERVICE- -- - - - . , (Chapter 9 (commencing with Section 7000) of Division 3 of the - Business and Professions Code) or that he-is-exempt therefrom and the -WATER HEATERS -BTU OUTPVT-- --- - - - - - - - . . . - _ ` •basis for the alleged exemption. Any violation of Section 7031.5 by applicant for -a-permit subjects the-applicant to a civil penalty SEWER CONNECTIONS ' - - . - 11‘J lot more than five hundred dollars ($500). V I,as owner of-P a:property, or my-employees-with wages as their 'SOLAR TANK - -COLLECTORS - ,Nl Sole compensation, will do the work,and the structure Is not intended _ - or offered for sale. (Section 7044, Business and'Professions Codei The" ' SOLAR PIPING SYS. '� - • ' - ISSUE FEE `I Contractors License Law does.not apply to an owner of a property ' Illi who builds or improves thereon, and who does such work himself or ISSUE FEE • -' - - •APPLICATION APPROVED BY DATE through his own employees, provided that such Improvements are not _ + intended or offered for sale. If, however, the building or Improvement MECHANICAL ,PLAN CHECK , . SUMMARY OF-FEES Al is sold within one year of completion,the owner will have the burden of proving he did not build-or improve for the purpose of sale): BUILDING' t-• HEATING SYSTEM 0-100,000 BTU PERMIT $/>• SMIP $ ❑ I, as owner of the property, am exclusively contracting with AND DUCTING - - - - - - - - . . . . - licensed contractors to construct the project (Section 7044, Business 100,000+BTU PLAN CHECK $ . PERMIT - •n- and Professions Code: The Contractor's License Law does not apply to - .. ' ISSUANCE S ' '4 an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from-such- projects with a contractor(s) licesned pursuant to SYSTEM - GRADING' S the Contractor's License Law). - - 100,000+BTU - PLAN CHECK.-S' - • ❑ rim exempt under Section , B.& P.C.for this - -- - -' •- $ - $ - - BOILERS BTU ` reason - - -- - - - - - • - N- - -_ PLACHECK g MICROFILM S - SYSTEM REPAIR,ALTERATION I-- Date Owner _ - ' • TOTAL FEE$ • I hereby certify that I h ver ad t•'s application and state that the above EXHAUST SYSTEM MULTIPLE ilkMEG HANICA L- E LESS AD- information Is c re agr -oto comply-with all city and county -PLAN CHECK $ VANCE PC $ - - - `� ordinances an a rel..,g to construction,and hereby authorize representati f th- c' t e ter upon the ab v mentioned _ property f in c op • �.//-(/ /5„5-40 ( 7� mil Signature i,�/ Dae / G FINAL FEE $ �J tJ ISSUE FEE - • Drivers' Lice e 0 5- - - - - - - • CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod.Assessor CONSTRUCTION AND PLANNING 01 88 • O(aL2 POOL&`SP/3_K-- - , • Date , Inspector Date Inspector APPROVALS Permit APPROVALS . PePer mitTh i.: ^lOS 1.: 1.(5V 02 . ' _ _1. Temporary Electrical Service or Pole ••.•••• , 43. Pool & Equipment Location WOY70i�i .:f1 a yJla't9!-] .S - - • Soil •ipe-Undrgrn - .0(.444.-91iSteel Reinforcement •cs.-) .0tow s6OY >_11TOOtT 'Lt.S - 3, Electrical Conduit.Utility-Undrgrn. - - 4 -,TET V20f2 bnS 45. Forms - 4. Electrical Conduit-Undrgrn •46).VEgidtrical Bonding - . . 5. Steer-Reinforce _• _ 47. RoughPlumbing&tP`re'ssur'e't€'st •0) [NTL t0C H T5X6YY:>'�J ' - • • 6. Electrical UFER Grn _. . . _ 48. APPROVAL TO COVER=G'UNITB t ogwsi4 .f2 EE '.VE - 7. _Footings . - . . 49. Electrical Conduit-Undrgrn 8. Foundation - • - . 50. Gas,Pipe, ❑Undrgrn,Test • a-Undr rn _. ... rty. P 9 51. _Backwash Lines. P-Trap i't-SUn lrgrn * L -J. . 9. Water Pi _ -10. Structural.Floor System .. _ _ 52. APPROVAL TO DECK - - - - 11. Property Sewer Line & House Connection. . . - 53. Backwash & Receptor-Final ' •' -12: - Street Sewer Connection . - -- - . - - . 54. Heater & Vent-Final , -- 13. Rough Plumbing .. - 55. Plumbing System -Final 14. Rough Electric-Conduit - - - - _ '56. Electrical-Final - _ 15. Rough Electric-Wiring -- .. -57. Solar-System-Final - ' .16. . Rough Heating &Air Conditioning _ - - - . b8. Fencing &Access Approval • 17. Ducts, in Structure -- • - . .. ---- • . .59. APPROVED FOR PLASTERING , '18. -Ducts, Ventilating-- - - - • - , - - --- 19. Gas pipe-Rough &Test - • l . 60. POOL/SPA.SYSTEMS FINAL - f 20. Roof Framing• - - - - - - •- - ' 21. Roof Sheathing 1 22. - Frame and Flashing - - - - - - -- NOTES: - . - • . 23. - Insulation- - - - - - - _ - -- . _ . " . -" - .. . __ 24. Lathing& Siding . _ ._:-- . _ . . -_ ` - - - - - 25. - Drywall Nailing - - - - - - --- -- i ' - - - 26: - Plaster Brown Coat - -- - - - _- - -- - 27. Electrical Power Meter-Final- - - , - - - - - - • - - . 28. Final Electric - - - - -- - • - . 29. Final Heating-& Air Conditioning - - - • -- - • - 30. Final Gas-Pipe-Test - - - a 31: Final Plumbing - - _ . 32.-Water Service-Final - - - -33. Gas-Service-Final - - . - - 34. Solar Domestic Final _ • .• ' 35... 5Landscape Sprinkling Systerh-- • - 1 36. Sound Attenuation • 37. Handicap Regulations - '�'% 38. FINAL STRUCTURE& BUILDING 39. Special Requirements Completed 40. Electric Release to Edison • 41. Gas Release to Southern California Gas Co. • • 42. CERTIFICATE OF OCCUPANCY ' - -I:. No Date . - .. - . . . _ .. ... _. . Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. - CITY OF COSTA MESA - PERMIT NO. TRACT-NO: LOT NO. BLDG.NO. - - - - - - .- • - • CONSTRUCTION PERMIT +� ® 5160 - 87 10 • ?�i N I/I ^/'j''," 15o 0 TL Project 150 Val Vey Fnrt3P C' M TYPE OF CONSTRUCTION • .. - • j Ow rAxthur M^Senaio Pnpn,45 . 8688 ."EW 'ADD ' O"ALTERATION /- = � R -Add EPAIRECONVERSION DDEMOLISH -"'ZONING REGULATIONS • �3a1 Ticonderoga Wad, S.M. ❑ OTHER RPrn 'Arch/Eng. ` License o.- Of Rt. 'Address -' ' - - __ • _ DESCRIPTION OF WORK_;...:-1--!-_-;.-..;.•-,. - - ONE -' - RL NG. REF: - - ' - 2nd Story Tar & Gavel / -Contractor FPrrArn Roof 4 ng CO_Phone643. 82. 3TYPE OF PERMIT - SETBACK C/L ST. TO PE BUILDING _ PROPERTY'LINE - Address 379 23 Si-. Newport R^h -QA - El GRADING. ❑ 'FOUNDATION ❑-STRUCTURAL - •• WARD-YARD- . - - FT LICENSED CONTRACTOR DECLAMATION ❑-TENANT -❑ ELECTRICAL DPLUMBING -❑MECHANICAL/ -SIDE YARD I hereby affirm that I am licensed under prov"-io o harter 9 (corn- - . RIGHT mencing -with section- 7000) -of Divis .n '- e Business and ❑ OTHER - -. Professions Code, and my license ..- it 1-I force and effect. I - REAR YARD (TO P/L) - '- - License'Class . - - ' s-N• 42740 - PROJECT.ESCRIPTIO�J -.. _ .. . . �!'f-d SO'.FT. tJU r f'' PKG.SPACE REQ.' PROVIDED Date 1-3-8'3 CO Signature i1•ii' - -' - - STREET WIDTH - . - -'PARK FEE.$ ' - WORKERS'COMPENSATION • CL' R• • ' ' OCCUPANCY/ C NISTRUCTION TYPE • _ - I hereby affirm that I have a certif ate of consent to self-insure or a VALUATION l/) 'ZONE - ZONING'APPROVED'BY I' DATE 'certificate of Workers' Compensa in Insurance,.gy a certified copy thereof(Section 3800, Lab.C.). • GRADING CU.YDS. ACRES SPECIAL CONDITIONS: 'Policy No. Company - . - • - . . . - , - - - - - -- - _ - - _ _ • _ _ • :edified copy is hereby.furnished,. __ _ _ i REMARKS: " _ . - _ _ -_ _ _ _ ' '' ' :ertified copy is filed with the city Building Division. - - - - 'tXEMPTION FROM WORKERS',-COMPENSATION DECLARATION - - .. - - - - "' �I ..(This section need not be completed if,the permit is for one hundred - '- _ ($100) or less). - _ - " . ._ - . .. . . _ _- _ . _ . . _. . _. - . I certify that in the performance of the work for which this permit is issued, I shall notiemploy any person in any manner so as-to-become :PLUMBING, 4 PLAN CHECK - ' ----- -- 'ELECTRICAL - - PLAN CHECK ' ..subject to the Workers'Compensation Laws of California', ' ' ' - - - - - -BATHTUBS ' ' --- "SHOWERS '- '• ' Date Signature ' SO FT SO SO FT FT " NOTICE: If after making this declaration, you should become subject, • TOILETS_- •,-•o , URINALS" - - " - -- - - GENERATOR to the Workers' Compensation provisions of the Labor Code,you must - - TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS ' - - - - - -- - APPLIANCE - -10-50 KW..‘--- 50+KW • - revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per-. SERVICE SINKS - , SUMPS ' `-- -- - - ' - - -- - - UNC.SOLAR) . - 10-50 HP_50 + HP. , formance of the work for which this permit is issued (Section 3097 - - ` Lender's Name FLOOR SINKS" "FLOOR DRAINS" " . -- " -" FIXTURES '- OUTLETS- SWITCHES-' -- ---- - Lender's Address - DRINKING FOUNTAINS -j. ' - _ -- •� GAS TUBE SIGNS . - - _ , - . . - OWNER BUILDER DECLARATION - -' - - INTERCEPTORS- - - ' 'CLARIFIERS I hereby affirm that I am exempt from the Contractor's License Law for the-following reason-(Section-7031;5-Business-and Professions Code:- SWIMMING POOL- ' p tRAP'" -" LOBS KUL I Iury_ Any city or county which requires a permit to construct, alter, POLES METERED `SUB -improve,demolish-or repair any structure, priorto its-issuance;also re • WATER SERVICE ALTERATION ' ^ -'PANELS- -- -MAIN-- SUB '.. - _ - - - • -• - quires the applicant for such permit to file a signed statementthat he .. is licensed pursuant to-the provisions-of-the Contractor's License Law- -GAS-SERVICE •"-"`OUTLETS' "-' _ 'SERVICE- - - - - - AMP - - (Chapter:9 (commencing with Section 7000) of Division 3 of the -- - - 'Businessand-Professions-Code) orthat-he-is exempt therefrom•and the- -yvgTER'HEATERS basis for the alleged exemption. Any violation of Section 7031.5by - - - "—applicant f •a permit - uba-s plicanC-to a-civil -penalty -SEWER CONNECTIONS "• - - -- - - ot more than five hundred dollars ($500). - ,+ as owrier of the property,Or my employees With-Wages-as their- - SOLAR TANK - - - -'COLLECTORS -- `• T' - ----- -- • - - • •-- -- • --- - -- ---.- - .suie compensation, will do the work„and the structure is not intended _ ..- - or offered for sale.'(Section 7044, Business and Professions-Code:The SOLAR PIPING SYS. - -- - - - -- - --- ,Contractor's_License.Law does not apply to an owner of a property. -qpp LIGATION APPROVED BV- .•- - - GATE •� who builds or improves thereon, and who does such work-himself or - 'ISSUE FEE '” - - " "" .through his own,employees, provided that such improvements are not ' ' intended or offeed for sale. If, however, the building or improvement MECHANICAL PLAN CHECK - - -' is sold,within one year of completion, the owner will have the burden S MMARV OF FEES • of proving he did not build or improve for the purpose of sale). rw HEATING SYSTEM 0-100,000 BTU PERMIT $ �V SMIP '- $ - .wJ V -❑-I,- as. owner- of -the-property, -am exclusively contracting-with AND DUCTING' ' --• - - - - - - • - - ,- - licensed contractors to construct the project"(Section 7044, Business 100,000 + BTU , PLAN CHECK $ PERMIT, r and Professions Code:-The-Contractor's License Law does-not apply to. -_. . .ISSUANCE_$ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ - . , - - -tracts from such-projects with-a contractor(s)•-licesned -pursuant to SYSTEM - .--- . ... . . . GRADING $• '' - " the Contractor's License Law). 100,000.BTU - - PLAN CHECK: $ - - . . .. , ❑ I'am exempt-under Section - - " - - ' ' B.'8. P.C.for this BOILERS BTU - -ELECTRICAL $ - - - -'$ -- - . . _ _. _'MICROFILM•$' . SYSTEM REPAIR,ALTERATION -PLAN CHECK"$ Date Owner TOTAL FEE$•-• _ MECHANICAL $- I hereby certify that I ha - re.• phi teplication and state that the above EXHAUST SYSTEM MULTIPLE - - 'I; -LESS ACI information is co -E I- ;roe comply-with alt-city and county' PLAN CHECK ' $ - •VANCEPC $ - ordinances and s 5 ati r o construction,and hereby authorize , representatives- is to -ter upon' the above'mentioned- property for j�. tie /J� _ • Signature / •�z""' Date%�� •FINAL FEE $ Drivers'Licen or S -ISSUE FEE CMF 0865 -6 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING Of l 8 0 1 c POOL&SPA, : _ - , : r+ • , - - - Date Inspector "' Date Inspector APPROVALS Permit# .•APPROVALS , Permit# . '1.,,....i•I. ,(;,jtsV 0c'_. tnr41- - _ - _ 1-- Temporary Electrical Service or Pole --k 43. Pool-& EquipmentlLocation-'�C-- - - - sitneHO14 ttirii'YA_ ; ._ • 2... .Soil Pipe-Undrgrn - :44n-fStepl Reinforcement - •ria 3 .\EW EpO"r9b'tOD.[T_ 14 LS' "`-- - 3.- Electrical Conduit.Utility:Undrgrn _-- - -,_Ori-tO, 45. Forms - . - - - - - 4. . Electrical Conduit-Undrgrn - -_- • ._ - . 19VSYc: i 14d' ;01,ra"t`isal Bo1itling' - . - - - - •- - - - __ 5..., Steel Reinforce i . - _ - - 47. Rough Plumbing&:.4riessurelTtst .03 prti3b_r- OO$I. s1 " 9'3 _ .- 6._ Electrical_UFERGrn_ .. _ _ . - 48. APPROVAL TOCOVER-GUf4ITEC`Od .fouwe' •a- t-'• e\t- -: .J. 49. - Electrical Conduit-Undrgrn - - - - 8.- Foundation -_. _. _ -__-:. __ 50,-, Gas Pipe, -❑ Undrgrn,Test '` - ., ' 9. Water Pipe-Undrgrn ._ . _ .- .._ _ - _ ' 51. Backwash Lines;P-Trap.1 'ln'dri4rn - - t c--) -. . - 10.. Structural Floor.System , . - , _ _. _ 52. APPROVAL TO DECK - _ t d-c--1 ' 11,._ Property,Sewer Line& House Connection ... - _ _ 53.--Backwash & Receptor-Finalr ' . - 12.. Street Sewer_Connection. -". :- '_'_ -, --- - . - 54. - Heater &Vent-Final ' - .13.,. Rough.Plumbing __ - T.__. _ .... .___. . _ ' 55. Plumbing Svsiem - Final 14. Rough Electric-Conduit --- --- - - `- -- - - -56: Electrical-Final - • - - - " 15. Rough Electric-Wiring - - .--- - - - --- - - -- - 57: Solar System-Final. ' , , ' _ " - 16.---Rough-Heating"&-AirConditioning : - -- --- ,- -- - - - -. 38. Fencing &Access.Approval . . `' "• - - . • 59. APPROVED FO.R PLASTERING , '. ' ' ` ' --1-7- Ducts; in Structure .,, _ __ . _ _ 18: --Ducts,-Ventilating • 2t_ - _ _ _ . _ - _ . __ _ __-_ . -_ . . _ 19. Gas Pipe=Rough &Test - ' -. -= 60- _POOL/SPA SYSTEMS FINAL .. .. . . 21. Roof Sheathing - - --- - --- -- - 22: Frame and-Flashing - -- - - - - - =NOTES:"__._ - , . - 23. Insulation " r 24. ....- . , . Lathing - -- -- - - - - ---` -- - -- - - --- - --- - -- 25. DrywallNailing - . .. „r.-,r; - - - - _ __ . . _ _ . - -26.- -Plaster Brown'Coat - -- - - - - • - 27: Electrical Power Meter-Final .. . - - .. -28. Filial Electric- - - --- - -- - -• - , -29. Final Heating & Air Conditioning -` -30. -Final Gas Pipe-Test - . . - - - - - ..31. -Final Plumbing . _ - - _._ _ _ _ _ _ . . .... - - • -32.-„-WaterService-Final-- - - . - • - - --. --- - . - . .. . . - • - - - - - 33. Gas-Service-Final-_ - -. - - - ... . - - ' ,34.. Solar Domestic-Final " , • . ' 35.-' Landscape Sprinkling System - - - - 36. Sound Attenuation - - - - - 37. Handicap Regulations - -- - ' . - 38. FINAL STRUCTURE& BUILDING ' - _ _ 39. Special Requirements Completed -, _ • 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. , - - , . 42. *CERTIFICATE OF OCCUPANCY _ • - _. No • • Date - _ - - • _ .. `4 . —ApphcBnt to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PEgy�IT NO. TRACT NO. LOT NO. BLDG.-NO. • - - CONSTRUCTION PERMIT PZ — 40C ;j • -5160 90 . (10 3s4` I./"/n ' 1;,.. .i IL Project '.• . ... 150 Valley Forge. C.M. TYPE OF CONSTRUCTION. `L...-- . • Ow 'r Tllf'kRan Phone 0 NEW 0 ADD 0 ALTERATION / Add. •335 .TicondeS Way. C.M. 0• REPAIR ❑'CONVERSION ❑DEMOLISH , QRa - ZONING REGULATIONS - Arch/Eng. License N0. ! - g 0OTHER A P • DESCRIPTION OF WORK 2nd Story Tar & • Address 'ZONE PLNG. REF. Contractor FERRARA ROOFING CO. Phone842823 TYPE OF PERMIT ' - - ' - BUILDING Tp B`1I INC SETBACK C ST. PROPS RTV LINE \ v,j Address • • , - I• • : e • 0 GRADING, 0 FOUNDATION 0 STRUCTURAL SIDE YARD LEF LICENSED CONTRACTOR DECLARATIO 0 TENANT 0 ELECTRICAL DPLUMBING .DMECHANICA - SIDE VA-• 1 I hereby affirm that I am licensed under proyls on of Charter 9 (corn- RIGHT mencing with section- 7000) of Div Ion o the Business and 0 OTHER_ Professions Code, and my license' f force and effect. REAR YARD (TO P/L) �, / :PROJECT DESCRIPTIO, License Class - • p / Ao • se No 349740 -SOL) 7 PKG.SPACE REQ. •- PROVIDED " Date 1-3-A1 Signature •/'YAr/ SQ.FT. i ii-� (/ • STREET WIDTH PARK FEE$ ' WORKERS'COMPENSATION DEC •R OCCUPAfiCY_CONSTRUCTION TYPE • I hereby affirm that I have a certi tate of consent to self-insure or a VALUATIONnOU •ZONE ZONING APPROVED BY • I DATE certificate of-Workers' Compens. on Insurance, or a certified copy _ thereof(Section 3800, Lab. C.). • GRADING CU.YDS. • ACRES 'SPECIAL CONDITIONS: - Policy No4R7R90-R9—Company •u • • • •I - - - r' -ertlfied copy is hereby furnished. ,, REMARKS: ' - _ artified copy Is filed with the city Building Division. L.-e•MPTION FROM WORKERS' COMPENSATION DECLARATION - -- (This section_need-not be completed if the permit Is for_one hundred ($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 PLUMBING ' - PLAN CHECK ' ELECTRICAL PLAN CHECK • subject to the Workers Compensation Laws of California. _ _ uw LLLIrvb GARAGE Date Signature BATHTUBS ' - SHOWERS • NOTICE: If after making this declaration, you should become subject TOILETS URINALS' GENERATOR 0-1 KW_1-10 KW ' to the Workers' Compensation provisions of the Labor Code,'you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW- -50 +-KW . . - - -' revoked. - _ - _ CONSTRUCTION LENDING AGENCY • KIT:SINKS -- DISHWASHERS - MOTORS- - 0-1 HP_1-10 HP - - I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS - • SUMPS - (INC.SOLAR) 10-50 HP 50 + HPC _' • formance of the work for which this permit is Issued (Section 3097 Civ: C.). - ' FLOOR-SINKS - FLOOR DRAINS - - FIXTURES- OUTLETS SWITCHES - - ' - - Lender's Name — - Lender's Address -- DRINKING FOUNTAINS ' ' ' ' GAS TUBE SIGNS - • OWNER BUILDER DECLARATION - - - INTERCEPTORS CLARIFIERS • POLE LIGHTS - - ,- - ' ' I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business-and Professions Code: SWIMMING POOL -P TRAP-- _ LUGS I NUL I ion Any city or county which requires a permit to construct, alter, POLES' METERED SUB . improve',.demolish or repair any structure,-prior to its issuance,also re-- WATER SERVICE 'ALTERATION - PANELS MAIN • - SUB - -- • • quires the applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law -GAS SERVICE OUTLETS - • SERVICE- AMP - — --- (Chapter 9 (commencing with Section 7000) of Division 3 of the Business-and Professions Code) or that he is exempt therefrom and the WATER HEATERS - BTU OUTPUT - —. - - -- -basis for the alleged exemption. Any violation of Section 7031.5 by ar•^appliranl for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - ---. • - : - r -t more than five hundred dollars ($500). • as 'owner of the property,or my employees with wages as their ' SOL•AR TANK '' ' COLLECTORS' - - - - • . - - - - - 5e,_.compensation, will do the work, and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. - ISSUE FEE - - - • - -- Contractor's License Law tloes not apply to an owner of a property _ - APPLICATION APPROVED BV - - =DATE- who builds or improves thereon, and who does such work himself or ISSUE FEE - .- through his own employees,provided that such improvements are not intended or offered for sale. If, however, the building or improvement MECHANICAL ' PLAN CHECK SUMMARY OF FEES 5C) is sold within one year.of completion, the owner will have the burden of proving he did not build or improve for the purpose' of sale)' HEATING SYSTEM 0-100,000 BTU BUILDING r ,,1 -. ❑ I, -as owner of the property, am exclusively contracting.with PERMIT $ ✓-•�, - •.SMTP $ licensed contractors to construct the project (Section 7044, Business AND DUCTING' 100,000 +BTU PLAN CHECK $ PERMIT and Professions Cotler The-Contractor's License Law does not apply toISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 000,000 BTU PLUMBING $ _ • tracts-from such-proj -1 ects with a contractor(s) Iicesned pursuant to - SYSTEM - - •• GRADING S + the Contractor's License Law). - 100,000+BTU_ • PLAN CHECK $ ❑ I ani exempt under Section' - B.& P.C:for this - '- - - $ BOILERS BTU 'ELECTRICAL • $ I reason-- - - - - - - - , PLAN CHECK E • MICROFILM $' ' - - - SYSTEM REPAIR,ALTERATION Date Owner TOTAL FEE S - • MECHANICAL $ ' - • - 1 I hereby certify that I ave read ibis application and state that the above EXHAUST SYSTEM MULTIPLE .LESS AD- I Information is c'rr ct I agr /to comply with all city and county _- PLAN CHECK $ - VANCE PC $ ordinances and I s reL g to construction,and hereby authorize representative o ' is'GI /to enter upon the above mentioned - property for I�.p ct ton /••r•o _(�) / j� -� �� - f� O-J �■ FINAL FEE $/ �(L Signature ! Date Drivers' c.'s or - - ISSUE FEE - - - _ _ - . CMF 086 -4G White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor • CONSTRUCTION AND PLANNING ii U2 0aItool_&SPA '; . • I APPROVALS Permit# Date Inspector . APPROVALS '..• • • Permi�# Date Inspector 1. Temporary ElectricalService_or_Poler elm-tOu'1' Lauer - _ Po Y _ _ 43. Pool & Equipment Location __ -__ _ _ 2. SoiIPipe-Undrgrn . - 44j,,.,,Steel Reinforcement -"'"'' ` r"" o #W JuuJ.L.t cc.Er4 3. . Electrical Conduit Utility-Undrgrn . . . 3 -(GT y'1O..1 il11 45:.- Forms . •- • - 4.-.Electrical Conduit-Undrgrn _ Steil-Reinforce • 46. ElectriFaU66dIDing'_ _ „ _ �.,�HH - - - _• 5. SteReinforce _ 47. Rough Plumbing FatiiA TLrst -`)-1 cliff 2.1/4-'i an'an-t.i I - . 6. Electrical UFER Grn - - _ 48. APPROVAL TO COVEN-GUN1tE7zOt evl "1c. uat' :t t 7. Footings _ - - -._ _ 49. Electrical Conduit-Undrgrn - �, 8. Foundation. . ... . 50. Gas Pipe, ❑Undrgrn,Test_ . _ 9. Water Pipe-Undrgrn. - - _ _ .- .. 51. Backwash Lines,P-TraP.'U-Llndrgrn r' . _ EV"' - - 10. Structural Floor System _ L. 4 1 - - - _ . _ 52. APPROVAL TO DECK _ • ' - - 11. Property Sewer Line & House Connection. -- - - 53. Backwash & Receptor-Final - 12. Street Sewer Connection . '_'. ' - •. - • - 54. Heater & Vent-Final • gar r.,. 13. Rough Plumbing -. - _ _ . -' ' - - 55. Plumbing System - Final _ 14. Rough Electric-Conduit --- --- - - - - - •56: - Electrical-Final- 15. Rough Electric-Wiring • -- • - - - -- 57. Solar System-Final, 16. Rough Heating &Air Conditioning - - - - -- - _ _b6. Fencing&Access-Approval -17-. - Ducts, in Structure - - -- ` - - _ - 59. APPROVED FOR PLASTERING - ' 18. Ducts, Ventilating- - - -. - . . .. •_ .- - _ - - • - _ - -- 19. 19. Gas Pipe-Rough'&Test . • - -- , - . . . 60. POOL/SPA SYSTEMS FINAL , • 20.- Roof Framing - - - - -- - - - . . - - ' ` 21. Roof Sheathing - - _ . - - - - . . • -- - - ' NOTESr ' 22. - Frame and Flashing : " 23. Insulation ----- - - - - -- -- _ _ - _ - . - ' 24: Lathing & Siding - -- - - - - - - ' -- --- _-- - - - - -- - - - - ' 25: Drywall-Nailing - - - - -- - -- - - ' • - 26. Plaster Brown Coat - - - - - -- i . 27: Electrical Power Meter-Final - - -. . . . - • • .. .. ' - • 28. --Final Electric- - - - - - -- 29. Final Heating & Air Conditioning - . 30. Final Gas Pipe-Test-- - - - - - _ 31. • Final Plumbing .- • - - - 32. Water Service-Final - - - - - _ _ 33.- Gas Service-Final - • 34. Solar Domestic-Final . . • 35. ' Landscape Sprinkling System - - 36. Sound Attenuation - - 37. Handicap Regulations - 38. FINAL STRUCTURE& BUILDING - - • 39. Special Requirements Completed - 40. Electric Release to Edison - - . - - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY - • - No Date - - <0 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. )0' CITY OF COSTA MESA a PERMIT NO. TRACT NO. LOT NO. BLDG.NO. 7FSE I :/ i , CONSTRUCTION PERMIT • - Q 9/(p(p 5160 141 - 146 7 Applicant's Mailing Address) S 0 Un?P P/! Fon 9 P r G•n•1 , - ' TYPE OF CONSTRUCTION LI NEWtUJ AD6 U ALTERATION ❑ REPAIR - - • ' - - PfOjeCtAddress- Came -- • ❑ CONVERSION 0 DEMOLISH 0 OTHER ROI nn 113 • - • Owners Name Muni mer a I I n ('nmm AAAv'phone 540-1097 DESCRIPTION OF WORK C•Qa44 A; FA bertg•Qa24, Comp. ZONING REGULATIONS Address came . A f . TVP OF PERMIT •V GRADING M FOUNDATION • STRUCTURAL A.P.* ZONE _ PLNG. REF.4h BUILDING Arch/Eng. ' License No. 0TENANT ❑-ELECTRICAL 0PLUMBING 0MECHANICAL , Address - • ❑ 'OTHER - ePrnnry rn cT • - TO BUILDING REAR YARD(TO P/L) San, 1�,tt'i () 00,( 74-30706600R PROPERTY LINE. Contractor's Name A 'S ('n Phone Q - PROJECT DESCRIPTION SQ.FT. OCCUPANCY -] Addreu(rriailing)? 1k7' N 1{a.tn VAn ( kntll�P 92h65 i CONSTRUCTION TYPE 5-N VALUATION$ /DS00• LEFT SIDE YARD RIGHT SIDE YARD License NO. City - -0260k5 • I ' ZONF ' GRADING CU.YDS. ACRES • PKG.SPACE REQ. I PROVIDED - LICENSEE) DECLARATION Remarks: STREET WIDTH PARK FEE$ O I hereby affirm that 1 am licensed under provisions of Charter 9(commencing - ' with section 7000) of Division 3 of the Business a Professions Code,and SPECIAL CONDITIONS: i - my Ilcense.is In full force anti?. 1 Ucense Class ""y . LI se N PLUMBING ELECTRICAL tie 9-1k-k 3 Signature Bar Sink Sewer Cap ' ,ORKERS'COMPENSATION DECLARATION • - - I hereby affirm that-I have a certificate of consent to self-Insure or a certificate Backflow'Preventer Sewer Connection' - - - - _ Automatic Washer Meter Dover 100 amps ' of Workers' Compensation Insurance, or a certified copy thereof (Section - '- Construction Pole • 3800, Lab. C.) • Backflow Irrigation Soler Collectors • Sub Panel, Policy No. • UIP '!J2 1504�$pany Frtein pit IRd2mRit4 Cooking Unit • Sub Pole 1fll1--1ll Certified copy is hereby furnished. ' Bathtubs $018r Piping ..1(Certifie copy is flied with the cltY-B n DI sl Dishwasher Motors 00-1 HP ❑1 S-8 , Date 4'1,y'ef b ' Applicant Clarifiers Solar Tank _ EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Swimming Pool w/Spa Dryers ❑Gas ❑Electric - - • Inc Sblal 09-15 HP 016-15+ (This section need not be completed If the permit Is for one hundred($100)or , — - • DrinkingFountains Urinal i Fan • Microwave I certify,that in the performance Of the work for which this permR Is Issued I , shall not employ any person In any manner so as to become subject.to the ' ) F.A.U. , POIe Light Workers',Compensation Laws of California. - Floor Drains l Water Closet Date' • Signature • I Fixtures ' ' NOTICE:-if;after-making this-declaration,you-should become subject to the - Floor Sinks . -I. - - - Water Heater - -- • n .. , _ _ _ __ _Range - Workers' Compensationprovisions of the Labor Code, you,must forthwith •. Gas BoxesSign comply with' such provisions or this permit shall' be'deemed revoked. 1 Gas Service Outlets , Water,Service ', • _ , , ' CONSTRUCTION ;LENDING AGENCY - I Outlets Standing Sections j I hereby affirm that there is a construction lending agencyfor the performance i v Interceptors , - ' - - , of the 'work for which this,permit is issued•(Section 3097 Civ: CJ. • - Switchest Lender's' Name - - _ • . Kitchen-Sink, _ 'Trash Compactor Lender's Address, " - - Lavatories - Garbage Disposal ' ' OWNER,BUILDER DECLARATION - _ - . I hereby,affirm that I am exempt from the Contractor's License Law for the , , - Generator 00.5 KW 05-15 KW - 1 following reason"(Section 7031.5 Business and Professional Code: Any city or' • - I F—Trap : , - . I ' : county which requires a permit to construct,alter,Improve;demolish or,repair , .; - - - .. - - - - I Transformer 015-50 KW ` ' l ,' any structure;prior to Its'issuance,-also requires the applicant for uch permit , l Roof Drains - I - . , ,? • - 1 ' '`'o file a signed statement that he/she I5 licensed pursuant to the provisions of _ - - I 050+KW', ' I ;Reinspection Fee , $15' • '°"' he Contrattor•s License Law(Chapter 9(commencing,with Section 7000)of ' , t - - Reinspection Fee $15 Division•3 of the Business and Professions Code) or that he/she,Is exempt - Showers �^ • therefrom and the'basis for the alleged exemption: Angviolatlon of Section '"- - - _ _ Meter ❑up to 100 amps -Issue Fee. - '$ 3 .7031.5 by-any applicant for permit subjects the;applicant to a-civil - i — enalty of riot more than five hundred dollars($500). ' • _ Service Sink' - ; Issue Fee $ 3 J Zoning Approved By - .Date U I,'as owner of the'property or my employees with wages as their sole , MECHANICAL' compensation will,do the work,and the-structure is not intended or offered _ , Application Approved 8y Date ' for sale,(Sec/Ion 7044, Business and Professional Code: The Contractor's — , ' License Yaw does not apply to an owner of a property who builds or improves Boiler , , Refrigeration System • Application Issued By - Date I�/��% ' thereon,-and who does such work himself/herself or-through his or her own employees,ees, provided that such Improvements are not Intended or offered for . ❑010Q000 BTU 0100,000 BTU - . yyDuct-Under Ground sale. If, however,the building or Improvement is soltl within one year.of com- .. I t ; I , I S MMARV OF FEES . 1 ' pletion,'the owner:will have the burden of proving he/she did not build or Im- - //u m^ ' ,S© 1 prove for the burpose of sale). Duct-Structural - , System Repair/Alteration ' 'BUILDING PERMIT $ Se I SMTP ; $ l 0 O I, as owner of the property, am exclusively cOntractinglwith licensed con- I1 tractors to construct the project (Section 7044,Business and.Professions Code: - l- 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 0 • I - - PLUMBING , $ tractor(s) license pursuant to the Contractor's License Law). l ( 1 I I - 'PLAINCHECK $ ' GRADING I ' $ • 1 ❑ I-am exempt under Section - B.& P.C.for this reason Firepl/Fact.Bit.ICBG# I $ ELECTRICAL $ _ Date 1 - - Owner; t t • Heatingsystem 8. Ducting I � I , , ' MICROFILM $ • I hereby certify-that I have read-this application-and state that the-abbve-, 00-100,000:BTU 0100,000 BTU - - y - -- - -- I ,PLAN CHECK $ Information Is correct. I agr:. to comply with a0 city and county ordinances ' 'MECHANICAL $ TOTAL FEE, $ and state laws relating t'.•ullding co,stru on,and hereby authorize repre- I .I ; ' sentatives of,this l city enter,u• n - above-mentioned property',for Hood or Typal ❑� I Reins action Feel $15 I ' ' LESS Inspection purposes. /j y I ' 1 Canopy Type II 01 , p. _ 1PLAN CHECK $ - I , ADVANCED PC I $ ' Signature Date .9—I 1:)-.R 3 i { ; 1 : - Drivers'License or - ' - - Registers 1 Issue Fee ' $ 3 • I • FINAL FEE' : $ : '+"0.3� CMF 0865-46 rev-12/82 White-Building:Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - - ^ - 92. .;CONSTRUCTION AND_PLANNING - - -- -- - --'- - ;POu�`&SPA - - - if ,. Inspector i - " - - Date Inspector :APPROVALS Permit:#- I - , APPROVALS -y-11 -S7. - 1,. Temporary Electrical Service or Pole.- - - • 752:Pool &'Equipment Location - - : _ 2,- Soil Pipe-Undrgrrid. -y s ` . - r ' •i`- ` ' ' 53.'Steel Reinforcement .. - r 3: Electrical Conduit Utility=Undrgrnd L. C• ' l r - ., 54:, Forms _ _ Al • cr 4: Electrical Conduit-Undrgrnd: - = 1' `f? 55' Electrical"Bondin - . - _ 5: Steel.lReinforcemeni - " ' "` l'`' _ - P. ",56., Rough Plumbing&Pressure Test 57'.- APPROVA'LiTO COVER-GUNITE 6: Electrical OF ER Grnd.- r• - : .; ` - - •7 - 7. Footings - 2, ' - • 58. Electrical;Conduit-Undrornd. _ _ - ,- • - 8. Foundation _ q __ _ 9' ' 59. Gas Pipe,-,E.Undrgrnd.,Test . - 9. Water Pipe-Undrgrnd. • ; ; rgrn ',60. Backwash Lines;P-Trap, O Undd. 10. Structural Floor System . , 0 •�' 61. APPROVAL.TO-DECK - , - . -' - - - 11. Property Sewer Line& House Con}ection. -: 4-S; -a 62. Backwash &'Receptor-Final s . .. . 12. Sewer Cap • °-, . 63. Heater&Vent-Final „ 2• v 13. RoofDrains ati.rt./ "- ' _ ?; o 3; ' 64. Plumbing;System - Final , ' 14. Rough' P-lumbing i% - .� 65. Electrical=Final J - c. ''15.'1136d -Conduit-" `- "--� - - --•-T" .66:, Soler System=Final - - - -" -- • - -- " '.'t - I I , - , - 2 .`?16. TRough••Electric;Wiring, r• I - .' --- • ': ±; '7 ' 67: Fencing'&Access-Approval - - - - "' ;17. Rough Wiring-Signs - I ,; II . i , I `, 68,. APPROVED FOR-PLASTERING' 1 -- -, 18. Rough Electrical-T Ba• ri' Ceiling '' I ' r I r ' 169. POOL/SPA SYSTEMS FINAL , - • 1 19. Rough Heating & Air,Conditioning .. • - _ I 'FIRE DEPT. REQUIREMENT ' ' ' 20. Rough Factory Fireplace j , ; r APPROVALS ' Permit# , • 21. Ductiin Structure'+ ' 1 I ; + ''70.! Underground Hydro • 22.'Ducis,,Ventilating •, 1 f, , ' 71: Product Piping 0Gas EOil ! ' l'= I 172.' Underground Flush - 23:',pas & Test ; , � -- -- • '-24';,Fbof"Framingi ; I 'i d - i I . ;! j - 73. Undergrnd.Stoiage Tank 0 Gas 0 Oil , 25.iRbof Sheathing •- _ I - - 74. Overhead Hydro1/41 r : , _ ; -26. T-Bar Ceiling"(Structural).& Monocoat E I _ ; 175. Dry Chemical ,27[ Fram&end Flashing . , , 76. Dry Standpipe 7 • 28.).Lathing & Siding; . _ • . $ . i I l -} .77. FIXED SYSTEM:FINAL 29.; IrisulationX := I ,I 1 i 178: FIRE PREV. FINAL 30. Drywall Nailing - l1 I • Notes: . '„'31•. I Plaster.Brown Coat' ' 1 ' . ' - 32. Electrical Power Meter-Final ' •- I - 33. Final Electric _ _ _ • • 34. Final Heating"&'Air Conditioning i ' I ' , 35. Final Gas Pipe-Test , � - ' 1 1 ' ' ' - _ . 36, Hood or,Canopy , .._ 1 n' • i t - - n 37. Final Factory Fireplaces . 1 ' - , 38. Final Plumbing ' - , ' - i - 39. Water Service-Final I 40. Gas Service-Final ' ' L. 41. Solar Domestic-Final I ' I i , - 42. Backflow Preventei , j i _ ' _ . . - _ __ ' 43. Backflow Oigatian. - - , ' 44. Landscape IrrigationSysteml '"- r j '_ , - l ' - r. 45. Sound Attenuation.' - - - ' -.a- - '• ' 46. Handicap Regulation-Si I • _• _ ' - T 47. FINAL STRUCTURE& BUILDING' - i r l - ' 1 i 1 • • 48. Special Requirements Completed 1 i' _ , 49. Electric Releaseto'Edisori i ; , ' a _ - -- I__'__ _-'_ _.�__: - ' 50. Gas Release to Southern California Gas Co ; ! I - ' 51. CERTIFICATE OF OCCUPANCY _ . - _ I _ _. _.. - - No II Date ' ' r • /"p Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - 7.x-57 �� „o- CITY OF COSTA MESA' PE MIT NO. TRACT NO. LOT NO. BLDG.NO. '1 I CONSTRUCTION PERMIT / — 7/'0 ' �5160,; 147- 1,51 . 8 I , Applicant's Mailing Addressl50 If2eeey�,'F0/(,gQ r C+'M' TYPE OF CONSTRUCTION• LJ NEW JADD UALTERATION-U REPAIR • - • - Project Address Same • ❑ CONVERSION ❑ DEMOLISH El OTHER Re.2 O:O�.CYLO - - • • - , Owners Name MOYl.'t:(.0 2-Q-QOC 0111111A s-8n Phone S'40-1097 . DESCRIPTION OF WORK .1+Qa 6 o Ir...i E-LbelL9�246- Camp. - ZONING REGULATIONS Address Same . - • ,TYPE OF PERMIT GRADING U FOUNDATION U,STRUCTURAL ' ' A.P.# • . ZONE - Arch/Eng. ' -' ' License No. ❑ TENANT' 0 ELECTRICAL ❑ PLUMBING- ❑'MECHANICAL ' PLNG, REF,# BUILDING • Address - ❑ OTHER • TO BUILDING - Cr-runny rn 5r REAR YARD (TO P/L) Contractor's Name SajIMan,r 11 ORO O S Co r Phone 9743070 PROJECT DESCRIPTION SQ.FT. 6000 - OCCUPANCY R- 1' PROPERTY LINE Address(Mailing/ 91 A7 N Rata via Ohan'ge 99 A6; - C ONSTRUCTION TVPF 5-N VALUATION$ 6500 : .LEFT SIDE YARD • RIGHT SIDE YARD u ZONE I - GRADING CCU.YDS. ACRES - PKG.SPACE REQ. PROVIDED r License NO: C#J, 0960R; •- LICENSED CONTRACTOR DECLARATIONRemarks: I I STREET WIDTH ' . 'PARK FEES .. • I hereby affirm that I an,licensed under provisions of Charter 9 (commencing ' .. . with section 7000) of Division 3 of the Business an Professions Code,and _ i SPECIAL CONDITIONS: ' , • •_+ 4 MY license is in full force and effect. - LJcense Class • C-3�9(- uca e 2 4 9 PLUMBING • ' • 1 rte 9=19-R3 Signature • Jf fs^'l . ELECTRICAL • ORKERS'COMPENSATION DEC LLLjjj RATION ' • Bar Sink -Sewer Cap ' Automatic Washer Meter ❑over 100 amps I hereby affirm that I have a certificate of consent to self-Insure eorr&certificate-, ' Backflow Preventer Sewer Connection - - - --- -- - - --- - - - - of Workers' Compensation Insurance, or a certified copy thereof (Section r . ' - ' 3800, Lab. C.) Backflow •Irrigation Solar Collectors Construction Pole Sub Panel Policy No. WP Z 1 5 04 5 S CompanyFO - Cooking Unit Sub Pole aCertified copy is hereby furnished„ -/Lp e f Bathtubs . • Solar Piping ' Certifled copy Is filed with the ciif�Buu/'WnNg vi TILL Dishwasher Motors 00-1 HP 011/2-8 • _Date 9 19 83 Applicant Clarifiers Solar Tank EXEMPTION:FROM WORKERS'CO PENSATION DECLARATION' Dishwasher I Swimming Pool W/$ pa -- Dryers ❑Gas ❑Electric " - - Inc,Solar'❑9-15 HP 016-15+' less): ection need not be completed if the permit Is for one hundred($100)or __.. - less): i I I DrinkingFountains Urinal : Fan .Microwave 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 te - , F.A,U, Pole Light ' Date s';Compensatlon'Laws of California-: I • Floor Drains I l ' water Closet; - ' Date Signature 1 - Fixtures ' • • Ran e ' NOTICE:if;after making this declaration;you•should become subject to-the --- Floor Sinks ..-- _ Water Heater. - -- _ - - 9_ _ __ 1 ' Workers' Compensation' provisions of the Labor hall you must forthwith l - - r Device Boxes I ' comply with'CTIONsuch provisions, or this ;permit ,shall be deemetl_' revoked' , Gas Service. Outlets tWater.Service Sign, . . CONSTRUCTION 'L is AGENCY - •- Outlets StandingSections ' • I hereby affirm that there Is this&construction lending agency for the performance Interceptors '.. - , ' 'of the 'work far which this permit is !issued (Section 3097 Civ. C,). Switches Landers Name ^ ' - ' •• . " - - I - _. Kitchen • Trash Compactor Lender's Address I - ,- - - c. I . I , - Lavatories I ' I - Garbage Disposal OWNER BUILDER DECLARATION s - + I hereby affirm that I am exempt from s the-Contractor'sofessLicense Law for the Generator,❑0-5 KW 05-15 KW following reason (Section"7031,5 Business and Professional Code: Any City or .' - Trap , - - ' county which prior to a permit to construct,alter Improve;demolish uc or repair - _ -_ _ _ u i Transformer 015-50 KW '- � - ' • :any structure:prior to Its issuane/shesis requires t Pursuant llcan thfor such permitl- ' j Rdof Di•ains- - I + 10 file a signed statement that he/she is licensed pursuant to theiprovIslons of _ - ❑50+•KW' I ' the Contractor's License Law(Chapter 9 (comma Code)'or with,Se/she.'000)of ; - • I • Reinspection Fee - $15' Division-3 of the-Business and Professions Code)'or that'he/she-is+exempt Showers _ £ ' ' " Reinspection Fee $15 - therefrom and the basis for the alleged exemption:Any violicant•to Section - .-. Meter ❑up to 100 amps Issue Fee; '$ 3 7031.5 by.any applicant for permit.subjects:the applicant to arcivil ' - 1 I -- — • enalty of not more than five hundred dollars($500): i ,r j j ) Service Sink +_ - Issue Fee - $ 3 Zoning Approved By Date • 'U I,`as owner of the property or-my employees With wages•as their sole _ ' , ' ' : 1 ' compensation will do the work,and.the structure'Is not Intended or offered •_: MECHANICAL - • Application Approved By Date , for sale (Section 7044, Business,and Professional Code: The;Contractor's _ • //'j /�/�D/p- '? License Law does not apply to an owner of a property who builds or improves Boll-r ( 2- I [ i ' - . Refrigeration System Application Issued By ' //�'' 'Date 'O V thereon, and who does,such work himself/herself or through his or her own < , • , ,.employees, provided that such-improvements are not Intended or offered Jour Duct=Under, ' 1 00-100,000 BTU 0100,000 BTU, I ; 1: , . • sale. If; however, the building or improvement Is gsold within one'yearotof in-- I , l j UMMARY OF FEES I pletion, the ownerwlll have the burden of proving he/she did not build or in-- /$ I - 4f0 rove for the purpose of sale), I Duct-Structural i System Repair/Alteration I .BUILDING PERMIT $ `ia COO • SMTP t $ , Q L11, as owner of the property, am exclusively contracting'with-licensed con- I I tractors to coostruct,the Project `Section 7044,Buslness.antl.professions Code' Duct-Ventilating 1 t - _ I' - ( _,. _ i 'PLAN CHECK' $PERMIT The Contractor's License Law does not apply to an owner of.property who -1 - $ ' ISSUANCE ; $ builds or-Improves thereon,and who contracts for such projects with a con- ; ,- Exhaust System ❑ PLUMBING Multiple ❑ ' :, I tractor(s)license pursuant to the Contractor's License Law). • I ' I GRADING ' $ ' ❑lam exempt under Section B,& P,C,for this reason I on Firepl/Fact. BIt. ICBG# I 1 • ,PLAN CHECK, $ 1 , Date- ' I 1 I Owner! 1 ! i_ I ( ; Heating`System&Ducting • � ; . ,ELECTRICAL !: $ 1 . 1 1 I I I'MI CROF ILM $ i y- y applicationOU100,000 BTU ❑100;000BTU -- _ - 'PLAN CHECK $ 1 -I -hereb certH -that-( have read-this andstate that-the above -1- --:' I 1 Information-is correct. I agree to comply with ail city and county ordinances ' 1 1 TOTAL FEE $ 1 and;state laws.relating;to building co ruction, and hereby authorize recta Hood of T e I ❑ • MECHANICAL $ - j , Sig at ore of:th s�by;to enter u the above-mentioned property ,for I I - yp Reinspection Fee' I ' $15 PLAN CHECK $ 1 t LESS • ADVANCED PC � '$ inspection purp j Canopy -Type II I • t / 9 19-83 . Signature ' Y - 1 ' Date I • I ' - /Q I.�yt • , I , Registers • ' , Issue Fee ' 1 $ 3 • FINAL FEE' $ I (S/ J V Drivers' Lice orISS it. +_ - - : . CMF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - _ "- _ - "----' - - - - -- - • "--' - 5:: CI CONSTRUCTION AND PLANNING , 2 *, , - .6I. " . '- POY""PA' • , - 4. ,Dete 'Inspector '" " -,' • Date ' Inspector APPROVALS : Permit#- - - - - r -= ; , _APPROVALS Permit# - - - - - .1 T: Temporary Electrical Service orPole'- .i' •..'•c- •521 Pool &Equipment Location, • - �� •• _ • 7t 2•,: 2f Soil Pipe-Undrgrnd. •:;......;;.: :`?'' c ro a,, z , 537 Steel Reinfo?cement - . ; _ ' • • 31 Ellectrrical Conduit Utilitv-Undrgrnd: I - ' -o ' -544. Forms i - - c 4 Electrical Conduit-Undr rnd.T. - � . .+ - •.55 Electrical Bonding - q 5: Steel:Reinforcement ' "- ; n' ' - = T - 56. Rough Plumbing &Pressure Test ' ;, ' 6. Electrical OF ER Grnd1 -. 51 " • , 57." APPROVAL TO'COVER-GUNITE, - 7. Footings '.? ' _ ' c:. ;- • •I 4I . -.58. .ElectricalConduit Und'rornd. :• 8. Foundation . . -, .-r; i -• , _ cc ' 1- `- • 59. GaslPipe,:D"Undrgrnd ,Test;, ' • ''' 9. Water Pipe-Undrgrnd. ' - :60. Backwash Lines;P,Trap,:0 Undrgrnd._ - 10- Structural Floor System ' s r_ -- ' 61. APPROVAL TO.DECK i 11. Property Sewer Line &:House Connection: _ r-. : , £62. Backwash& Receptor-Final::_ = - - 12. Sewer Cap , ; ✓ -r -, ' co .i{ 63. Heater &Vent-Final . r I 13. Roof Drains �'� -.64. Plumbing`System zFinal - I. • 14. Rough Plurimbing d ,� . • n ' - 11 ° ; !6 • 5. Electrical -Final- - - - - .i• o Cr15.`Rou h-Elecfrieal-.Conduit • -- " - - - r -- ' -` _-'- - 9 n. 1 1 - 66.:SolaCSystem-Final , ?16. Rough;;Electric Wiring / l . '- -ha-17T' •-• -i :-:: il-r•IT-.677 Fencin -&=Access A - _ 1.r17.'Rough WIrind:Sign; , ' • I i r _ ' Q ' X68: APPROVED FOR�PLASTERING - i .i 18. Rough Ele,ctrical`T'v_Ba:r Ceiling I L; . -1' 1 E 69! POOL/SPA SYSTEMS FINAL • ' ' , 19.IRough Heating & Air,Conditioning ' I , � i •_ ' . ;FIRE DEPT,;REOUIREMENT • ' ' , ;• I 1 20 . Rough:Factory Fireplace : 1 ; I 1 APPIROVALS' Permit# 21. Duo-is;--: uo-s;}in'Structure' ' , . i '70, Underground Hydro ' t22.,[?,ucts,rtVentilating,., i i I I i ;71.' Product Piping Cl ! . , ' i-23.7Gas.Pipe-Rough & Test r 1 I • 172: Underground Flush:v - -- I _I . 24.‘Roof; \91(7 70 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ "__ - 7G6.. IQ/,t_I-` - 7 CITY OF COSTA MESA; _ PERMIT NO. TP ACT NO. . ,LOT NO. 'BLDG.NO. i . CONSTRUCTION PERMIT , - ' .• 4 = �/6 8� 4 : 51'bo 2691274 31 Applicant's Mailing Address 1 5 0 ate, Fong ' . C. M- TYPE OF CONSTRUCTION: U'NEW U ADD '❑ ALTERATION U REPAIR _ - - ' _ Project Address- Same, • • I ❑ CONVERSION ❑ DEMOLISH 1j1)OTHER. RPh oa ng , - _ _ Owner's NameMQ nt.Leelto Comm Abbn phone540-1097 DESCRIPTION.OF WORK L'.QQ66 nAIr Pi bon l�.PCAA (,'Om�l. _ ' Ab 11 't Roup/-Ln . -ZONINGREGULATIONS Address. Same . • TYPE OF PERMIT' LI GRADING L FOUNDATION"LJ STRUCTURAL _- A.P.`# ZONE • Afch/Eng.I 'r License NO. III TENANT Ll'ELECTRICAL El-PLUMBING ❑ MECHANICAL , -PLNG.REF. -BUILDING' ' - . i - TO BUILDING'" -ear Rork rn Cr - Address - - - • El, - •REAR YARD (TO P/L) _ Contractor'sNamlSan •Mah-.Lno Roo 6 C0 Phone974-3070 " PROJECT DESCRIPTION SG. FT...6600 • OCCUPANCY R-'1 PROPERTY LINE - •- Address(mailing) 2187' NEatau.f� Oha iiga 926AS ., CONSTRUCTION TYPE 5-N - ' VALUATION$6'c 00 ' . LEFT SIDE YARD ! RIGHT SIDE YARD _ ,. • License No. C__ .: 'C-Lt� 026083 ZONE _. GRADING CU.YDS: ' ;ACRES - PKG.SPACE REQ. PROVIDED ` ' - -- - LICENSED CONTRACTOR DECLARATION Remarks: ` STREET WIDTH :PARK FEES , I hereby,affirm that I'am licensed under provisions of Charter 9 (commencing ' ' ' ' with section 7000) of Division 3 of the Business and Professions Code,and - SPECIAL CONDITIONS: f my license is In full force and effect. . - ' • Licenia class - �•-'�-r� Lit se N - —' PLUMBING ' • • , nate 2 n-83 Signature ' T 'ORKERS'COMPENSATION DECLARATION Bar Sink Sealer Cap • _ ELECTRICAL _ "hereby affirm that I have a certificate of consenf to self-insure ora certificate ._ __. -_ -_ Automatic Washer.i - :Meter Dover 100 amps• of Workers' Compensation Insurance, or a certified'copy thereof (Section BackflOw'Preventer Sewer Connection, - " 3800, Lab- C.) 1 - -- "Construction Pole ' Sub Panel U/P82 15045 ; Fhemon Indemnity Backflow Irrigation Solar Collectors Policy No. Company I .... Cooking Unit 1 • i Sub Pole ' Certified copy is hereby furnished. Bathtubs Solar Piping ' ! i Certified copy Is filed with the city inion. ' . • ,Date 9-20-83 APoiicant Clarifiers i i 1 • Solar Tank Dishwasher Motors ❑0-t HP ❑iy.-B EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher ! I I Swimming Pool w/Spa ' _ Dryers ❑Gas• DElectric T•'• ' (This section need not be completetl If the permit Is for one hundred ($100)or , IncIna Solar ❑g-15 HP ❑16-15+ i Iess)i. ' i ' Fan' 'Microwave ' I not employ in the performance of the work for which this permit is issued, I 3 Drinking Fountains I Urinal I I r _ shall'not employ any person In any manner so as to become subject to te - F.A.U. I l Pole.Light 1 . ' Workers'Compensation,Laws of California-' - Floor Drains' - : 9 Water Closet i - 7 Date Signature - - Norkers 9f,after making rovisions ofithe you should become mustj to'the ' Floor Sinks t - -• - -� Water Heater' Fixtures _ - Range __�_ .1 1 Workers' Compensation provisions the Labor Code, you,must forthwith • - - • comply with' such .provisions"or.this permit shall be deemed revoked: ' Device BO. ' ; Gas Service' :Outlets 'Wate%Servlce -� Sign ' ' 1 • CONSTRUCTION.LENDING AGENCY , - ' 1 ' - - ! - • I � i Ylending 9 y' Interceptors - - - - 1 '• -i 1 rr ; � Outlets ' _ g • . I hereby affirm that there -thus ion a enc Tor the performanceStandin Sections of the ',work for which this permit is issued (Section 3097 Civ. C:) - -- - : Lentler's. Name I _ - - _ Kitchen:Sink - Switches i Trash Compactor , • - ' • • Lender's Address F ' - - - _ - , • - OWNER.BUILOER DECLARATION, - - lavatories � - I '-' 1 Garbage Disposal I , , I hereby:affirm that I am exenipt'from the-Contractor's • .License Law for the . - Generator.❑0-5 KW ❑5-15 KW - ) • following reason.(Section'7031,5 Business and Professional:Code: Any city or , P-Trap, °- - j T I I , ) I I i ,'county which'requires a permit'to construct,alter,improve,demolish,or repair , - Transformer ❑75-50 KW ' • 'any structure;prior to Its'issuance,ialso requires the applicant'for such permit; ' j Roof Drains I - 5- t 41: I - - •i i- i i r •.qto file a signed statement that he/she Is licensed pursuant to the'provisions of - V ' ' - ' ❑5 •U+KIN' ' '7he Contractor's.License Law(Chapter 9 (commencing:with Section 7000)of ' I-- i - I f Reinspection Fee $15' iDivision 3-of,the'Business and'Professions Code)'or,that.he/she'is'exempt ' j Shower! � Reinspection Fee $15 ' - - _ , therefrom and the;basis for the alleged exemption-.Any violation-of,Section j I I , '- Meter Dula to 100,amps I . 1 :Issue Fee - . -$ 3 7031:5 by .any applicant fora,permit,subjects the;applicant to a civil _ "eenalty of not more than five,hundred dollars($500) 6 •r I ' Service Sink "i I Issue Fee $ 3 Zoning Approved By ' I Date ' 1J I, as+owner of;the.property or my employees-with wages/as their sole.l 1 I ' ' compensation will do the work,and the'structure is not intended or offered , , f ' '-+ ' •• MECHANICAL I I ; Application Approved RV Data • . for sale-(Section 7044, Business'and Professional Code:I The•Contractor's I /) -/a1/4-4°V1-3 / /. I License Law does not apply to an owner of a property who builds or improves Boiler' I rt Refrigeration System I : ' i '4f/// Q r�'O 1-3 ; I thereon,-and who doesisuch work himself/herself or through his or her own ' i 1 Application Issued By / 'Data i ! employees, provided that such'Improvements are:not intended or offered for ❑0-„100,000 BTU ❑100,000 BTU f ' sale. If, however,the building or improvement is sold within one'yearlof com- Duct=Under Ground I , i 1 ) • i 1 U MARY OF FEES , • p letie thetpurpose o have the burden, . of proving.' •she did not build or im- - , i , drove for the purpose of sale)L I Duct-Structural , ? System Repair/Alteration r i ,BUILDING PERMIT $; ii f%fJ SMIP $ f O I 1 ❑ Multiple ' ' 'PLUMBING . ' ' r ©'S I,as owner of the property,am exclusively contracting:with;licensed con '.tractors to.construct-the•project.(Section.7044,.Business a nd.Professions.Code:. _ - Duct_Ventilating _.-, ., ' 1__,- PLAN CHECK' $' PERMIT 1 • The Contractor's License Law does not apply to an owner je property who ; - . , , ' builds or Improves thereon, and who contracts for such projects with a con 1 ' Exhaust System ❑I - i 1 I 1 4 � $ ISSUANCE $ ' tractor(s) license pursuant to the Contractor's License Law). . - 1 ❑ Yam exempt under Section • B,& P.C.for this reason . Firepl/Fact,Bit.ICBG# ) i 4 'PLAN CHECK i $ ' GRADING i I $ i ; ' 1 , ) t , 1 i 1 I i ` 1 ) $ ) I 'ELECTRICAL , $i ' Date i ! ' Owner : i I j Heating System& Ducting 1 j { S j : i $ i ! -i hereby certify'that Ithave read-this application-and state-that-the-above--r” - ❑0.1061000''BTU ❑100;000BIU -- "---"I'--^1 '- a- - 'PLAN CHECK i $, MICROFILM 1 , information is correct. I agree to comply with all cityand count ordinances I ! y ; I 1 1 antl°state laws relatiu to building construction,:andhereby authorize repre- i ' I MECHANICAL $; 1 TOTA LIFE E, $ ? I sentatives of,thij ty)to en -r,upon the above-mentioned property for , I Ho•od or Type I ❑; 4 Reinspection'Fee $15 ' I + i LESS f 1 Inspection pur•.. I r Canopy, -Type I ❑i 1 1 i r PLAN CHECK' $� • ! 9-20 83 - ADVANCED PC $ ' 4 I Signature �: Date I 1 ) ! - I i I 1 DriJers Licerr'S�or.55 `. / i ! ! i Registers j I Issue Fee $ 3 S I i , 1 FINAL FEE 1 $ ��t�0 CMF 0865-46 rev.12/82 White-Building;Canar -Applicant;Pink-Accounting;Goldenrod-Assessor - - -- --- ..,. a -- -POI, &'SPA - - ,.., - , . `3 'tCONSTRUCTION.AND;PLANNING 7 : ' _ :r . -84: •P-1.:1/4, _ e =;t';:6' ; ' I I' ' = - . :Date Inspector ' - . ` - , ,, ' r Date � Inspector '- .- :APPROVALS ' Permit#- - ' - -;APPROVALS Permit# - • - . 11^74 Temporary:Electrical Service or,Pole `�' `52:•Pool & Equipment Location i•'". I -,c 2? Sod Pipe-Undrgrnd. _ s - I _ I v: ' %ti I ''53. Steel Reinforcement . 17f ; 3? Electrical Conduit Utility-Fndrgrnd. - : 54: Forma') :-.) ` t .`- r'. Erin: Electrical Conduit-Undi rnd'- c r u ' 215;0; ;'-'-'7...-.11:1:;--;. 7. ' r. a ' g , - 55._ElearicalBondrng. 5: Steel Reinforcement' : -', .•' w_ 1 - v; = °" ;.56. Rough Plumbing&Pressure Test • ,1 ! 6: Electrical UFER Grnd, : c .. l i 1 - I' r.) ' n, _" . 57.;APPROVAL•T000VER-GUNITE ' 7. Footings , 1• ^.<, �_, t -� •__ :58'• El_ectrical'Cond_uit-Und_rar:,d.'. • " 8. Foundation , = - • -- - n r.-• _ _ �; __� - •.' 1• �- ,., , ' 59. Gas iPipe,-D:Undrgrnd,Test _ _ 'f:' 9. Water, Pipe-Undrgrnd.; s 4 . ' c' „` : ? • !,60. Backwash'Lines-,31-Trap, O Undrgrnd. . .- ' ' 10. Structural Floor System • I;•;,, - :' . i ; ; 61. APPROVALTO DECK -,- * . '. 11. PFoperty Sewer Line.& HouseConriection '-'i { I -62. Backwash & Receptor Final.=, :',` - �_,i 12. Sewer, Cap , i-.1 �; `✓; ; ..41 :, - -.63. Heater&Vent-Final - - t- C.11, 13. Roof,Drains . _. ...-,a�4 , I • ..64. Plumbing System- Final - • " i ' „ 14. Rough Plumbing 1" r'� • . -' ;T' ;' - - ' 65. Electrical-Final' ' , - - - : -. `Q • '15i"Rough-Electrical-Conduit '� -;'t;--i --; :.---""-7-7-66.; Solar System-Fihal' ` ----' '16. Rough Electric Wiring^ I °' _i.-T- ',71 :i3 -:i .; f- • _ _ _ " .'`._. `.'1 '- _ a; . , � _ _ � - _ 67. Fencing&Access APProval c, ( .,; �: ,,t 17. Rough Wiring Sign,: r . - 1 P i "T •i I ` 68. APPROVED FOR PLASTERING . ss-18. 'Rough;Electrical-T',Bar Ceiling I, I I . i I I '' l.�, i I( . 69.. POOL/SPA SYSTEMS•FINAL . '� _ 19c Rough Heating &Air Conditioning 1, I. ' i _ I i FIRE DEPT, REQUIREMENT .4 ' - t I I , , -1 20'. Rough Factory Fireplace, ; I 1 . APPROVALS' Permit 1 - ' !I 2'1'Ducts "in Structured I I I; . , i ; i I t 70.• Underground Hydro - , , , 3 ; 22t. Ducts; Ventilating i_ I 1 � 1 I I 71-I Product Piping O Gas D Oil • t;23:'Gas Pipe &'Rough Test" ", 1 I•^ i i r ` 72 Underground Flush 114 24;;Roof Framing' I:' ' i -., t : • -•, .'i t.--.• I , I _ : •?r 73. Urideigrnd.Storage Trank`iD Gas D,Oid' i „' 25. Roof Sheathing I ; , • • , I . i 1 .74.1 Overhead Hydro I . ` , , 1 -T -26., -Braeilirig (Structural) & Monocoat' . I . I L. Y j^`; i j 75.' Dry Chemical ; r .. ' I • i 1,.27;•Frame'and Flashing ;r . f. : i t i . ! 76.• Dry Standpipe ; : , - , - _ , ; '_ . , ' ' 28- Lathing & Siding; ;? ,; i' ' I 77.; FIXED SYSTEMFINAL t; 29 d " nsulation ` ; " it i' -I I I ,78: FIRE PREY. FINAL • ' :r30. Drywall Nailing ' > -. ei ; 1I I t ' ; ;Notes: I I <'3T-Plaster-Brown Coat � , - . 32. 'Electrical Power Meter-Final 1 I; I I 1 , ' 1 I ' • -, - ; . 33.-'Final Electric t _ • .I I, J .. r 1 !.-_i .__ . _ i- !. - __._. J _ . -_ .. . . . . .. 34. Final Heating &IAiri Conditioning i i I j 35. Final Gas.PipeTestiP ; 1 , 1c ;' I + i > • ' I - ". i .-. 1 ` ' '' 36. Hood or Canopy'">: , i 1 • 1` I • I - T ' , I • • - - - _ 37. Final Factory Fireplace n 15. _, 1 .- I° - , ' ( I 1 5.. 38. Final Plumbing I i is .s- „ - 39. Water Service-Final' i '=1 i ! I ', I • �,, _ I C . 40. Gas Service-Final ' , i I , I t 1 ' , L I I 1 41. Solar D`'ernestic-Final I I I i_ ,_i_ _{_�l . . -- __�_ , I__ ' _ , 42. Backflow Prevented i i i 1 I _- `_ t , 43. BackfloIrrigatioh T i I.- 1£ = I _ ! ••�� ` w. 11 L ' 44. Landscape Irrigation:System 1` �!_ q I ' o g , ' - r 45. Sound Attenuation I r ; ; c 1 I ; I i i '' 1 ' ;I ' - - 46. Handice PlRegulations 1 , l i 15 Ic I L I I - , , l ; I r -, - '� .i, i, I. 1 I. 47. FINAL STRUCTURE & BUILDING ! / U _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. �/[� bps CITY OF COSTA MESA' PERMIT NaRACT NO. LOT NO. BLDG.NO. /'l s /O/?`x/63 6 o CONSTRUCTION PERMIT , . 1 ,G. - y/ �, 9 j1 ` 275 279 Applicant's Mailing Address - t a • ' u .TYPE OF CONSTRUCTION- L� NEW L ADD LJ ALTERATION REPAIR ' Project Address Same ' - . ❑ CONVERSION ❑ DEMOLISH ❑ OTHER .RPh OOf i ng - - "' • . ; • ' Owner's NsmeMO 11•t.LCPQ2000mmA44n Phone54O-1097 . DESCRIPTION OF WORK C.PfAA"A n FA'6 Ph gillA A, Comp--, - ' ._ . ZONING REGULATIONS Address $amP • TYPE OF PERMIT GRADING L.] FOUNDATION (J STRUCTURAL A.P.7/: • ZONE • Arch/Eng, • License No.. ' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING- 0 MECHANICAL • BUILDING - . PLNG.REF.Hf • sr-rig Ari( rn' ST - Addfess! - -' ❑,OTHER - • TO BUILDING . ' • Contractor's Name canMahA nnRoOSCn Phone974-3070 _PROJECTDESCRIPTION SQ. FT.; 6000' - OCCUPANCY ' R-� PROPERTY LINE REAR YARD (TO P/L) _ I Address(mailing) 91 Al ti Ra to DAa Ona ng P , 92665 CONSTRUCTION TYPE 5j-M VALUATION$ 6500 LEFT SIDE YARD RIGHT SIDE YARD - • - LicenseNo. 0 1` A . i iCir - n�6n�S ZoN): - GRADING CU.YDS. - ACRES PKG.SPACE REQ. PROVIDED • . LICENSED CONTRACTOR DECLARATION Remarks: _ STREET WIDTH •, PARK FEES .. I hereby affirm that ram licensed under provisions o„Charter 9(commencing - . with section 7000) of Division 3 of the Business d'Professions Code,and , - SPECIAL CONDITIONS: - ' • my license is In full force and effe , • - License Class I�--�� LI•:n /r'49 '9 PLUMBING - -late '9-2 0-83 Signature i---.9. A.-. i� nein' /i")42•117---�7—� • - - - - I Bar Sink • IORKERS'COMPENSATION DECLARA ON • Sewer Cap ELECTRICAL , ,hereby affirm that I have a certificate of consent to self-Insure ora certificate_ _ Automatic Washer Meter Dover 100 amps , • of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - - Sewer ConneMiOn - - - - -- - - 3800, Lab. C./hi 2150458, �Jtem o n•t Indemnity ! Backflow Irrigation ' Solar Collectors Construction Pole Sub Panel • I Policy No. Compan - - - : - --• Cooking Unit Sub Pole ' Certified copy Is hereby furnished. Bathtubs Solar Piping Certified copy Is filed with the city v15i • Dishwasher .Motors D0-1 HP 0 VA-8 • Date 9-28-13 Applicant �- ' Clarifiers - Solar Tank - ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher t Swimming Pool w/Spa Dryers-OGas ❑Electric - - IncSolar09-15 HP 016-15+ ' ' (This section need not be completed If the permit is forone hundred ($100)or _ _ less).- : ; Fan' Microwave I certify that in the performance of the work for'which this permit is issued I Drinking Fountains Urinal 1 ' shall-not employ any person in any manner so as to become subject.to the • - 1 I, • - F.A,U. Pole Light Workers' Compensatlon'Laws of California.' , Floor Drains Water Closet - Date - Signature - - , -NOTICErlf,after making this declaration,-you should become-subject to-the - - • Floor Sinks- --- 1 - -. . _- Water-Heater - Fixtures _ _ .Range j I _ ' Workers' Compensation provisions of the Labor Code, you,must forthwith - Device Boxes SI n, ' comply with such provisions' or this-.permit shall be deemed revoked:; Gas Service' • -Outlets ' - Water Service ,- 9 I • CONSTRUCTION LENDING AGENCY ' - -• Outlets ' I hereby affirm that there is a'construction lending agency for the performance, Interceptors _ ,_ , Standing Sections I • of the work for. which-,this, permit is issued (Section .3097 Civ: C.) - - • - -- - ,Trash Compactor Lender's Name' - - ,_ Kitchen Sink • ' - Switches r p Lender's' Address. ' ' { Lavatories'', ' '� + Garbage Disposal , ' OWNER[BUILDER DECLARATION' ij ' "', I ' ' r , _ - • I hereby affirm that I am exempt.from the Contractor's License Law for the' ,- I l - I , Generator 00-5 KW 05-15 KW . - l ' following reason (Section 7031:5 Business and Professlonal;Code: Any city or ' Pr-Trap; r _. _ - 1 'county which requires a permit to construct',alter Improve;demolish or repair - I _ •_ r _ k. _ Transformer 015• -50 KW - ' any structure;prior to its issuance,also requires the applicant'for such permit. n , Roof-Drains • • I 05U+KW to file a signed statement that he/she Is licensed pursuant to the-provisions of - - , - - :he Contractor's License Law(Chapter 9(commencing•wlth Section-7000)of - - - Reinspection Fee $15 ,Division i3 of the'Business and.Professions Code),or'that he/she is exempt ( ; Showers - • Reinspection•Fee $15 - - therefrom and the basis for the alleged exemption. Any violation-of Section ' '- ' • - Meter ❑up to 100 amps • 'Issue Fee -$ 3 7031:5 by,any applicant for Tai permit.subjects,the'applicant to a civil I ` - 1 I - ' enalty of not more than five hundred dollars($500) < 1 1, , I Service Sink i -. - I .. Issue Fee $ 3 _ • , --_ • - ( ' Zoning Approved By Date co I, as;owner of, the!property or"my employees with ince s as their sole , . � t compensation' will do the work,ono the structure is not Intended or offered _ , _ I , ! f• MECHANICAL Application Approved By - Date • - I for sale'(Section 7044', Business and Professional code:,The Contractor's . _ - ( I License Law does not apply to an owner of a property.who builds or Improves ' • Boiler I - I Refrigeration System Applica •tion Issued By ' , 'Date employees, on,'antl who'd thasuch work himself/herself or through his or her own - { r -♦ - employees, provided that sor improvement are not intended or offered_for • 00-100p006TU O100,0008TU ' sale. If, however,the buildingor Ica rovement is sold within one year'of corn- • Duct-Under Ground t , i ; P ; • SUMMARY OF FEES , I;merlon, the the wlll have the burden of proving he/she did not build or ins- , I / • rove for the purpose of sale). . , , t Dyct-Structural j I System Repair/Alteration BUILDING PERMIT $ ' Go• i SMTP $ Q'SQ ..� I,as owner of the property,am exclusively contracting!with licensed con- • • • I i i 1 tractors to.construct the,project (Sectlon.7044,Business and.Professions Code: _ Duct-Ventilating- 1_4._-{ _ - _- _- -- I ,PLAN CHECKS $ PERMIT • The Contractor's License Law does not apply to an owner of property who i I ISSUANCE $ builds or improves thereon,and who contracts for such projects with a con- ' Exhaust System 0 Multiple ❑l , i PLUMBING , I $, - t I tractor(s) license pursuant to the Contractor's License Law): . - - t I I GRADING •• ' $ 7 0 !ram exempt under Section - B.& P.C.for this reason , Firepl/Fact.Bit. ICBG# PLAN CHECK, j $ • $ 'ELECTRICAL $ I ' Date ' - • • owner: : ' - - ' -; • - I Heating'System&Ducting 4 - $ -I hereby certify-that-Y-have read this application and-state-that the-above -I- -- Do-100;000 BT-U-0100000BTL-- -• -. _ ___ ,PLAN CHECK • $ i MICROFILM information is correct. I agree to comply with all city and county ordinances ; I � } I 1 ' - : I 1 TOTALFEE! ' $ I 1 - antlstate laws relating to building •onstruction,+and hereby authorize repro- y I 'MECHANICAL I $ : ! I j - y? p propertyI • Hood or Type I ❑, ( , sentatives oflthis t to enter on above-mentioned for Type I Reinspection Feel $15 j LESS I , inspection nu('• j I Canopy. Type 11 a !PLAN CHECK $ • Signature �. 9'2.0 :83i ADVANCED PC $ j .%/- .�� �- —i- Date , , t Drivers'License 55 1 i I Registers I • Issue Fee 7 $ 3 I • } FINAL FEE $ ' ( "r® CMF 0865-46 rev,12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - - - - -` - -- - '-' -' - -- r CONSTRUCTION AND;PLANNING - ,• ? C - . -. : __wI &SPA - . v m - - ' r _ ' -Date 'Inspector ` -- Date : Inspector APPROVALS ,� Permrtf# - _ ! APPROVALS --'Permit# '• �;; Temp"ovary,Electrical Service or-Polec 2-' , ? 0'52,,'Pool & Equipment Location _ `: - . -. 2! Soil Pipe-Undrgrnd? . '.r _ I' . : : ; ' _ 5314 Steel Reinforcement ; - _ - = • _u... : 3' Electrical Conduit Utility-Undrg rnd. i • 54. Forms = `° 4: Electrical Conduit-Undrgrnd'. ' n.. 55.- Electrical Bonding - - • • • 5: , ,-,' einforcement I ;: _ _ - - _ ;'56. Rough Plumbing & Pressure'Test a :' c . 6: tElectri al UFER Grnd i = ‘' 57 APPROVAL TO COVER-GUNITE-. ' '' - 7. Footings j ,•7 - a. :58' Electrical'Conduit-Und�rarnd. - r 8. Foundation c^ i.- , a - .59. Gas Pipe jD-Undrgrnd.,Test - ' G. - q 'i: , _ . . - 9. Water Pipe-Undrgrnd. • -: , - - - ',60• . Backwash�Lines,.P-Trap, O'Undrgrnd. ; 10. Structural Floor System o ;. _ 61. APPROVA'LTO DECK `': 0. - 11. Property Sewer Line &;HouseConnection ' -- 1 ,62. 'Backwashr& Receptor-Final " ." - i 12. Sewer Cap ; 1 ' '' r-, = 4= - , 63. Heater &Vent-Final ' 7.5 13. Roof Drains !rr, ' . ' r•. c - - �64. Plumbing System - Final :. - -▪ 14. Rough flumbingl,��r'. - . ^ '•� - ; '65. Electrical-Final- - - • - '=r� � V p .'15:'(Rough-Electrical-Conduit ---',- ' ' :- -SI• -; -,''766.-Solar Scsierci-Final. ' - ' _. _' __ .. -- - ,. _ - 1 ',-16. 'Rough-Electric Wiring, , 1 '"=, ,' . -r., ' 7171,'r- '67.-Fencing &,Access Approval -- - ';-17. Rough Wiring Sign;' • '! ' • % I -Q '' 1 , ,1 '68I APPROVED FOR PLASTERING ' ' ' - ;; 18:• 1Rough Electrical-T Bar,Ceiling' : , . ' I'= . !69., POOL/SPA SYSTEMS FINAL I ' ' F - � V 19. 'Rough Heating &;Air:Conditioning ' > I I , I FIRE DEPT. REQUIREMENT ' ' , : ' - • 1 20.:Rough_'Factory Fireplace ! ' I I , APPROVALS Permit# , 0q 21. 'Ducts'in SVucture . . i 'I 1 ' I I 70.' Underground Hydro . • , ; I e 1:22.,D cts,Ventilatin I + y 9 + ) 1 171., Product Piping 0 Gas 0 Oil r23-1Gas.14e-Rough&,-fest I I 72. Underground Flush _ ! 1 `c24: of-Framng, I`j r, . Ir$ . c , ,• ! - 73. Undergrnd.Storage Tank 0Gas 0Oil • ' , ,, 25.'•Roof Sheathing i , _ • I ,- ,, ' ; ' r 1 ' ' ', •74. Overhead Hydro • -26`T-Bar Ceiling'(Structural),& Monocoat I r = . 1 ' 75. Dry Chemical , • - 27.,4Frame and Flashing. _ , ' I; I - X76, Dry Standpipe • -. O 28%p Latfiinr. , , , 4. ' i >g& Siding5 I i1 j I 77.i FIXED ,, ' 29.,Insulation3 _ � ' ' ' ! I 1 1 1784 FIRE PREV. FINAL - • o -303 Drywall Nailing - " 1 , ! ' ,Notes: ! '31,IPIaster,Brown Coat- 71 , 1 ,1 ; . I 1 ' ' � 32.�Electriccl,Power MeteFinal ; ' + i , I i _ , - ' 33. Final Electric , 1 I. -." -,. 1 I_ _ • y 34. Final Heating &'AirConditioning 1 ' ' i • 35. Final Gas; Pipe-Test ; i ', •, • M ;` - i • •r, 1 36. Hood or1Canopy •1 - -- I '- I - 37. Final Factory Fireplace I a I I ; - • - 38. Final Plumbing! , ' 'i t, ' 1 I 7 ' ' '- 39. Water'Service-Final '! i i ` t ' ! - I 40. Gas Service-Final I 41. Solar Domestic-Final j ' I ' 42. Backflow Preventer ; i r-i' I I ' 1 I ' ! • 43. Backflow Irrigation ;_ - - - - - � • 44. Landscape Irrigation-System' 1 - . 45. Sound,EAttenuation. - I i - ;• ;;-i - _ 46. Handicap Regulations I I" : ;$ I '' I I ! •" _ .-47. FINAL STRUCTURE & BUILDING 'is i 1 r_ 1 . ' ' I ! r 48. Special 2. Requirements Completed ' • I ci 1! I ' 49. Electric Release tolEdison I _ --I„ __t. _-I_ 1 y-1-1-1-4 a . I' i i i • 50. Gas Release oto Southern California Gas Co ! ' , , .. • 51. CERTIFICATE,OF OCCUPANCY _ J _ _. - . .� _. __ __ . , I , e. No aDate I ' , , - 1 . . _. E. ,� Applicant to fill In all spaces -ler lines and sign all appropriate declarations. CITY OF COSTA MESA - ..- 7594 I"/" .: - _In I . (' PERMIT NO LOT NO. BL . CONSTRUCTION PERMIT , • - J/70 26'9-274 34 , Applicant's Mailing Addressi5 0 V a••Z e y F ong e C. M TYPE OF CONSTRUCTION 'LI NEW U ADD U ALTERATION U REPAIR - • - ProjectAddress Same 0 CONVERSION _❑ DEMOLISH 0 OTHER RPnnn6in, Owner's Name Mo n.tice Leo Comm. 'Add Rhone 540- 10.9/ DESCRIPTION OF WORKPIaAAO Ap ' Fiheh3Pao4romp Asphalt Rnri{An3 ZONING REGULATIONS Address came TYPE OF PERMIT ❑❑ GRADING 0 FOUNDATION U STRUCTURAL A.P.# ZONE Arch/Eng. ' License NO. • 0 TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICALPLNG.REF.Os BUILDING ' Address ❑.'OTHER p ,y • TO BUILDING CFI-Park' rn CT - Contractor's NampSanMah.Lno Ro o 6 Co - Phone974-3070 PRO.IECT DESCRIPTION SQ. FT. 6800 • OCCUPANCY R-1 PROPERTY LINE REAR YARD (TO P/L) Address(mailing/ 2187 N. Batavia, Oitnag a 92665 CONSTRUCTION TYPE VALUATION$ 4 coo rn' . LEFT SIDE YARD RIGHT SIDE YARD - CM Cali 026085 ZON License No. )= GRADING CU.YDS- ACRES PKG.SPACE REQ. PROVIDED __ LICENSED CONTRACTOR DECLARATION Remarks: - STREET WIDTH PARK FEE$ - I hereby affirm that I am licensed under provisions of Charter 9(commencing with section 7000) of Division 3 of the Business an• ofesilons Code,andSPECIAL CONDITIONS: . ' • my license is in I orce and effect. • • incense Class � '� i/ 1c se '-gym— I PLUMBING ' -1ate9-20-83' Signature ' . - "# • - Bar Sink Sewer Cap ELECTRICAL . YORKERS'COMPENSATION D- ON - - ' - • .r hereby affirm that I have a certificateto of of consent to self-Insure or a certificate 4 - gackflOw'Pr¢venter • Sewer Connection' - Automatic Washer - Meter Dover 100 amps - _ of Workers' Compensation Insurance, or a certified-copy thereof (Section , 3800, Lao. VP82 1 fn,em ont,I ndem nitBackflow Irrigation • Solar Collectors I Construction Pole Sub Panel Policy No. Compan _.- Certified dopy is hereby furnishe Bathtubs Solar Piping Cooking Unit Sub Pole Ce/tit}pgcopy s filed with the city Bu v � ,{� -_- Dishwasher Motors 00-1 HP 0114-8 _ _ _DateY-L U-b Applicant "'..���•• Clarifiers Solar Tank EXEMPTION FROM WORKERS'COMPENSATION DECLARATION (This section need not be completed If the permit is fon one hundred($100)or Dishwasher I Swimming Pool w/Spe 1 Dryers ❑Gas, OElectric 'I nc.Solaf09-15 HP 016-15+ , ' less)" I - Fan•• Microwave' I certify that In the performance of the work for which this permit Is Issued I Drinking Fountains Uflnal I I 'a I shall not employ any person In any manner so as to become subject to the • ' Workers'.Compensation Laws of California- 1 ' I I Floor Drains' ' I I ' F.A.U. _• Pole Light i I Water Close• t I Date ' 1 Signature ' ' Fixtures 1 NOTICE:It;after-Making this declarf the'you should become subject to the - Floor Sinks - . •.• Water Heater • ` - - -•- , - - - Range .. _ ... . • Workers" Compensation provisions of Labor Code,-you,must forthwith comply with such .provisions ;or'-this- permit .shall be deemed revoked: I GBS Service -Outlets Water Service - : i r, Device Boxes _ , Sign , • CONSTRUCTION(LENDING AGENCY Outlets ' I hereby affirm that there is a construction lending agency for the•perfCe I Interceptors . , Standing Sections of the work for which this permit -is 'issued :Section 3097 Civ. C:); - - • - - - , Lender's Name 1 - - Kitchen Sink - Switches Trash Compactor ' .. - _ I Lender's Address E ' - • I - - • • OWNER•BUILD-ER DECLARATION . ' •: " I Lavatories- Garbage D isposal , I hereby affirm that I am exempt from the Contractor's License Law for the : P-Trap.I - Generator,00-5 KW 05-15 KW following reason (Section 7031.5 Business and Professional Code: Any city or- p - I ' county which.requires a permit to construct,alter,improve,demolish or repair , t . _ ._ - Transformer 015-50 KW any structure,prior to Itslssuance,-also requires te-applicant-for such permit- • , , Roof Drains' •• - ' ' ' 1 to file a signed statement that he/she is licensed pursuant to the'provlslons of - - 050+KW i :he Contractor's Ucense law(Chapter 9(commencing with Section 7000)of - • - - , ,Reinspection Fee • $15'' Division 3 of the Business and-Professions,Code)"or'that he/she is'exempt ' Showers : ' I Reinspection Fee '. $15 - therefrom and the basis for the alleged exemption. Any violation of Section ' - Meter Oup to 100 amps ,Issue Fee • '$ 3. 7031.5 by any applicant for a permit subjects the applicant to a civil + •_ . penalty of not more than five hundred dollars($500). - . Service Sink Issue Feb $ 3 Zoning Approved By 1 ' •Date • •U 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 - ' ' MECHANICAL ; Application Approved By • - Data , for sale'(Section 7044, Business and Professional Code: The Contractor's Ucense Law does not apply to:an owner Of a property who builds or improves Boiler , . Refrigeration System • //,/ Y (,2 ' thereon, and who does such work himself/herself or through his or her own Application Issued By �j /''✓ Date ���/O/l+V ;employees, provided that such Improvements are not intended or offered for • I ❑0-100,000 BTU 0100,000 BTU 'sale- If, however,the building or improvement Is sold within one yearof com- Duct-Under Ground1, SUMMARY OF FEES • i pletion, the owner:will have the burden of proving he/she did not build or Im •- rove for the purpose of sale): ,- - • ; t1CONSTRUCTION AND'PLANNING _ P -' r - - n: . - - - PO(.L &SPA - _-. - _APPROVALS ., 7' DateInspector Date Inspector, ; Permit# `APPROVALS 'Permit# ' '' ;L Temporary Electrical Service or.Pole;, ' ,. 52 Pool & Equipment Location'.. , - - . to 2: ,Soil Pipe-Undrgrnd. , , -`.,`;=' i c. iv q_, 53. Steel Reinforcement ' - r 3' Electrical Conduit.Utilitv'Undrgrnd. 5 l. r ` o • 54. Forms - - - , .c. 4' Electrical Conduit-Undrgrtid. , _ ti. - ' .• 1 ' •'55: Electrical Bonding b _ : - 5 Steel Reinforcement 1'-,' ' - ' - ... ' '-` 56,t Rough Plumbing& Pressure Test - - •_ ; 6. Electrical UFER G?ndE _ t ' -1'. ;•57`: APPROVAL TO COVER-GUNITE 7. Footings' '01:"., i, ` '' - 58. Electrical_Conduit-Undrornd.- . 8. Foundation 'O'Gi' ' ,r ,59. Gas Pipe, 0-Urdrgrnd:,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 Cor(hection -< t 62. Backwash & Receptor-Final' . 12. Sewer Cap f : ri 7! _63. Heater & Vent-Final - - _ 13. Roof'Drains •�.;u ` .� t; 64. Plumbing System,- Final - - - 14. Rough;Plumbing =' ' 65. Electrical-Final I, • ' r 15. 1Rough"Electrical-Conduit . "- " - i -,'"66. Solar System-Final - _ - - , ' . - - 16. Rough Electric Wiring - "r n - 67. Fencing & Access Approval - i 17. Rough Wiring Sign' - 4 ' 68.' APPROVED FOR PLASTERING 18. Rough.Electrical'T,Bar Ceiling _ 69.; POOL/SPA SYSTEMS FINAL - , 19. Rough Heating & Air Conditioning 1 FIRE DEPT. REQUIREMENT _ 20. Rough Factory Fireplace • APPROVALS Permit# . Ducts, inStructure, I 70. Underground Hydro i . : Ducts,Ventilating . 71. Product Piping ❑Gas ❑Oil r - ,Gas Pipe-Rough&�(Tesi . , 72. Underground Flush . 'Roof framing `> j 73.' Undergrnd.Storage Tank O Gas ❑Oil - 25.,Roof Sheathing I ,t - - _ 74., Overhead Hydro • 26.,,T-Ber Ceiling (Structural), Monocoat '• 175.: Dry Chemical - • 27..• Frame and Flashing 76. Dry Standpip • e ^ 28:-,Lathing & Siding - - I ' 77. FIXED SYSTEM FINAL - _ • 29.. Insulation - - ' ii I ' 78' FIRE PREV. FINAL ' -30. Drywall Nailing - I I Notes: •'31. 'Plaster Brown Coat' 32. Electriial'Power Meter-Final - • , 1 • - 33.33. Final Electric .. " _ - - _ 34. Final Heating &Air Conditi• oning - 35. Final Gas Pipe-Test - - '' - ' • 2 • . 36. Hood or Canopy : ; _ - - - - - 37. Final Factory Fireplace I �' • - . 38. Final Plumbing 1 ; _ I • 39. Water Service-Final s. i ' - I I ' 40. Gas Service-Final . I ' ' . , I 41. Solar Domestic-Final l L : . - - _. • - 42. Backflow Preventer i ' - _ _ - _ 43. Backflow Irrigation ' I 1 Ti ' ' I • - • 44. Landscape Irrigation System , , it ' - , '' . : I r n i I _ 45. Sound Attenuation : • _ •' I - 46. Handr. icap Regulation• 's ' . • 47. FINAL STRUCTURE & BUI LDING . - i I. , 48. Special Requirements Completed 1 1 ' '- i • � ! , i . I 1 . 49. Electric Release:to Edison ; _ ' _ . i - I- 50. Gas Release to Southern California Gas Co 1 ' 1 I l i ' - - 51. CERTIFICATE,OF OCCUPANCY _ _ __,_ _ r - . .. No - Date t 1 _ Applicant to fill in al(/T-''r hln heavy border lines and sign all appropriate declarations. C'TY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. CONSTRUCTION PERMIT•, F- 3671 61 97 5/21 /82 5.00 TU Project Address /J�6/ �v4�L.� �C ` TYPE OF CONSTRUCTION . �a.s _ ._ . _ _ Owner VT+C.P/�J.ó as (_. Ph6nes ra+^/o`/J NEW 0 ADD 0 ALTERATION _ - . Address • 0 REPAIR 0 CONVERSION' 0 DEMOLISH - ZONING REGULATIONS Arch/Eng. License No. ❑ OTHER Address - DESCRIPTION OF WORK �-1�s A•'p' ' GLOSNOuSE got- ZONE PLNG. REF.t Contracto��a;h .1....,..e- C...- Phone G��J V TYPE OF PERMIT / BUILDING �DBP I �YNLINE `� SETBACK C/L ST. Address/,5q 5 ''i-n-c Or 4c'-r 0 GRADING' ❑' FOUNDATION -0 STRUCTURAL SIDE,rYARD • LEF LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICALPLUMBING ❑MECHANICAL SIDE YARD I hereby affirm th:.t I am licensed under provisions of Charter 9 (cam- RIGHT mencing with section 7000) of Division 3 of the Business and 0 OTHER Professions Code, and my license Is In full force and effect. REAR YARD(TO P/L) ' , .e-as V ' PROJECT DESCRIPTION - License Class Licens N PKG.SPACE REQ. PROVIDED Date sSy• c.-8 - Signature ✓r A.-b.."' 50. FT. STREET WIDTH PARK FEE $ WORKERS'COMPENSATION DEC / ATION - OCCUPANCY_CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent t self-Insure or a VALUATION' ZONE ZONING APPROVED BY I DATE Ncertificate of Workers' Compensation Insurance, or a certified copy thereof($/14��9'D 800, l.�p C.). ,/ GRADING CU.YDS. ACRES SPECIAL CONDITIONS: • 00 Policy No4 I C¢""XL Company Sf�ff rUK/7 - -- - ( 'entified copy is hereby furnished. - REMARKS: -- \ .ertified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION I (This section need not be completed if the permit is for one hundred _ . - i. ($100) or less). - . . I 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 PLUMBING . PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers'Compensation Laws of California. ' - BATHTUBS SHOWERS UW tLLING GARAGE Date Signature ' SO FT SO FT , NOTICE: If after making this declaration, you should become Subject TOILETS' URINALS - ' GENERATOR ' 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must - ' TRANSFORMER ' forthwith comply with Such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50 + KW - revoked. - .. _ CONSTRUCTION LENDING AGENCY KIT.SINKS - • - DISHWASHERS - MOTORS 0-1 HP -1-10 HP • I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS ' ' SUMPS' ' ' - '.(INC.SOLAR) - 10-50 HP_50+ HP - - formance of the work for which this permit is issued (Section 3097 - Civ. C.). - e iG J - - - FLOOR SINKS FLOOR DRAINS FIXTURES - OUTLETS SWITCHES Lender's Name _ !�•/ 'Lender's Address DRINKING FOUNTAINS - - GAS TUBE SIGNS OWNER BUILDER DECLARATION - - INTERCEPTORS CLARIFIERS POLE LIGHTS - - ' I hereby affirm that I am exempt from the Contractor's License Law for . the following reason (Section-7031.5-Business and Professions Code: SWIMMING POOL P TRAP' - - -LOINS I Rut.l.iuN _ - ; Any' city or county which requires a permit to construct, alter, POLES. METERED SUB improve,demolish'or repair any structure, prior to Its Issuance,also re- WATER SERVICE ALTERATION - - PANELS - -MAIN SUB - quires the ap.licant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's-License Law [GAS SERVICE' ) OUTLETS'- a_00 •SERVICE - AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the / _ Business and Professions Code)'or that he Is exempt therefrom and the WATER HEATERS BTU OUTPUT _ � - - basis for the alleged exemption. Any violation of Section 7031.5 by . - •• - 'applicant for"a-permit subjects the applicant to a'civil penalty SEWER CONNECTIONS - - - -. - - - - -- ' ft more than five hundred dollars ($500). _ as owner of the property,or my employees with wages as their SOLAR TANK - COLLECTORS - • '— -- -- " ' - - sole compensation, will do the work, and the structure is not intended - _ . - - ' • or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. • - ISSUE FEE ' - - -- I Contractorts License Law does not apply to an owner of a property _ _ who builds or improves thereon, and who does such work himself or ISSUE FEE - 3 ?O .APPLICATION APPROVED BY '- DATEtt/pL through his-own employees, provided that such Improvements are not. intended or offered for sale. If, however, the building or Improvement MECHANICAL PLANCHECK is sold within one year of completion, the owner will have the burden SUMMARY OF FEES of proving he did not build or improve for the purpose of sale). BUILDING' - ❑ I, as owner of-the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU (PERMIT $ - SMTP_•. S _ • licensed contractors to construct the project (Section 7044, Business AND DUCTING- 100,000+ BTU _ ,PLAN CHECK $ PERMIT and Prof Code: The Contractor's License Law does not apply to00 ISSUANCE '$an from' ' chpropertyprwho with a improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ ' tractshe Itom' sush projects with a contractor(s) licesned pursuant to SYSTEM - - • GRADING S ' • the Contractor's license Law). 100,000+BTU_ PLAN CHECK $ • ❑ I am exempt under Section - - B.&-P.C.for this BOILERS BTU ELECTRICAL $ $ reason - - - PLAN CHECK g MICROFILM $ Date Owner SYSTEM REPAIR,ALTERATION TOTAL FEE$ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE _ MECHANICAL $ information is correct. I agree to comply with all city and county PLAN CHECK' $• V ordinances and state laws relating to construction,and hereby authorize , _ t VAN CEE P PC $_ representatives of this city to - ter upon the above mentioned ' property for inspect'-I .os' • . Signature - - -f" ' Date 1A0'2"— - FINAL FEE $I.:V Drivers' rose or SS 7f •. 0 - . - 'ISSUE FEE • - • - - - CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNI - POOL&SPA . P i APPROVALS Permit # - Date Inspector APPROVALS Permit# . Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - • 2. Soil Pipe-Undrgrn . 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms , 4. _ Electrical Conduit_Undrgrn 46. Electrical Bonding • - ' 5. Steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL'TO COVER-GUNITE - - . 7. Footings 49. Electrical Conduit-Undrqrn • 8. Foundation - - ,_ 50. Gas Pipe, ❑Undrgrn;Test 9. Water_Pipe-Undrgrn _ - 51. Backwash Lines, P-Trap. ❑•Undrarn -• • 10. Structural Floor.System . 52. APPROVAL TO DECK - .- 11.. Property Sewer Line & House Connection _ . 53. Backwash & Receptor-Final ' - - 12. StreetSewer Connection _ . .' _ • - . 54. Heater & Vent-Final . . 13. Rough Plumbing 55. Plumbing System= Final ` • 14. Rough Electric-Conduit - - . 56. Electrical-Final - 15. Rough Electric-Wring - -' - - - 57. Solar System-Final- ' . 16. - Rough Heating & Air Conditioning . _ 58. Fencing & Access.Approval i . . 17. Ducts, in Structure - _ 59. APPROVED FOR PLASTERING • 18. Ducts, Ventilating L ' . 19. Gas Pipe-Rough &Test . , _ 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing _ _ - . . . 21. Roof Sheathing NOTES: ' ' 22. Frame arid Flashing ._- - - • - 23. -Insulation ' - - _ - _ _ • 24: Lathing & Siding. - _ _ _ - . . . . . - - .- 25. Drywall Nailing . . 26. Plaster Brown Coat _ • . . . • ' 27. Electrical Power Meter-Final . - • - • 28. Final Electric - - . - - - _. • - . • 29. Final Heating & Air Conditioning. . ' ' 30. Final Gas Pipe-Test _ _ ra'a Er 2-6---t" 31: Final Plumbing "_ - • 32. Water Service-Final . - _ . _ . ' 33: -Gas Service-Final - ' 34. Solar Dometic-Firial '+ ' 35. Landscape Sprinkling System . - 36. Sound Attenuation . _ _ - , 37. Handicap Regulations . 38. FINAL STRUCTURE & BUILDING - 39. Special Requirements Completed ' 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co'. A---zV rf'zc. . 42. CERTIFICATE OF OCCUPANCY . . - ' No. Date _ - - - L Applicant to fill in all. thin heavy border lines and sign all appropriate declarations.14 CITY OF COSTA MESA PERMIT NO / TRACT NO. LOT NO. BLDG. O- CONSTRUCTION PERMIT P3660 �j'L S-/Gd / a/17 - - • 6.1'77 5/21/82 5.00 IL: Project Address ,,•y p gAtzte/.cgAtcte ,fl.i ^ -• TYPE OF CONSTRUCTION . �� /� - - HG• Owner Il 7cj44/9 'Tofu 4.4449/11 Phone 1a4 • r7 0 NEW g ADD ❑ ALTERATION CIA Address 55-4111/[ _ 0 REPAIR ❑ CONVERSION ❑DEMOLISH - ZONING REGULATIONS , Arch/Eng. License No. 0 OTHER .. - _. A P Address 16 DESCRIPTION OF WORK • • ZONE PLNTGo. REF.p46 Contractor 0/46,a • Phone TYPE OF PERMIT BUILDING PROBPEIRTVNLINE - SETBACK C/L ST. .Address 0 GRADING 0 FOUNDATION 0 STRUCTURAL 51❑E YARD 'LICENSED CONTRACTOR DECLARATION - 0 TENANT 0 ELECTRICAL LUMBING"❑MECHANICALI LSIEDFEE YARD I hereby affirm thkt I am licensed under provisions of Charter 9 (com- RIGHT mencing with section 7000) of Division 3 of the Business and El OTHER _ Professions Code, and my license Is In full force and effect. REAR YARD(TO P/L) PROJECT DESCRIPTION - License Class • License No- PKG.SPACE REQ. PROVIDED Date • Signature Y - - SQ. FT. - - , WORKERS'COMPENSATION DECLARATION - OCCUPANCY—CONSTRUCTION TYPE STREET WIDTH PARK FEE $ _ .- I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION ZONE. ZONING APPROVED BY .DATE - certificate of Workers' Compensation Insurance, or a certified copy -- , thereof (Section 3800, Lab. C.). SPECIAL CONDITIONS: _ GRADING CU.YDS. ACRES '--lioy No. Company - - - -- :ertified copy is hereby furnished. - - . . REMARKS: - - • - - Certified copy is filed with the city Building Division- - - - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION _ . - - - - - - - - (This section need not be completed if the permit is for one_hundred . . - . - - - ($100) or less). - I certify that In the performance of the work for .hich.this permit Is, - _ _ -- , issued, I shall not employ any person In any manner so as to become PLUMBING PLAN CHECK • ELECTRICAL PLAN CHECK subject to the Workers'Compensation Laws of.Callfornia.- - UWtLLIrvO GAHAtat Date Signature - - BATHTUBS SHOWERS -SO-FT SC) FT r' ' • , NOTICE: If after making this declaration, you should become subject TOILETS- _ .(',- , URINALS GENERATOR 0-1 KW_ KW to the Workers' Compensation provisions of the Labor Code,you must - -- ,TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW 50+ KW . revoked. - - _ _ _ CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS • - 'MOTORS 0-1 HP_1-10 HP •- . - I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS - 1(INC.SOLAR)" ' 10-50 HP 50 + HP. ' ' - ' ' formance of the work for which this permit is issued (Section 3097_ _ - Civ' C.): FLOOR SINKS FLOOR DRAINS 'FIXTURES OUTLETS SWITCHES Lender's Name _ __ - , Lender's Address DRINKING FOUNTAINS , • GAS TUBE SIGNS - - - ,, - OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS (POLE LIGHTS - - - ' I hereby affirm that I am exempt from the Contractor's License Law for - the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP - - tUNSIHUt-I FON -- - Any city or county which requires a permit to construct, alter, POLES METERED SUB ' Improve,demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE ALTERATION - - PANELS MAIN SUB quires the ap,.Iicant for such permit to file a signed statement that he _ - is licensed'pursuant to-the provisions of the Contractor's License Law GAS SERVICE - / 'OUTLETS a — •SERVICE' • • - AMP • - (Chapter 9 (commencing with Section 7000) of Division 3 of the - - Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT - ' ' ' h=ats for the alleged exemption. Any violation of Section 7031.5 by s:ap liceortiharn aliveermiit ed jdctllsrt e applicant to a civil'penalty -SEWER CONNECTIONS _ - •- t - - ,� I, as owner of the property,or my employees with wages as their SOLAR TANK - COLLECTORS •- - • - - -- - -. solecompensation, will do the work, and-the structure is not Intended ' or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. I ISSUE FEE Contractor's-License Law does.not apply to-an owner of a property - who builds or improves thereon, and who does such work himself or ISSUE FEE `3 -� 'APPLICATION APPROVED BV • DATE - - through his own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK _ SUMMARY_ OF FEES is sold within one year of.completion, the owner will have.the burden _ _ •_ o proving he did not build or improve for the purpose of sale). BUILDING .�j1 P, as owner of the-property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU_ PERMIT ' _. .E '41 $MIP' E IiCensetl contractors to construct the project Section 7044, Business AND DUCTING - - - , ( 100,000.+BTU _PLAN CHECK $ PERMIT _ and Professions Code: The Contractor's License Law does not apply to - ISSUANCE E an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ _rte tracts from'such-projects with a contractor(sy licesned pursuant to SYSTEM - ' - - - - -- - - - - GRADING E - the Contractor's License Law). 100,000+BTU •PLAN CHECK $ '• ❑ I am exempt under Section B P.C or this ' $ _ - V' / as/fleaf!� BOILERS BTU ELECTRICAL $ reason ' / / - + MICROFILM $ CTI T" ✓ er •7_� / SYSTEM REPAIR,ALTERATION -PLAN CHECK $ Date �•� Owner - - --- - - • - TOTAL FEE$ I hereby certify that 1 have read t is applicati• and state that the above EXHAUST SYSTEM MULTIPLE _ MECHANICAL $ Information is correct. I agree to comply with all city and county - - - '.PLAN CHECK $ - - 'LESSD- - - ordinances and state laws relating t• construction,and hereby aut'orlae VANCE PC , $ representatives of his city •/-nter upon t above e '•ned property .for inez,_..•- _'_' / Date !u ' ~/ I - FINAL FEE $ Signature �i Drivers'License or SS 7F a�� - - _ ISSUE FEE - ' - I - - - - - - . - CMF 0865.46 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNI G / o _ POOL& SPA _ ,,,! APPROVALS Permit# - �"'� Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. Soil Pipe-Undrgrn -• 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn - 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding - -. , 5. Steel Reinforce • 47. Rough Plumbing & Pressure Test - . . 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - 7. Footings 49. Electrical Conduit-Undrgrn • 8. Foundation .50. Gas Pipe, ❑Undrqrn;Test i! 9. Water Pipe-Undrgrn 51. Backwash Lines,P-Trap, El Undrgrn - . - 10. Structural Floor System . 52. APPROVAL TO DECK - - - 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final . 12. Street Sewer Connection 54. Heater & Vent-Final ' 13. Rough Plumbing - 55 Plumbing System - Final - - • 14. Rough Electric-Conduit - - • 56. Electrical-Final . 15: Rough Electric-Wiring -- - 57. Solar System-Final - ' 16. Rough Heating &Air Conditioning-. _ • - - 68. Fencing &Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING - 18. Ducts, Ventilating - • - . 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL ' 20: Roof Framing _ - -. - 21. Roof Sheathing _ 22. Frame and Flashing - - - -- NOTES: • ' • 23. Insulation - ' - -- . _ - _ _ - _ _ 24. _ Lathing & Siding _ - . - . _ . ._ _ - . - - 25. Drywall Nailing -- • . 26. Plaster Brown Coat - r - • • 27. Electrical Power Meter-Final ' 28. Final Electric _ ' 29! Final Heating &Air Conditioning _, _ _ ' 30. Final Gas Pipe-Test _ r�--o 5-• -6�+- ' 31. Final Plumbing - 32. Water Service-Final _ • • . 33. Gas Service-Final - - ' 34. Solar Domestic-Final • . -• - ' 35. Landscape Sprinkling System • - ' 36. Sound Attenuation ' 37. Handicap Regulations • - _ • 38. FINAL STRUCTURE & BUILDING ... . 39. Special Requirements Completed - ' ' - 40. Electric Release to Edison ya� - - - 41. Gas Release to Southern California Gas Co. y�2 - (r- 42. CERTIFICATE OF OCCUPANCY _ • No Date /(0 Applicant to fill in all'spaces except those within heavy border lines and sign all appropriate declarations. 6o'" CITY OF COSTA MESA - - PER IT NO TRACT NO. LOT NO. BLDG.NO. -- - - CONSTRUCTION PERMIT - !/?/ �7-il o 245-252 . 35 • 7593 10/2 /5"3 • E-3,EU It Project Address f ! t ! ! ' 4 - TYPE OF CONSTRUCTION ❑ NEW (Li ADD Li ALTERATION U,REPAIR R Applicants Mailing Address Same. • ❑ CONVERSION ❑ DEMOLISH OTHER Reh o to �sL (7� 1[] �1A.P.;RNone Owner's Name MOn (.C2-Q.0oC0mm. Abbn phone 540-1091 DESCRIPTION OF WORIYLa.b.d l A" FLUke9-(.a44,Comp. a A4�?haP t Po 9.6 Lng S Eain Building: Accessory Building: Z Address Sal"e TYPE OF.PERMIT Li GRADING ❑ FOUNDATION ❑ STRUCTURAL - T Front N Arch/Eng. _• License No. ID TENANT 111 ELECTRICAL ❑ PLUMBING' ❑ MECHANICAL B Rear - I Address ❑ OTHER A N Contractor's Namp SanMax.Lno Roo£ Co Phone 974 3070 PROJECT DESCRIPTION SQ. FT. 8300 OCCUPANCY' R-1 C Right G Address(mailing) 2187 N-Batavia OtLa.ng P. 92665 CONSTRUCTION TYPE VALUATION$ 6500- S Left - E ZONE GRADING CU.YDS. ACRES Q City License No. 026085 Ping. Ref.# Park.Fees $ U LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided . 1 , 11 I hereby affirm that I am licensed under provisions of Charter 9 (commencing R W with section 7000) of Division 3 of the Business and Professions Code,and • Use of Building: '- E my license is in full force and effect. License Class - Li 'se�No�. PLUMBING FEES Planning Notes: M Date 9-2D-83 Signature - Uvice. E WORKERS'COMPENSATION DECLARATION - Bar Sink t Showers T hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer _ Service Sink I • S Workers' Compensation Insurance, or-acertified copy thereof-(Section _ • \ .800, Lab. Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. wr 82 15045'8 CompanyF/Lemont Indemnity Certified copy is hereby furnished. -- Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW Certified o,,py ks pled with the city Bui i -Sion. _ Date V-Z U-5 3 Applicant vC../- L Clarifiers - Solar Collectors l - Construction Pole Sub. 050+KW EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Solar Pi in - (This section need not be completed if the permit is for one hundred ($100)or P 9 - ' Cooking Unit - Meter Dun to 100 amps less). - I certify that in the performance of the work for which this permit is'issued, I • Drinking Fountains Solar Tank Dishwasher l 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 ❑Electric Sub Panel Date Signature NOTICE:'caller making this declaration, you should become subject to the • Floor Sinks Urinal • Fan Motors❑0.1 HP ❑1'/:-8 workers' Compensation- provisions of the Labor Code, you must forthwith - - -- . . • - . comply with such provisions or thispermitshall Be.deemed revoked. � Gas Service Outlets - - 1 Water Closet F.A.U. • . Inc.Solar ❑9-15 HP ❑16-15+ CONSTRUCTION LENDING AGENCY. . ' I - I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures of the work for which this permit. is issued (Section 3097 Civ. C.) - - 'Microwave • Lender's Name - , Kitchen Sink - Water Service . - Device Boxes Pole Light - Lender's Address - Lavatories ' OWNER BUILDER DECLARATION - - Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the P-Tra •p reason (Section 7031.5 Business and Professional Code:Any city or p '- - Switches Sign -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' - - ons - Garbage Disposal Standing Sections -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 ' -.vision 3 of the Business and Professions Code) or that he/she is exempt - - - _• Generator 00-5 KW ❑5-15 KW Trash Compactor 'refrom 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 i l Reins ction Fee 3 enalty of not more than five hundred dollars($500). Pe I $25 Issue Fee $ • LJ I, as owner of the property or my employees with wages as their sole • MECHANICAL I FEES Reinspection Fee $25 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered 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 D sale. If, however, the building or improvement Is sold within one year of com- Duct-Under Ground _ Application Approved By Date pletion,the owner will have the burden of proving he/she did not build or im- A� • prove for the purpose of sale). Duct-Structural • Refrigeration System Application Issued By ,..40/,���/�J/l'✓! / Date /O r Z • LJ I,as owner of the property, am exclusively contracting with licensed con- ❑a100,00D BTU ❑100,DD0 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY 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- - • BUILDING PERMIT $ F3'CO SM IP $ O'' ' tractor(s) license pursuant to the Contractor's License Law). - Exhaust System D Multiple 0 System Repair/Alteration • PLAN CHECK $ PERMIT ❑ Lam exempt under Section a.&P.C.for this reason Firepl/Fact.Bit. ICBG# - PLUMBING $ ISSUANCE $ Date Owner Heating System&Ducting - PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above -❑0-100,000 BTU 0100,000 BTL GRADING $ information is correct. I agree to comply with all city and county ordinances -- ELECTRICAL $ and-state laws relating • building construction,and hereby authorize repre- - MICROFILM $ sentatives of this c. o ente . upon/he above-mentioned property for PLAN CHECK $ G Inspection purpose//' 9-20-83 • - TOTAL FEE $ O'?'SQ L. MECHANICAL $ Drivers' / sf�l Date $25 Issue Fee $ 3 PLAN CHECK $ Drivers' License ("1.5 _�-� Reinspection Fee • CMF 0865-48 rev. 7/83 White-Building; Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - - - - - - - - - • ' CONSTRUCTION AND P -_LANNING` ' . 'POO WA - Date ' Inspector" - Date ' Inspector C, APPROVALS Permit# ' - ...APPROVALS ' Permit# _ , •1. Temporary ElectricalSer.vice or Poled I 52. Pool &Equipment Location . 2. Soil Pipetlndrgrnd. . oo . . . , _I53. Steel Reinforcement 31'Electrical'Conduif,Utility-Undrgr id. . 'I, • .,"" ' 54. Forms; 4..Electrical ConduitlJndrgrnd. ej. - 55.- Electrical Bonding 5. Steel°Reinforceme"nt' r" ` - ^� . - ' 56.,.Rough Plumbing & Pressure Test. "' - • 6. -Electrical LIFER Grnd. . - - 57. -APPROVAL TO COVER-GUNITE 7.'Footings , , t ' . : 1 58. Electrical Conduit-Undrgrnd. 8. Foundation 'i j.r. - .59:'Gas Pipe, 0'Undrgrnd.,Test 9. Water pe- PiUndrgrnd ' c7 - = - 60.' Backwash Lines, Pi-Trap, O Undrgrnd. 1 10:Structural Floor System ti - ; ,,61 APPROVAL TO DECK • - . 11. Property Sewer Line<& House Connection I-. . - 62. Backwash & Receptor-Final _ 12. Sewer=_Cap `.: "; . ' n.i y, .. 63.,Heater & Vent-Final f , 13. Roof'Drainsfr.) y _- «' = 64. Plumbing System - Final I _ 14. Rough Plumbing - • ',2• - 65.-Electrical-Final • " 15: Rough Electrical:Conduit .- ","66: Solar Systern=Final ' - • 16. Rough Electric Wiring . - ' - . • '67. Fending &,Access Approval ' " " ' 17. Rough Wiring Sign - 68. -APPROVED FOR PLASTERING - • 18. Rough Electrical-T Bar Ceiling .. - i • ' 69. •POOL/SPA SYSTEMS FINAL , • 19. Rough Heating & Air,Conditioning FIRE DEPT. REQUIREMENT cr.' 20. 'Rough Factory Fireplace APPROVALS Permit# 21. Ducts„ in,Structure , 70. Underground Hydro ' 22. Ducts, • Ventilating ' 71. Product Piping 0 Gas O Oil 23 'Gas Pipe-Rough &Test; 72. Underground Flush • 24: Roof Framing :� , • � _ 73. Und'ergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - - 74. Overhead Hydro ' 26: T-BaliCeiling(Structural) & Monocoat ' - 75. Dry Chemical 27. Frarrib and•Flashing ' 76. Dry"Standpipe ' 28. Lathing & Siding 77. FIXED SYSTEM FINAL • . 29. Ins"ulation 78. FIRE PREV. FINAL ' - : HEALTH DEPT. REQUIREMENT . 30. Drywall Nailing ''r., ' 3.1. Plasfe'r Brown Coit 1 79. FINAL INSPECTION . 32. Electrical Power Meter-Final , , ' ' 80. FOOD CERTIFICATE ISSUED ' • 33. Final Electric ; - ' Notes: ' 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 2 , ' ' ' - . 36. Hood or Canopy ? :i , 37. Final Factory Fireplace • ` .. • .. 38. Final Plumbing - ' • • 39. Water Service-Final 40. Gas Service-Final - ' • 41. Solar,Domestic-Final 1 - _ - 1 . - • '- _ • •42. Backflow Preventer , ,. 43. Backflow Irrigation - ' • 44. ,Landscape Irrigation System _ ' 45. Sound"Attenuation ` ; a i 46. Handicap Regulations , ' ' - 47. FINAL STRUCTURE & BUILDING - , 4 , 48. Special Requirements Completed , . . ; - ' 49. Electric-Release to Edison - - --- - - - - I - ' - - 50. Gas Release to-Southern California'Gas Co - • ' I 51. CERTIFICATE OF OCCUPANCY • __ _ ' No. • Date ' Applicant to fill in all spaces ex- nithin heavy border lines and sign all appropriate declarations. 10 CITY OF COSTA MESA • PERMIT NO. TRACT NO. LOT NO. . BLDG.NO. - - r, . CONSTRUCTION PERMIT • �j- 9/ 7 _ I' 5160 • 1 ' 45 / 9`� In/r �O^ � '`�` T! - Project Address 1 5 0 VaZZey t-ohn9 e, C. M• TYPE OF CONSTRUCTION ❑ NEW U ADD U ALTERATION U REPAIR Applicant's Mailing Address Same ❑ CONVERSION El DEMOLISHp ❑ OTHERR Ph OO f ng AP # ' IZone Owner's Name MO n-t�.ceZka C ommA44 n Phone 974-3070 DESCRIPTION OF WORK C.Za44lA F.f,behg-Zaeb, Comp. . A6phnP# Rao/ ink ES Main Building: • - Accessory Building: Z Address Same ((�� ° TYPE OF PERMIT GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front' N Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Address - ❑ 'OTHER Contractor's Name SanMah.in n Rn nro Phone 974-3070 PROJECT DESCRIPTION SQ. FT. 3n00 OCCUPANCY• R-1 CK Right - R Address(mailing) I i I , 0 - e I II • • • • CONSTRUCTION TYPE 5M VALUATION$ 3000. S Left E City License No- 026085 ZONE GRADING CU.YDS. ACRES Ping. Ref. Park.Fees $ Q U . LICENSED CONTRACTOR DECLARATION • Remarks: Parking Req./Provided , - I I hereby affirm that I am licensed under provisions of Charter 9 (commencing R with section 7000) of Division 3 of the Business and P ofessions Code,and - Use of Building: E my license is in full torte and effect. . License Cless - icens: � • • PLUMBING FEES Planning Notes: M • Date - t - • Signature Air A. i- .Sid E WORKERS'COMPENSATION DECLARATION Bar Sink Showers N hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink I S Workers' Compensation Insurance, or a-certified copy thereof (Section 4800, Lab. C Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. w}P82 150458 ContpanI/LemO Indemnity ❑ Certified copy is hereby furnishetl� i - Bathtubs Sewer Connection Automatic Washer , Transformer 0 15-50 KW ?(�Cetttifiggd copy 11s filed with the cit• -il• n• Di isi... Date 9-70-X4 Applicant -�./ - .,_�" �_ ./� Clarifiers - Solar Collectors I Construction Pole Sub. - - i 050+KW EXEMPTION FROM WORKERS'COMPENSATIO DECLARATION Dishwasher Solar Piping CookingUnit - - - Meter Dup to 100 amps (This section need not be completed if the permit is for one hundred ($100) or less). . I certify that in the performance of the work for which this permit is issued I Drinking Fountains Solar Tank Dishwasher Meter❑ Over 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 ❑Electric Sub Panel Date Signature NOTICE:If,'after Making this declaration, you should become subject to the Floor Sinks Urinal Fan ' Motors 00-1 HP 01%-6 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. • Inc.Solar ❑9-15 HP 016-15+ CONSTRUCTION LENDING AGENCY - - I hereby affirm that there is a construction lending agency for the performance Interceptors - Water Heater - Fixtures i Microwave ' of the work for which this permit is Issued -(Section 3097 Civ. C.) - •_ Lender's Name - Kitchen Sink • Water Service . - Device Boxes ,Pole Light • Lender's Address - - - - OWNER BUILDEDECLARATION - Lavatories R ' ' .- Outlets Range 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 Switches Sign 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 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 - Generator ❑0-5 KW❑5-15 KW Trash Compactor 9vision 3 of the Business and Professions Code) or that he/she is exempt - P erefrom and the basis for the alleged exemption. Any violation of Section - 331.5 by any applicant for a. permit subjects the applicant to a civil ' LIenalty of not more than five hundred dollars($500). I Reinspection Fee $25, . Issue Fee $ 3 ' I, as owner of the property or_my employees with wages as their sole I - Reinspection Fee • $25 Issue Fee $'3 compensation, will do the work,and the structure is not intended or offered MECHANICAL FEES for sale (Secion 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 0 i sale. If, however, the building or improvement is sold within one year of com- Duct-Under Ground - Application Approved By Date pletlon, the owner will have the burden of proving he/she did not build or im- — prove for the purpose of sale). - Duct-Structural Refrigeration System Application Issued By x v( Datg� /t/ L I I, as owner of the property, am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES The Contractor's License_Lawdoes not apply to an owner of property who BUILDING PERMIT 0•0 m 0 SMTP $ • COQ builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration $ .� • tractor(s) license pursuant to the Contractor's License Law). - PLAN CHECK $ • PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# ' PLUMBING $ ISSUANCE $ . Date Owner Heating System& Ducting • • PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 0o-100,000 BTU 0100,000 BTU ELECTRICAL $ 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- PLAN CHECK $ MICROFILM $ sentatives of this to ent r upo he above-mentioned property for . inspection purpo MECHANICAL $ 3°,..00Signature Date 9-19-�3 - TOTAL FEE $ Drivers' License or SS# Reinspection Fee I $25 Issue Fee $ 3 PLAN CHECK $ ' Silk CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor _ CONSTRUCTION AND PLANNING ' , ` • • POO SPA APPROVALS; Permit#. Date ' Inspector APPROVALS Permit - Date Inspector 1. Temporary Electrical Service or Pole 52.-Pool & Equipment Location • - 2. Soil Pi pe:Undrgrnd. •• 53: Steel Reinforcement - • - 3.; Electrics iConduit'Utility-Undrgrnd. - ' 54. Forms . • 4..Electrical ConduitUndrgrnd. - I ru _ 55. Electrical Bonding ' 5. SteelReinforceme %, ;ht o - , ' - ^ ' _ 56. Rough Plumbing & Pressure Test 6: 'Electrical UFER Grntl. ' • 57..APPROVAL TO COVER-GUNITE 7"'Footings .. • • , - 58. Electrical Conduit-Undrgrnd. B..F.oundation -o ri rr 59. Gas Pipe, 0 Undrgrnd., Test ' 9. WaterPipe-Undrgrnd,?, .. 60. Backwash Lines,P-Trap, ❑.Undrgrnd. : 10. Structural Floor System _ 61. APPROVAL TO DECK ' • . 11. Property Sewer Liner& HouseConnection - 62. Backwash & Receptor-Final • - 12. Sewr.Cap c. _ to.: 63. Heater & Vent-Final i 13. Roof Drains ' '; 64. Plumbing System - Final .: ' r 14. Rough Plumbing t-- ,i 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 _0. Rough factory Fireplace, i APPROVALS Permit#' 2L. Ducts;in Structure 70. Underground Hydro t22. Duct , Ventilating -. 71. Product Piping LI Gas Ill Oil 23. GasKP.ipe-Rough &,Test . 72. Underground Flush ' '24. Roof,Framing , - 73. Undergrnd.Storage Tank 0 Gas ❑Oil • 25'. Roof Sheathing - 74. Overhead Hydro • 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. FOrime and Flashing - • • 76. Dry Standpipe _ 28. Lathing & Siding; ' + 77. FIXED SYSTEM FINAL . 29. Insulation . 78. FIRE PREY. FINAL ,.., 30. Drywall Nailing. - ( HEALTH DEPT. REQUIREMENT • i. 31 Plaster Brown Coat'; ' • 79. FINAL INSPECTION . 32. Electrical Power.Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric - Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test ' ' • ' ' ' - 36. Hood or Canopy - - - - 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final ' 40. Gas Service-Final ' , I . • i 41. Solar Domestic-Finali :: _� • 42. Backflow Preventer • 43. Backflow Irrigation - - 44. .Landscape Irrigation System 45. Sound Attenuation .. . . - • 46. Handicap Regulations - - - - 47. FINALSTRUCTURE &BUILDING - ' 48. Special Requirements Completed , 49. Electric Release to Edison I -' - - - - - . 50. Gas'Release to Southern California,Gas Co1 . 51. CERTIFICATE OF OCCUPANCY _ _ . . -_ _ No. - - :Date - i • I. L . 150 VA LLEY FORGE ROAD / 0 � ° ; ,i • �` ' COSTA MESA , CALIFORNIA ?4y`.AL kaI k S S: • June 28, 1971 • Mr. Roy June, City Attorney • 1500 Adams Blvd. , Costa Mesa, California Dear Mr. June : We would appreciate a ruling from you in regard. to the requirement of employing licensed, contractors to perform work in the Monticello Townhouses . This would be in the nature of the installation of tamper proof light fixtures on the existing electric wiring system. upgrading and. repairing existing asphalt road ways , water and, gas pipe lines etc . We understand. the necessity of a permit and inspection by the City of Costa Mesa for some types of maintenance work but respectfully request clearification of City, State add County regulations in re- gard to this type of maintenance on common owned. private property. We find no sections in the Codes which makes it mandatory that we employ only licensed contractors to perform work on undivided common interest property (excluding the private homes ) . We also have residents who are qualified. and willing to do light maintenance , without a fee, in regard. to the jointly owned. areas , • with the approval of the Board. of Governors . Thank you for giving this matter your consideration. Yours very trunly, 1 iSisk, ChalYMN.6i ARD OF GOVERNORS JFS:mf 150 VALLEY FORGE ROAD STIO lib Cello COSTA MESA , CALIFORNIA TOWN HOUSES July 14, 1971 Mr. Richard, D. Hanhart 44 Fair Drive Costa Mesa, California Dear Mr. Hanhart : On June 30, 1971 we were advised by Mr. Roy June that he had. forwarded. to you for handling our letter to him under date of June 28 , 1971. This was in connection with our request for a. ruling as to the requirement of employing licensed, contractors to perform light maintenance on the undivided. common interest areas of our private property. As stated. we appreciate the necessity of a permit and inspec- tion by City of Costa Mesa but find no sections in the Codes which makes it mandatory to employ only licensed. contractors Will you please favor us with a reply. Yours very tr.u/ly,4 PW7 B� OARD OF GOVERNORS Jerry F. Sisk, Chairman JFS:mf cc: Mr. Roy June • BUILDING SAFETY DEPT, J U L 2 1 1971 . 0. V . E,A1.17/e1z1s'icA2 a C©.0 SACC.. 7910 MAN STREET. --- STANTON, ..iFORNiA ' 828-8040 64 CMS - 025 - 002 XXXXX Field Data on Test Specimens Core Concrete Gunite Grout/Mortar Project San Vista Building Co. Swrimpoa4 *2 Permit No 21274 'ProsectLocation 150 Valley Forge Road, Costa Mesa, Calif. !'Contractor Pools by Automation Architect Location in Structure Deep end wall Engineer Date Moulded 2/24/64 No of Specimens 3 Slump Specimens Marked Specified Strength at nays 2000 P.S.I. Mix Designation Age to be tested days—days_ days._ clays READY MIX PLANT Job Mia AGGREGATE SOURCE Consolidated Rock Proguc SK Cool clear, windy 2 Weather Condition ° I Yd. _A,I. Batch Cement Monolith Type I Cement, lbs. 2 Admix Sand 9 of. Specimens made by Pools by Automation #4 Data by Brackney #3 Delivered by #2 Date Delivered # REMARKS: Water, Gals. 7 FOR LABORATORY USE ONLY Lab. No. 309 310 311 Day Test Day Test Day Test Day Test Date of Test 3/2 3/23 _el \101 Irr Specimen Dimensions 5.94 X 12 5.94 X 12 / RECE�I�EQ %, Area 27.71 27.7; IN. �Pg 24 1964 ultimate toad 57,000 88.000 a Gi4) of Ds.'L,rt. — Lbs. per sq. in. 2,055 3,175 * rit- it i H/D Corrected H. V. LAWMASTER & CO., INC. N . V f'atr9011/ASSl C$ .':P.CO., OAC. -. , '. ".:.. r r, _ r e •,.T :.., . i` •,i A 828-8040 64 CMS : 025 — 003 r MX . Field Data on Test Specimens . Corn Conctete Gunite Grout%Mortar i San Vista Building Co. Swim of #1 21274 Pro act Po Permit No Project 150 Valley Forge Road; Costa Mesa, Calif. Location t Contractor Pools by A u5c'tr r ion Architect Location in Structure Deep end wall Engineer Date Moulded 2/24/64 No of SpecimonS 3 Slump Specimens Marked C Specified Strength at 28 days 2000P.S.i. Mix Designation Age to be tester 7 dayEs.s days . days days . READY MIX PLANT Job Mix • AGGREGATE SOURCE Consolidated Rock Products clear, 2 SK Cool,Weather Condition !Judy 1 Yd. �H. Batch Cement Monolith Tyne I Cement, lbs. . 2 Admix Sand . • . • 9 cf. Specimens made by Pools by Automation #4 . Data by • COMM #3. Delivered by #2 Date Delivered # REMARKS: I Water, Gals. ,t1 I/ I V • FOR LABORATORY USE ONLY Lab. No. 312 4313 . 314 Day Test Day Test Day TestDay Test Date of Test 3/2 3/23 \9ylUi� I/\_ Specimen Dimensions 5.94 X 12 5-94. X 12 • t VON ' �,=) Area 27,71 27. 71 . N OR ..,Sa _ t� 4 .4; Ultimate Load 64,000 AR nnn �`:'Bitot-Q, '_.r- Lbs. par sq. in. 2,309 3,175 . S iv I �k 11/0 Corrected Ull ifkaWc- r C—VY C.fir ^--L— H. V. LAWMASTER & CO., INC. • • 1 CITY OF COSTA MESA CALIFORNIA P.O. BOX 1200 FROM With OFFICE OF TRE PLANNING DEPARTMENT San Vista Building Company Oct. 19, 1964 150 Valley gorge Rd. Costa Mesa, -California Dear Pool Owner: The Costa Mesa Planning Department has been notified of the completion of your swimming pool. So that your pool will be a safe one and for the purpose of advising you of your responsibility regarding the requirements of the Costa Mesa Municipal Code, we quote Section 9298.9: 1. No swimming pool shall be constructed closer than five (5) feet to any property lines, measured from water line of pool. 2. No swimming pool shall be constructed under any electric power lines or on any electric power easement. 3. No swimming pool shall be constructed unless the yard surrounding such pool is completely enclosed by a fence six (6) feet in height and have a self-closing and locking type gate or gates. This courtesy letter is directed to you so that you will be aware of our ordinances and can make a complete safety check of your pool area. Sincerely yours, � {"' (feu William L. Dunn Director of Planning • • LOS ANGELES • CALIFORNIA PORTER, O'B R I E N & ARMSTRONG PARTNERS O. J. PORTER & COMPANY O. JAMES PORTER K. N. O'BRIEN NEWARK • NEW JERSEY CONSULTING ENGINEERS ELLIS L. ARMSTRONG JAMES R. PORTER ASSOCIATES 510-31ST STREET SACRAMENTO • CALIFORNIA JAKE C. YOUNG NEWPORT BEACH,CALIFORNIA C. F. GRIGG 673-085 C. H. DARBY OTTO M. VIHRE WASHINGTON O,C. J. F. WHITE (A.I.A.) W. J. WAGNER V. J. SPOTTS (A.I.A.) RENO • NEVADA March •O 1961. LEONARD C. UROUHART �{�, .LJV•f 1969-1960 Department of Building & Safety City of Costa'Mesa 695 West 19th Street Costa Mesa, California • gentlemen: • SUBJECT: Report at Completion - Timber Truss Inspection - . Trussco, Inc. r Job No. 778 - Fair Dr. and Faiirbiew Rd., Costa Mesa, California Building Permit Nos. (A �r / Our Job X000-49. cf&ui'did--6j/& . S "`D We have completed inspecting the fabrication of a series of wooden trusses to be used-in building construction near Fair Dr. and Fairview Rd. in Costa Mesa. A total of 536 trusses for this project were assembled at the fabrication yard of Trussco, Inc. in Westminister on March 2nd through March 6, 1964. I , Inspections were made at the start and periodic checks were made during the week to insure construction in accordance with engineering drawings furnished by the manufacturers. The units are identified as Drawing No. T-20-5-23.5 • 536 20'10" Span 5/12 Pitch Bldg. No. of Trusses. 11 91 16 - 91 23 91 3391 36 91 43 81 We certify that the-trusses inspected were assembled according to the engineering drawings and were in good condition when stacked at the end of the assembly line. Bundled truss units fabricated without , assembly line inspection also appeared to be properly constructed wh- .,,cIt@i0i viewed in the shipping area. p K6A f � . Very truly yours, ; 'rf�oval 'c BAR. fG PORTER, 0' & ARMS-u;e:G M1'; .,2� 1�4 Herbert J. Dix HJD:vl ;.91• \ti •,ownwr4 . winvwsys . STRUCTURES . UTILITIES . DAMS . REPORTS . SURVEYS - SOIL AND GEOLOGICAL INVESTIGATIONS . FOUNDATIONS AND STABILIZATION 'ate; INTERNATIONAL TESTING CORPORATION �� ^e— GEOLOGY - FOUNDATION ENGINEERING • TESTING - INSPECTION 6173 Cherry Ave., Long Beach, Calif. — Long Beach GA 2,65550 GA 2-7500 - NE 67821 1071 "D" Placentia Ave., Costa Mesa, Calif. — Costa Mesa MI 6.4826 - KI 5-8888 3552 Buena Vista Ave., Lemon Grove, Calif. — lemon Grove HO 3-7751 1-7 November 14, 1963 7-863-307-1967 Jakardy Equipment Company c74 � 7 / - 7/4 2500 West Orangethorpe, Suite V. Fullerton, California SUBJECT: Report on Inspection of Trusses for the San Vista Project, Fairview Road and Fair Drive City of Costs Mesa, County of Orange, State of California Gentlemen: In compliance with the request of Mr. Jack Nardy and Mr. Charles Noonan. this report has been prepared to establish the findings of an inspection of the trusses for the subject project. On November 12, 1963, we inspected a representative sampling of roof • trusses fabricated from TrusWal Systams.;West, Inc. , plans (File No. ANI`-31-9-35) for the Recreation Building. All trusses had been fabricated prior to inspection and no additional work was in progress. We certify that all trusses inspected had been fabricated according to plan using the proper stress grade lumber, the proper plate sizes and proper nail numbers, with exceptions that at three joints the number of nails was found to be deficient by not more than one nail in each joint. In one truss, a rafter mxmbere�` 7:= t.. reason 1� yl`v rGv \Gos�aOe44 • • il—c-cimit 4 , f4/./L d c/or F �C'b��,�cu�,&c4 - 4/4 , L s a /c . j Et_t(.1, (16.GJ�/ c /G9, c%_ . Y . CCbF ar ` �' l, �++ 7c. /lC C��� /l�/V CL/'�C. ( C.,c_4Y GLS (371,/ , C4/Q.rd /! CLCxc[c% — )cc) J q' Report on Inspection of Trusses for the Sacs Vista Project, Fairview Road and Fair Drive, City of Costa Mesa, County of Orange, State of California F-863-307-1967; November 14, 1963 Page 2 of splitting out of one knot. Suitable remedial action was requested in each of these cases. In general the spacing of nails was random and did not conform to the circular punch marks. No evidence as to sequence of nailing was presented. We are confident that adequate quality control of future production can be established and maintained during the course of fabrication. This opportunity to be of service is sincerely appreciated. Respectfully submitted, INTERNATI •ESTINO CORPORATION /j .� William F. Lever Structural Engineer No. 996 WFL:r 01 44°� 14, CITY OF COSTA MESA • ' 9 CALIFORNIA P.O. BOX 377 • •, ra.• FROM THE OFFICE OF THE CITY ATTORNEY • October 22, 1963 • •• •• • Mr'. Bill Dunn Director of Planning • City Hall Costa. Mesa, California Re: Tentative Tract Map 5160 Dear Mr. Dunn: • The problem submitted to this office involves the construction of a condominium development on the above . tract, said tract haying been specifically designed for this purpose. The owner and applicant now approaches the Planning Department and the Building Department • with the request to reduce his construction requirements to meet those of a similarly owned apartment building on a single lot . The distinctionsin the Building Code are specifically the specifications for an IIHII building. and "I" building. The "III building is one generally used for individual or single unit houses . The "H" building is the one generally used for multiple unit apartment buildings . The specific difference is in separations, being more usually described as firewalls . The Senate Bill- 600 was adopted and became law in September, 1961, and provided for condominium developments . Assembly Bill 787 was adopted some years ago adopting the Uniform Building Code by the State of California and was readopted approving the modification in the 1961 Building Code. I find nothing in Senate Bill 600 which in any way modifies the 1961 Uniform:Building Code as adopted by 'the State of California and the City of Costa Mesa. I can find no CITY OF COSTA MESA. CAL.. .RNIA • Bill Dunn -2- October 22, 1963 cases in California or any other jurisdiction which are • in point with respect to this problem. It therefore becomes a matter of policy with the City of Costa Mesa as to whether the"I"building specifications should be . followed on condominium development or whether the requirements maybe relaxed and the "H" building require- ments be allowed. It is my opinion that "I" building specification require- ments should be follotaed as a matter of policy by the City of Costa Mesa. My reasons for this opinion are as follows : 1 . We have on two previous occasions required construction of "I" building specifications, specifically the Shoreline Construction Co. development and the Doyle and Shields development . 2. No specific provision has been made in Senate Bill 600 to in any way modify the Uniform Building Code or to otherwise provide for building specifications on condominium developments . 3 . It is my feeling that the true spirit and intent of Senate Bill 600 was to create individual estate in land and space and that the closest example that we have in our building code to such es.tate'Bur specific requirements which we imposed on R-1 developments or the ' I" building . 4. There is no specific requirement by law or authority which will permit the Building Inspector or the Director of Planning to waive the side yard- setbacks without the granting of variance by the Planning Commission. We are thus without guidance by law or otherwise on this matter and must follow a policy which we must develop our- selves . Quite possibly you would like to have the opinion of the Planning Commission on this matter with respect to any policy that may be developed. , In the interim, it is my recommendation that building permits be issued for "I" type construction only. Very truly yours, CITY OF .COSTA MESA • B / 1 � , :ss s ant gip 'tto •,ey I REJ:sb / . • 41 •`-7 0-•-"n--42----1•1--9.---C___—. DPZc'� TKO 001°1 ,v)- A3A-Q/9) iz 15T/ N C Vc 4 LL I I C C IM c N T - C E n-i 5r N T I J I • I I 011 J 2. • x -. o �' o k h J . I �� ' I Q. • &' I I % Fa o T l NC / 27 X I J- " JI ,___ L_ — , — _ _ , I d . Jst I �� — — — — — — — — — — — — — I t \) a24 ' 131_ 0cr< Wn- LL PE / w FoRe r h wrT"ii ST if E L. I • APPROVED City of Costa%///MM a Building_Dept._ 7 BY Tc THESE PLANS MUST BE ON JOB Ai ALL TIMES ' NO CHANGES WITHOUT PRIOR APPROVAL .PT, THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL PLAgS AND SPECIFICATIONS SIiAtL NOT HE CONSTRUED • BE A PERMIT' FUR. OR AN APPROVAL OF, ANY VIOLATION ;F ANY OF THE PRCV010;:S CF IBI;: CODE, NO PERMIT PRE. SUMING TO GIVE AUTHORIT! TO VIOLATE OR CANCEL THE PROVISIONS Of THIS CODE SHALL BE VALID, EXCEPT IN SO FAR AS THE WORK OR USE WI ICH IT AUTHORIZES IS LAWFUL. THE ISSUANCE OF A PC MIT BASED UPON PLANS AND SPECIFICATIONS SHALL NOT YRLVLNT THE DU'.LDIRG OFFICIAL FROM THEREAFT:R REQUIRING THE CORRECTION OF ERRORS IN SAID PLANS AND SPECIFICATIONS OR FROM PREVENTING BUILDING OPERATION; BEING CARRIED ON THEREUNDER WHEN IN VIOLATION OF THIS CODE DR OF ANY OTHER ORDINANCE OF THE CITY. tS•r4ppROyA ROCrti OF fifer OsOpCgy"est �OF / tits , s Do ONT � l WA C, •Gi�7TR ySTq0A<< �RATrNRtrn Thi •s N1.1411)L-,--- ... ....... .... ASC rNb rla9LI3T "OC p la? ON RrPUE4 ANV D{ B,241 rr.s w TS '•�'aRim °iz•va,. ti 814 saysavz r 41):)1170.ui;esr a+i f aE a unn. 1, rHf t,;9�irT aPlsal t£D row TYPICAL 611 CONCRETE BLOCK FENCE Cement Coping Optional -- ', Channel Block With 1-3/8 , M � �� ■ GENERAL- NOTES 0 Horizontal Top of all t�j— MORTAR: One Part Plastic Cement, and Fences 6" Concrete Block Fence Three Parts Sand GROUT: One Part Cement Three and For Fences 5' or Less i' o al It One Half Parts Cement, Vert. Bars 3/8" 0 at 4-0' O.C. COPING: One Part Cement, Three For Fences Higher Than 5'—� ` a "-_M' 1 Parts Sand Vert. Bars 3/8•' 0 at 32" O.C. ' w CONCRETE: Well Mixed 1:2-1/2: 3-1/2 " > r Ell ,ii Max. of 7-1/2 Gallons Cof ement Inspection and > Water Per Sack of Cement Cleanout Hole at Location r - . - - `, of Vert. Reinforcement H f 11S MI A.S.T.EINFORCING STEEL SHALL CONFORM TO Fillw Cells Solid With Grout o SEC. A-I5-39 M. Where Steel Occurs IIw n II--I� MINIMUM. EL TO LAP WHERE SPLICED, 2-0 GROUT MAY BE POURED FROM TOP OF N 'I�I_� FENCEIN CELLS WHERE STEEL OCCURS. HOLES SHALL BE HERE , TEEL N, AND ' I " . III II - _ FREE OF ALL MORTAR, DEBRIS, ETC.,WITH NATURAL GRADE INSPECTION HOLES AT BOTTOM. wawa v• 444" BONDS SHALL BE PROVIDED BY LAYING c n'M� BLOCKS IN STRETCHER COURSES SO 1/ /. ��:i\/1 .4.: o ' -0N °• o ' • • . ° • ' . y .°. , ' O. ; ' o THAT VERTICAL JOINTS ALTERNATE IN TWO 3/8" 0 BARS _ y u . �. a .� • e. �.. e . EACH COURSE. CONTINUOUS I I ' : 1-0—WIDTH .,' 16' 0.C. MAX. p SEE CHART ••-• STEEL MUST BE TIED IN ' V BELOW , DEPTH OF EARTHTOOTH PLACE AT TIME OF TRENCH • I I C 1 I/3 THE HEIGTH OF FENCE INSPECTION. ? •L .. L 11 L BELOW BOTTOM OF FOOTING.P. • • •. • . o ! s J e s . • lo" la',�, Ioe -( 2„� + SCALE: I/2" = I' CHART HEIGHT A 5' 4' 3' WIDTH 14" 14" 12" 12" THICKNESS 10" 10" 8 " 8 " , DEPTH OF EARTHTOOTH . . . 24" ! 20" 16" 12" SPACING OF EARTHTOOTH. . '12' .QN. &1c74R•. . .14' 16' 16' OWNERS NAME: City of Costa Mesa, California JOB ADDRESS: PERMIT NUMBER: Building Department SIGNATURE: FORM BU25-2M-0-02 1111 RESIDENCE RESIDENCE RESIDENCE RESIDENCE y W CC W It Ct ti 1 \\ STREET L� City of Costa Mesa Building Safety Department CERTIFICATE OF OCCUPANCY N? 1994 C P. 0. Box 317 Costa Meso, California The Building located at 150 Valley Forge Rd. has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B 3 Occupancy. Use of Building Recreation Building Legal Description A. P. #1.41-343-1 (See reverse side for Metes and Bounds) Building Permit No. 20688 Electrical Permit No. 21541 Plumbing Permit No. 39607 Floor Load Signs have been installed as Room Capacity Signs have been instaled as required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C. 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency. (b) A new certificate of occupancy shall be obtained whenever there is a change in: 1) Occupancy classification of a building or portion thereof 2) The number of apartments or guest rooms 3) Ownership If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California Administrative Code, Title 8, Chapter 9, Article 8. Number of apartments and/or guest rooms ISSUED TO: Building Official BAN VISTA BUILDING CO. b y/- Date Date June 9. 1964 This Certificate of Occupancy SHALL BE posted in a conspicuous plate on the premises and SHALL NOT BE removed '.except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Farm B1.734-1M_11_e3-54B P ti OWNER SAN VISTA BUILDING COMPANY DATE 3-2-64 JOB ADDRESS 150 Valley Forge Road BUILDING PERMIT NO. 21641. — GENERAL 1641. - - GENERAL CONTRACTOR fireside Const. Co. VALUE $ 17,000.00 AP No. LOT 1 TRACT 5160 FIRE 'LONE 3 DESCRIPTION OF WORK Block Walls I ECTIONS Signature DATE GROUP J TYPE III ZONE ES iSo.. PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water Rough Corn. Refrig. ❑ Air Cond. ❑ Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line 0 House Con. 0 St. Swr. 0 Sprinkling System Construction Pole Underground 0 Power O Rou —rin-7 - Trenches Forms 0 Steel Reinf. .n („ . ' 3— / Amiw ; , //'a 1. _; /`- y-- , Floor System ' R i . : i G CF- Bond Beam 0 Steel Reinforce 0 Sheathing Frame and Flashing Lathing— Ino Out p P? der, brown coat WL. 0 Air Con. rip Final Heating, Final _ Plumbing Fixtures, Final Final Gas Test _ Electric Fixtures, Final �� _ / Building, Final (=j.'v`t.a-i1-2✓al — tom i/'Zs���' t701—a� j-�-/ OCCUPANCY Form 13U4-5M-3-63—S-B P of Chi • OWNER SAN VISTA Building Co. . DATEQ1963 JOB ADDRESS 104 Valley Forge N. BUILDING PERMIT NO. po618 GENERAL CONTRACTOR San Viata_Bng_Co• i �i lld.i VALUE $ 15439.00 AP No. 141-31 -01 LOT 140 TRACT 5 60 FIRE ZONE ` DESCRIPTION OF WORKRes.Watt.gar. Ii < CTIONS Si:'ature DATE GROUP, TGT TYPE V ZONEg 3 SGri � /- PERMITS ISSU$D Gas � SUBCONTRACTOR DATE NUMBER Water a.Z. '- Rough Com. Refrig. 0 Air Cond. 0 Rough HeatingLer oPp. !7:110.. :r: ''J.., td SCG t7 y Rough Plumbing • . y-/g-/y!147 y,- U-/-C 3 376 K-L_- Miscellaneous [l Prop. Swr. Line 0 House Con.igSt. Swr. 0 Q./ 3•/y-/N' (2,..,_x_ (?.,,.aO NOV 1 3 lyes ,lie /�l Sprinkling System / A, w^� Construction Pole / '' L.�M Underground 0 _ Power 0 _ arc / b� Rough Wiring 771777-4 2 `y s= Csr13�At GCSrc . 2,.� . /-R/-45' ,2%A/Y -- Trenches 0❑ Forms ❑ Steel Reinf. .❑ _ /2 3 / Floor System / 2 — 9 // -- Bond Beam 0 Steel Reinforce 0 Sheathing m- a' - S /C 4/ / 1 Frame and Flashjr 6 /6� efri Lathing - In, Out 9P7G Pi fir, brown coatgiro- ?<a G Ce Al 14,g. 0 Air Con. ❑ Final ,II Heating, Final !i.1 . L )1 GA' Plumbing Fixtures, Final I/Q" C 1-2- L`/ Final Gas Test/r al C. ,• N Electric Fixtures, Final �= . l'..,,, 64' C%y/c - ,t Building, Final 4 i Gi OCCUPANCY . Form BU4-5M-3-63--S-B P HOLD FOR SPFCTA T. until TTDC[.Tvwr'rd UWNtK SAN VISTA BUILDING COMPANY DAIt 4-5-ba JOB ADDRESS 150 Valley Forge BUILDING PERMIT NO. 2811.18 --GENERAL CONTRACTOR Custom Craft Masonry DESCRIPTION of WORK Landscape Walls P 'o. 141-701-03 LOT TRACT FIRE ZONE VALUES 800.00 ,ii ACTIONS Signature Date GROUP S TYPE IIT ZONE SOILI GAS PERMITS ISS ED SUBCONTRACTOR Date I Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER 0 ROUGH WIRING � Heatin• and Vent. TRENCHES ❑ FORMS • STEEL REINF. ❑ ��%/Vii� L FLOOR SYSTEM BOND BEAM n STEEL REINFORCE In SHEATHING FRAME AND FLASHING LATHING - IN in OUT n PLASTER, BROWN COAT 5 TURAL, FINAL Elertric HL .NG, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST • ELECTRIC, FINAL BUILDING, FINAL `��yiiKWi fer ,'i7ff t o /J.t „K a w d- C cyan L iC� �[ �X? ,(,.),eff) t City --�---D/� J en, w aeY . en, � , 1§, C 9/6`f . a ' / , ,✓ c�.G l tom- j &Intl - -e Iota �z taxo - . eA gni �l� 9�- A 1 28418 APR-S-6 X00 348 0*****6.00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 9192E For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING /s-0 94/2y /trys • For Office Use Only ADDRESS / RECEIPT NO. 28'4ISO(] COSTA MESA• CALIFORNIA �LC(��A} I o ` R/ — RECEIVED ST �O(ATTX RECEIVEDREy9AATE II99UUE[y� OWNER..- Al 14s]e ,L/^2 et' "/ v 6!1 / J -Co MAIL / / A BUILDING MAIL s /(p 0 k e /�/yp �'L -/"7,V g' ADDRESS TEL ZON T ZONA TYPE GROUP v CITY •./n • NO. APPROVED �//'/ny S b01 'ITECT TEL BY / ✓ DATE IGINEERNO. ZONING ADDRESS //�� I �/ A ZONAE No.OF USX OF HEN {5jt. • C91IC. CONTRACTOR L._V S`�-j71^', ere / t4�, (� , PLANS Z BUILDING r$Lk• �k� �j LESCR Lo I 7-444A- Sleo ADDRESS /.5 7 o A 9 d 4 U DEcnlmon J fI ^c-{/I� r I _ice - 3 �V CITY / P" '4 4 c-L ' O A.P.NO. . - STATING./� ,/ 5-a NO., �r /2 'IC 80T TO SIDE B REAR P.L OVERHANG SHALL BE I P'v THAN VES SIZE NO.OF SLOGS. AAL I ALLOWED EA U.B.C.REQUIREMENT) OF LOT NOW ONI..OT YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. (FROM C/L STREET) n&CI I SnewcK LINE PROM FRONT FT. SPT. ',fri- t' CENTER OP STREET REAR YARD SIDE YARD) LEFT RIGHT R.SIDE FT. A PT. DESCRIPTION OF WORK 1.. .,SIDE FT. VA FST. e..-ii ALTERATION ADDITION REAR FT. PT. DISTANCE BET. BET.MAIN S MAIN BLDQS, ACCESS.BLOCS. REPAIR MOVING, •peMOLISH BUILDING NO.OF VAR•# DATE SIZE ROOMS /STORIES C.U.P.# '�} APPROVED EXTERIOR WALL I ROOF APPROVED w��j /- COVERING COVERING BY ' ' J:jr•A- DATE �- (J 'F I7 OF BXI,LD7(5e D�WORK TO BE PERFORMED/F.� .. '{ M /�-`7 /r [/ 5 C A-/J C O- 4/( C , N, /yf,'ii,Ft - S ‘ ' h9% ; 8G,.PT. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT PEE ONLY. .iAi PLY WITH ALL CITY ORDINANCES AND ET Ti LAWS REGULATING BUILDING CONSTRUCTION. (^ VALUATION/� ,...-------'• / •OO CO PERMIITTEF SIGNATURE O y'� ��V 4 ta/CSCC: $ �J�G' = PERMIT FEE $ ,... c. //,T- G CJJI PLAN CHECK $ �- ("G AUTHORIZED AnfA �" O0 ` TOTAL FEE $ ki OWNERMONTICELLO TOWNHOUSES DATE 3-6-70 JOB ADDRESS 150 Valley Forge Avenue BUILDING PERMIT NO. 31481 ' GENERAL CONTRACTOR Owner-Builder DESCRIPTION of WORK Block Trash Enclosure -s 1 '0. 141-701-03 LOT 1 TRACT 5160 FIRE ZONE VALUE $300.00 II. ECTIONSSignature Date GROUP J TYPE III ZONE R-3 SOIL SUBCONTRACTOR PERMITS ISSUED GAS Date Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. 0 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING ANO AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER n ROUGH WIRING Heating and Vent. TRENCHES FORMS ❑ STEEL REINF. iTI 3.-9-re FLOOR SYSTEM BOND BEAM ❑ STEEL REINFORCE 0 SHEATHING FRAME AND FLASHING LATHING — IN n OUT n PL ASTER, BROWN COAT __ S TURAL, FINAL Electric HE,.i ING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL cmi nu.c C1MM /nth 'A-at--7f) • 3I48I PAID MAR -6-700190 c''i*****5.00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200. COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECE V D B DATE RECEIVED DATE ISSUED BUADIDRESS /�Q - O V� [ t FQ 4 3-6-7'o /t,� PERMIT NO. OWNER///D/YT/C t L La Diu Adria as -c A.P. NO. I q( - 70/- '03 MAIL I/ /'' BUILDING ttt --,I ADDRESS /3 4 / jq..h_is �L /"O fQ it C ADDRESS V L.. z . J , ill 0 U CITYCn s .-Al2S 4 ext.;F.-.No. o-/0 TRACTS! hQ LOT BLOCK ZCONSTRUCTION NEW ADD ALTER REPAIR IMOVI G OFMOI MN OI- LENDER o. in ' • J BRANCH Z J/P � / J OWNER /✓1 M aADDRESS VALUE m _ m ARCHITECT TEL. USE $ -IC OR ENGINEER NO. U a FIRE Z W ADDRESS ZONE 7/7,/TTYYPE ,�/� GROUP JO CONTRACTOR 00/0 e--- tel BYPROVED / DATE 5....4-70 mZ J m ADDRESS JO tL w TEL. ZO E NO.OF USE OF NE O= CITY NO. �..3 PLANS -]/ BUILDING 4074-41- Z H WO STATE CITY YARDS APPROVED YARDS APPROVED N m LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING D 0 (FROM C/L STREET) SIZE NO.OF BLOGS. OF LOT NOW ON LOT RONT FT. 0 FT. USE OF EXISTING BLDG. R SIDE FT 5 FT. 1- SIZE OF NO.OF 2 NEW BLDG. ROOMS STORIES L.SIDE FT. CC-T. - - UEXTERIOR WALL ROOF COVERING COVERING REAR FT. S F . USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& 0- J7� /! MAIN BLDGS. ACCESS. BLDGS. VAR.* DATE O &tick `'v°7-/t f 7P2 fcif` C.U.P.4 APPROVED APPROVED Mil N r/{lCA-17C� —BY "`i""�� DATE A / ?0 Z 111 a U I hereby acknowledge that I have read this application and state D that the above information is correct end agree to comply with all laws regulating building construction, and I shall not employ fx 1- any person in violation of the workman's compensation laws of N the State of California. �. m zI hereby .• Jr-licensed• or= OWNER SAN VISTA BUILDING COMPANY DATE February 20, 1964 p\ JOB ADDRESS 150 Valley Forge Road BUILDING PERMIT NO. 21641 \GENERAL CONTRACTOR Fireside Construction Company' VALUE $ 17,000.00 AP No. LOT 1 TRACT 5160 FIRE ZONE 3 DESCRIPTION OF WORKB1ock Walls I SECTIONS Signature DATE- GROUP J TYPE III ZONE R3 Sou PERMITS ISSUED Gas — SUBCONTRACTOR DATE NUMBER Water Rough Com. Refrig. 0 Air Cond. i] Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line 0 House Con. 0 St. Swr. Q Sprinkling System Construction Pole Underground 0 Power 0 Rough Wiring Trenches 0 Forms ❑ Steel Reinf. ❑ - 3 - .,7/c, tIL Floor System Bond Beam 0 Steel Reinforce 0 _ Sheathing Frame and Flashing Lathing — In,Q Out 0 `-Viler, brown coat : ag. 0 Air Con. 0 Final Heating, Final • Plumbing Fixtures, Final Final Gas Test Elctric Building,FFinales, Final A-- 0 _ 3.0/4.v. Qoe' OCCUPANCY Form BU4-5M-3-63—S-B P 21641 • 21641 FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT FEB z o 1964 P.O.BOX 317 COSTA MESA,CALIFORNIA FINANCE DEPT. CITY OF COSTA MESA ' For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING #.71, /...572Valley /arye raj Office Use Only ADDRESS RECEIPT NO. ,PF..ITN COSTA MESA. CALIFORNIA �� (� � VISTA RECCE BY DATE ICEIVB DATE ISSUED OWNER c4N �/ISTA Q,1UILDIM&, co; � a-,o -4, r2 b MAIL I (! 1 r" f Q��T s^r• BUILDING v,,--z. 5 /� ' • , 41 FIRE ADDRESS lG/b�} A'G,. �{SJ C/ ADDRE38 ,K/f( SS CITY LDS L N(,cL-Gs TEL. NO. ZONE TYPE , GROUP " I APPROVED / Ar '•ITECT ._-. TEL. BY DATE C GINEER NO. ' ZONING ADDRESS SCA; NO.OF. USK OF NN KW /� CONTRACTOR F12ES I b e COtvS-r Co. %?- 3 I PLANS// BUILDING �'P�I �j /�� -}y LEGAL Tj( s/Co 71 ADDRESS Jc7&3 I I(0. ( "7 Le It DESCRIPTION , 1 CITY EL Mr,& IF f A.P.NO. STATE p �] TEL. I SOTTO SIDE 8 REAR E: NO EAVE P.LN6 SHALL BE LESS THAN LIC,NO. I Lq-�Z / NO. (• 3643 j EAVES SIZE �fp �1 T NO.of SLOGS. ALLOWED (U.B.C.REQUIREMENT) OF LOT ( 1�-N-L 1 NOW QN LOT YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. �iQi /� (FROM C/L STREET) ,G SETBACK LINE FROM of /!7(� Teri/uet 21)4-i F ,'1 / CENTER of STREETCjC ,'yam[/-.REAR YARD)r'A(Pr--- SIDE — RONT FT. ��,WJ�.�) FT, R.SIDE FT.n\� L�• FT, a SIDEYARDI LEFT I RIGHT • I 544 R.O <\DEESCRIPTION OF WORK L.SIDE Q�i-r. Fr. f I 7� ALTERATION ADDITIQN REAR ` FT FT. / \ AC DISTANCE BET. BET.MAIN B MAIN BLDGE. ACCESS.BLDGS. REPAIR MOVING - DEMOLISH BUILDING NO.OF VAR.# DATE SIZE ROOMS �� STORIES —�_ C.U.P.# a APPROVED EXTERIOR WALL �� I ROOF OOERINO BTPROV A'D DATE ��Q/ /1 COVERING """VVV"��/ N/®^ l USE OF BUILDING AND WORK TO BE PERFORMED �j V-- ! (-ocIc MALL S ----•.( ) /so '/ X O"(,,,-cam) 1, r eme /.3'1S'is•>4•to ! '/ (�f silo',) N I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATI•/ IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION i q BUILDING CONSTRD ION. I .�^ N SIGNATURE OF AIL d- #1,1711,47_,..-‘ / PERMIT FEE $ L� O PERMITTEP AIL"II .L/J/r�GF//L B O tie PLAN CHECK $ , .. 0 %� AUTHORIZED GENT / 57r TOTAL FEE $ • 20688 FEE RECEIVED • SCP 26193 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 317 COSTA MESA,CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING • For Office Use Only ADDRESS 150 Valley Forge Rd. RECEIPT NO. PF{�MIT COSTA MESA. CALIFORNIA _ pQ � RECEI VEqq BY OA RECEIVED DATE155UEp go OWNER San Vista Building Co. r6.. /Q-76 MAIL BUILDING ADDRESS 1166 FL 58th St. ADDRESS FIRE TEL. ZONE TYPE47 GROUP CITY Los Angeles 11 No.Ad37187 / / ARCHITECT T L APPROVEDBDATE 6 OR 'INEER Raymond Levana, ,Or37010 ,J // Newport NING ADDRESS 3432 Via Oporto, Beach _ rte• I NO.PLANE S n UDI OP NEW I2 �' , BUILDING IF CONTRACTOR San Vista Building Co. LEGAL 5160 ADDRESS 1166 E. 58th St. DESCRIPTION Tract t7O6c Lot 1 CITY Los Angeles 11 A.P.NO. IW-3v-3--j NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE 192782 TEL. Ad 37187 30'TO SIDE&REAR P.L. LIC,NO. NO. EAVES ' SIZE 218 x 218 I NO.OF BLDGS. O ALLOWED (U.B.C.REQUIREMENT) OF LOT NOW ON LOT YARDS APPROVED YARDS APPROVED USE OF None MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG, '' (FROM C/L STREET SETBACK FTSE FROM 6V, C1I$ /FRQNTy87FT. aA' mitt CENTER STREET (�'J REAR YARD SIDE MARDI LEFT 511 I RIGHT 511 .SIDE /J`IFT. FT. DESCRIPTION OF WORK kC.SIDEJJV Fr. II, I" 1- , " Fr. IP N X ALTERATION ADDITION TEAR O'' >L3 PT. FT. DISTANCE BET. BET.MAIN a REPAIR MOVING 1 DEMOLISH MAIN BLDOS. ACCESS.BLDGS. BUr5 toy X VAR.# DATE SIZE IDING L Sha ed ROOMS STORIES 1 C.U.P.#f'ryn) 1. APPROVED BraEXTERIOR WAuStu cg. I ROOF Shlnole APPROVEgy V.{I,.--_ n_/ Q—G2 COVERING JJ COVERING b BY ��-""""""???QQa///""""""""-11, DATE `7 a/ /, USE OF BUILDING AND WORK TO BE PERFORMED rt..' y Recreation BUIL-D1v� � W"` ;�y 1114• PACS Ouch _Tot DEP - A 'FA /Ku1F_ (U Q0 4 F2 OF N SOFT. COA/p61'I PF(Z INT " r. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION J THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATINGVALUATION q BUILDING CONST ON. SIGNATURE 0 AN VISTA BUILDING CO. PERMIT FEE S. 33 —; PERMITTEE c S James N. Starbird 5 y!, 302J--. PLAN CHECK S �' / O0 AUTHORIZED G T CJ q I`' TOTAL FEE S / / / So 21274 FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT JAN 3 1864 P.O.BOX 317 COSTA MESA.CALIFORNIA CATIaFINANCEn� DEPMT�.�� For Applicant to Fill In Completely APFCINc'OR'PERhtti' TYPE OR PRINT BUILDING /,l For Office Use Only BUILDING ADDRESS Ard C( tQ \ .,Q_i gd J RECEIPT NO. PERMIT NO. COSTA MESA. CALIFORNIA Oa/./R7 • /j �, �///// �/ RICE' D CY DATEyRECEIIVE'D, DATE ISSU OWNER 4.[-7/ /),--,7. /<- 7-..cad-ttr IL..e. - a -J- 1(/Y /-3_/a MAIL !!////��, // 4 U ADD ES$Q (/ yi // I ADDRESS -w�--lis.J�� TEL. FIRE CITY ft-1 n NO. AZONE TYPE / GROUP ( 4ITECT TEL. BB I NEER �(.t ( � iTELYPROVHD DATE ,IG /,ui / ZONING ADDRESS ZO NO.OF USEOFNs.Ew -3 I PLANS I BUILDING r CONTRACTOR (7.7•• i er 4- 1 // LEGAL Lar- / rer/c c ADDRESS / (,ei y//Vi42yi�Ln_rcw-yam DESCRIPTION CITY //V'.�7.G__.ti�� , / q / A.P.NO. LIC.NO. / �J 0i7( NO. ,f P If-6 S Gb 30'r TO SIDE @ REAR P.OVERHANGE: NO EAVE SHALL BE LESS THAN EAVES SIZE ' I NO.OP SLOGS. ALLOWED (U.B.C.REQUIREMENT) OF LOT 24- �^-mss NOW ON LOT = YARDS APPROVED YARDS APPROVED EXISTING BLDG.USE OF MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET) Z 1 -1- SETBACK LINE PROM FRONT FT. FT. CENTER OF STREET REAR YARD SIDE YARD LEFT I RIGHT R.SIDE FT. DEESSCCRRII a'N-OF WORK L.SIDE PT. / FT. I ALTERATION ADDITION REAR FT. a -(- FT. DISTANCE BET. BET.MAIN @ 2-/-(MAIN BLDGS. ACCESS.BLDGS. REPAIR MOVING DEMOLISH - BUILDING NO.OF VAR.}j DATE SIZE ROOMS STORIES C.U.P. APPROVEDEXTERIOR OOF COVERING WALL I ROVVERING APPROVE A,/) DATE //3`/v/ C/ La USE OF BUILDING AND WORK TO BE PERFORMED HOLD FOR YSPECIA REQUIREMENTS -,CYa €4,cdor44 o I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VA UATION IS FOR THE 5 AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION �[/� m BUILDING CONSTR CTION. PERMIT FEE .� f/1 7 64 j SIGNATURE O �,, ,✓ PERMITTEE i � 1 !.�----"-en "� m II ' _� PLAN CHECK $ /� V _ o AUTHORIZED AGENT /.• w _ Si((///G"T77/ $ , '0. Vl I. TOTAL FEE /�' ,/0 APpllcam-wtrialn all spaces except those within heavy border lines and sign all_„propriate declarations. CITY OF COSTA MESA PE MIT NO. TRACT N . LOT NO. BLDG.NO. SC I qCONSTRUCTION PERMIT — 9 ?Sc' �� 322-326 28 Project Address 1 So 17a11 Py Worry, rn qi-a Mega_ TYPE OF CONSTRUCTION LI NEW ❑ ADD U ALTERATION U REPAIR , • - Applicant's Mailing Address acme 0 CONVERSION 0 DEMOLISH OTHER RPrnof—C'1 A S "A" A P 4 • `Zone 1 In C nmm Assn Phone DESCRIPTION OF WORK e ' r. . • n • _ e a - Owner's Nart�OI1t1CP - • S Main Building: Accessory Building: z Address SameROOPa.Ii E 0 TYPE OF PERMIT 0 GRADING LJ FOUNDATION 0 STRUCTURAL T Front N Arch/Eng. License No. 0 TENANT ELECT CAL 0 PLUMBING 0 MECHANICAL B I Address )C OTHER erecting A Rear N Contractor's Nam hone974--3070 PROJECT DESCRIPTION SQ. FT. 4000 OCCUPANCY R-1 C Right G R n Cq E CON ST RUCTION TYPE S—N VALUATION S Left - Address(mailing) 2187 N. Dat=,.-:e-a -Orange-907- -L-oma ZONE GRADING CU.YDS. ACRES Ping'. Ref.# Park. Q City License No. 02608-5 . U LICENSED CONTRACTORttiamlicensed DECLARATION ION Remarks: Parking Rep./Provided I hereby affirm that I am sion3 under provisions of Charter 9 (commencing R with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: E my license is in pill IQ a and effect, • - - --- License Class —•v ns0 9 59 PLUMBING FEES Planning Notes: M " Date 11-1R—R3 Signature • A ' `RKERS'COMPENSATION DECLARATION Bar Sink ShowersT N reby affirm that I have a certificate of consent to self-Insure or a certificate Backflow Preventer Service Sink S Workers' Compensation insurance, or a certified copy'thereof-(Section PoPolicy Lab. ' WP 82 1504Ap Tre� Indemnity _Backflow Irrigation Sewer Cap ELECTRICAL FEES 0No. pan -- ' - Ii•��I,Certified copy is hereby furnished. Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW `1L 1�S Is filed with the city 7 is ❑ 50+KW D Applicant ^ "'! ���{GGGGGG S/// Clarifiers Solar Collectors Construction Pole Sub. EXEMPTION FROM WORKERS'COMPENSA ION DECLARATION • Dishwasher Solar Piping (This section need not be completed If the permit is for one hundred($100)or __ 9 Cooking Unit Meter Oup to 100 amps less). I certify that In the performance of the work for which this permit is issued, I Drinking Fountains Solar Tank Dishwasher Meter Dover 100 amps snail not employ any person In any manner so as to become subject to te Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel Date Signature NOTICE:If,'after making this doclaratlOn, you should become subject to the Floor Sinks Urinal Fen Workers' Compensation provisions of the Labor Code, you must forthwith Motors 00-1 HP ❑1X-8 comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets Water Closet F.A.U. Inc.Solar 09.15 HP 016-15+ CONSTRUCTION LENDING AGENCY , • I hereby affirm that there Is a construction lending agency for the performance Interceptors Water Heater Fixtures of the work for which this permit is Issued (Section 3097 Civ. C.) Microwave Lender's Name Kitchen Sink Water Service Device Boxes Pole Light Lender's Address - _ OWNER BUILDER DECLARATION Lavatories Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the p—Tra following reason (Section 7031.5 Business and Professional Code: Any city or p Switches Sign 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 to file a signed statement that he/she Is licensed pursuant to the provisions of a Contractor's License Law(Chapter 9 (commencing with Section 7000)of 'sion 3 of the Business and Professions Code) or that he/she is exempt Generator 00-5 KW 05-15 KW Trash Compactor t ofrom and the basis for the alleged exemption. Any violation of Section J1.5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee penalty of not more than five hundred dollars($500). pe $25 Issue Fee $ 3 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. I/ however, the building or Improvement is sold within one year of com- Duct-Under Ground Application Approved By - Date pletlon, the owner will have the burden of proving he/she did not build or im- . strove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By .0r al ! Date///1/83 LJ I,as owner of the property, am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY 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 $ t'r)O SMIP $ re) tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ ISSUANCE $ Date • Owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00.100,000 BTU ❑100,000BTLGRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL ' $ ' and state laws relating to building constru, •n,an. hereby authorize repre- MICROFILM $ sentatives of this city to enter upon -b. pe ••ned property for PLAN CHECK $ inspection pur•Oses. -•�wwafe' rO,fMECHANICAL $ TOTAL FEE $ 4149/SC) Signature `•alaiR—RZ Drivers' License or 55 • Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 White- BuilOing;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - ' ' CONSTRUCTION AND PLANNING . - - PO( SPA APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspector ?. Temporary Electrical Service or Poly 52. Pool & Equipment Location. W 2. Soil Pipe_Undrgrnd. '1 I ' - 53. Steel Reinforcement p a 3.' IectrAakonduityUti(ili-Undrgald1`t . C 54. Forms • I.? 4. 'Electrical Conduit4Undrgrnd. • • 55. Electrical Bonding - �' f1. 5.;Sfee) Reinforcement ; 'u a oughi 56. RPlumbing & PressureTest •'i 6: tElrical OF ER &rid. - i 57. APPROVAL TO COVER-GUNITE w Ect 7. 'footings C -) - x ' . 58. Electrical Conduit-Undrgrnd. 8. FY oundption j .y n. 59. Gas Pipe, ❑ Undrgrnd.,Test .,1 • .• v .. .. , H 9. Wate pipe-Und rgtnd.' r.N • 60., Backwash Lines, P-Trap, 0 Undrgrnd. ..4 10. Structural Floor System • C 61 ..APPROVAL TO DECK c, .., 11. Property Sewer•Line & House Cdgnnection H 62. Backwash & Receptor-Final H 12. SewertapUI iq - 63: Heater &Vent-Final 7 ..r m M 13. �?oofLOraPns �� "v ' 64. Plumbing System - Final •� 14. Rough Plumbing E.,'. ,u I, '65: Electrical-Final - w r- V 15. Rough Electrical-Conduit - 66. Solar System-Final 16. Rough ElectribWiring . "67. Fencing & Access Approval 17. Rough Wiring Sign • 68. APPROVED-FOR PLASTERING ' 18. Rough Electrithl-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factorgg Fireplace APPROVALS ' Permit# 21. Ducts,in Structure 70. Underground Hydro .22. Ducts, Vventilting L 71. Product Piping 0 Gas 0 Oil 2q,Gas Pjpe Rough&±fest ' 72. Underground Flush 4 . i 24. Roof Framing a o73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof;$heathing • ' 74. Overhead Hydro 26. T-Bar'Ceiling (Structural) & Monocoat 75. Dry Chemical -I � .ts Fran- and Flashing 76. Dry Standpipe C _- 28. LaPhi�g & Siding • 77. FIXED SYSTEM FINAL n m . r 29. Insulation - 78. FIRE PREV. FINAL ! 30. Drav`all Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Powerj9eter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning . 35. Final Gas Pipe-Test 36. Hood or Canopy . 37. Final Factory Fireplace 38. Final Plumbing . 39. Water Service-Final 40. des Service-Final , 41. Solar Domestic-Final .- • 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System ' 45. Sound Attenuation ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed + 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. ' ' Date / Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. \.yD CITY OF COSTA MESA - PE MIT NO. .' TRACT NO. • LOT NO. BLDG.NO. - - `( CO JSTRUCTION PERMIT 29 �, a-7— � 9 9E'_2 I /':' , 9 7c's— 516 0 c E. Project Addressl SO Valley r Orge f .Costa Mesa , . TYPE OF CONSTRUCTION ❑ NEWH1 ADD LJ ALTERATION H REPAIR Applicant's Mailing Address same - El CONVERSION El DEMOLISH 0 OTHERRerOOf Cl ass RA" A.P.# l Zone Owner's Name Monticello C flint ASStphoni 4n-1 ny DESCRIPTION OF WORK Pi hergla ss, Comp, Asphalt S Main Building: Accessory Building: Z Address same - �' • ' E - - 0 TYPE OF PERMIT II GRADING S FOUNDATION U STRUCTURAL T Front N Arch/Eng. License No. - CI TENANT CI ELECTRICAL ❑ PLUMBING CI MECHANICAL BRear N Address ® ' OTHER Reroofing B , . Contractor's Name SartMari nn Pnf PhonB74-3070 • PROJECT DESCRIPTION SQ. FT. 9400 OCCUPANCY R 1 K CRight G n Address I mailing) • 5. _ • - • _ . CON ST RUCTION TYPE 5-N VALUATION$ 65n0 S Left, E 026085 ZONE GRADING CU.YDS. ACRES Ping. Ref.# - Park.Fees $ O • City License No. U LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided I 1 hereby affirm that I am licensed under provisions of Charter 9(commencing R with section 7000) of Division 3 of the Business an Professions Code,and Use of Building: E my license is in to Il loge and effect. - Licen las;Ts�L: .•ll Li tse ND. 55� PLUMBING FEES Planning Notes: M Date -I I—oa Signature �— E ORKERS' COMPENSATION DECLARATION Bar Sink Showers _ N `t.: - • T ,`hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink S `''of Workers' Compensation Insurance, or a.certified copy thereof (Section - 3800, Lab. C.) - Backflow Irrigation Sewer Cap - ELECTRICAL FEES Policy No. t!JP 82 150458 Compan - iCertified copy is hereby furnished, f ,7 1 • y Bathtubs Sewer Connection Automatic Waiher Transformer ❑ 15-50 KW jC�rtii conk filed with the city g i Isl.). Dalel—'yt3C3 Applicant /� Clarifiers Solar Collectors Construction Pole Sub. X50+KW • EXEMPTION FROM WORKERS'COMPENSAT 6N.DECLARATION Dishwasher (This section need not be completed if the permit is for one hundred($100)or Solar Piping - Cooking Unit Meter ❑up to 100 amps - ' less). - - , I certify that In the performance of the work 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/SpaDryers ❑Gas ❑Electric Sub Panel Date Signature ' NOTICE:If,'after making this declaration,you should become subject to the Floor Sinks Urinal - Fan Motors❑O-1 HP 01%-B . 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. Inc.Solar 09-15 HP 016-15+ CONSTRUCTION LENDING,AGENCY - - • I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater • Fixtures Microwave of the work for which this permit is issued (Section,3097 Civ. C.) - - _ Lender's Name Kitchen Sink Water Service Device Boxes Pole Light Lender's Address OWNER BUILDER DECLARATION Lavatories Outlets Range • I hereby affirm that I am exempt from the Contractor's License Law for the P—Trap reason (Section 7031.5 Business and Professional Code: Any city or p - Switches Sign 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 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 - Generator ❑05 KW ❑5-15 KW Division 3 of the Business and Professions Code) or that he/she.is exempt Trash Compactor - therefrom and the basis for.the alleged exemption. Any violation of Section - - 7031.5 by any applicant for a permit subjects the_applicantto a civil eenalty of not more than five hundred dollars($500). - Reinspection Fee $25 Issue Fee $ 3 , 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 MECHANICALFEES for sale (Section 7044, Business and Professional Code:, The Contractor's -- - - - - -' - - I`r PUBLIC SERVICES REQUIREMENTS: License Law does not apply to an owner of a property who builds or Improves • . Boiler . ' Hood or Type I , ❑ I T thereon, and who does such work-himself/herself or through his or her own I I Zoning Approved By Date employees, provided that such improvements are not intended or offered for Canopy Type II, ❑ • sale. If, however, the building or improvement Is sold within one year of com- Duct-Under Ground Application Approved By Date pletion, the owner,will have the burden of proving he/she did not build or im- �rove for the purpose of sale). Duct-Structural ~—Refrigeration System Application Issued By at f Date /7/9-2—/AaL 0 I, as owner of the property, am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY 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 ❑ Multiple ❑ System Repair/Alteration BUI LDING PERMIT $ 9410"0 SMIP $ 'CO tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason • Firepl/Fact.Bit. ICBO'#• PLUMBING $ ISSUANCE $ Date owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above , ❑o-100,000 BTU ❑100,000 BTU GRADING $ information'is correct. I agree-to comply with all city and county ordinances - ELECTRICAL $ and state laws relating to building construction,and hereby authorize repre- PLAN CHECK $ MICROFILM $ sentatives of this city to'enter upon t abov a tioned property for Inspection p oses y 'J Signature a J. Reilly - /`JDatel 1-1 R—R3 — MECHANICAL ' $ TOTAL FEE $ 9`�"S`D Drivers' License or SS 4 Reinspection Fee $25 Issue Fee ' $ 3 PLAN CHECK $ • CMF-0865-46 rev. 7/83 White-Building; Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - - - - - CONSTRUCTION AND PLANNING- - . :< - _ PO.._ &SPA - - • - Date`"1 ' Inspector Date Inspector \b• APPROVALS_APPROVALS_ :Permit# - '"I . • APPROVALS Permit# I .LI • --1. Temporary Electrical Service or Pole{ . -oa ' _ 52. Pool & Equipment Location - - 1 2...Soil Pipe,JUndrgrnd. - _ n 'j 1.4 53. Steel Reinforcement 3.'Electrlca'Conduit t4li5y-Undrg' d9 '- u , - 54. Forms - 4:hElectrcal ConduiaJDdrg nd.. - iu - 55: Electrical Bonding I;, .t5!-Steel'-Reinforcem pf� ru . • - rt ` � 56. Rough' Plumbing & Pressure Test -~ m �' ti- - - y - 6.'Electr0ical UF ER �rnd. - co. ,. i 57. APPROVAL TO COVER-GUNITE 7.rCFootings , : n a. ' - - 58. .Electrical Conduit-Undrgrnd. 2, 8. foundation .. yM °' 59:"Gas Pipe, 0 Undrgrnd., Test ,,-i 9. Water-Pipe-UndrgMd' i 0 • :60. Backwash Lines, P-Trap, 0 Undrgrnd. 10.�Structural Floor System 5 • 61. APPROVAL TO DECK - 11:*operty Sewer Line'& House Coy ection• H • - . . - - 62. Backwash & Receptor-Final _ ,ice 12. e''ver;Cap 4 'g ru ' ,a - 63. Heater & Vent-Final ' 1 a, `l _ .1 -.. . y 13.uRoof Drains oro 4 64. Plumbing System - Final - co 14: Roug Plumbing �; yi • -65. Electrical-Final . . . - o� 15. Rough Electrical:Conduit' 1 - r .- - . 66. Solar System-Final - 16. Rough Electric Wiring ; r- - ;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 . • ARE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS ' Permit# 21. Ducts,in Structure 70. Underground Hydro 0 22. Ductsi, l entila{ing .v I 71. Product Piping 0 Gas 0 Oil 23. Gas'PipERough&Test . ; . 72. Underground Flush 24. RdbfaFrn ing o 73. Undergrnd.Storage 0 Gas 0 Oil • 25. RooffSheathing 74. Overhead Hydro . 26. T Ba'r..Ceiling (Structural) & Monocoat - 75. Dry Chemical .2.7. Ftamn and Flashing - 76. Dry Standpipe 28. Lthag & Siding • 77. FIXED SYSTEM FINAL . 29. Iri3ulation 78. FIRE PREY. FINAL _ tir' - -30. Dhywaall Nailing ' • HEALTH DEPT. REQUIREMENT i. 1. Plaster Brown Coat) 79. FINAL INSPECTION ' 32. Etetincal Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric � I Notes: 34. Final Heating & Air Conditioning • 35. Final Gas Pipe-Test ' ' , r • • 36. Hood or Canopy ' - . ' 1 , 37. Final Factory Fireplace ' ' 38. Final Plumbing . ' ' p 39. Water Service-Final ' 40. Gas Service-Final 1 41. Solar Domestic-Final . , ' _ _ _ - - 42. Backflow Prevent?' - 43. Backflow Irrigation • - ; ' i • 44. ,Landscape Irrigation System , 45. Sound Attenuation ' ' - 46. Handicap Regulations ' , - • 47. FINAL STRUCTURE & BUILDING - ' 48. Special Requirements Completed • I , 49. Electric Release to Edison - - - -- - ' 50. Gas Release to Southern California,Gas Co . . • 51. CERTIFICATE OF OCCUPANCY - _ _ No. - Date • < fO Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. V CITY OF COSTA MESA • PEWIT NO. TRACT N9. LOT NO. LB NO. - -• 9c_1 , I. CONSTRUCTION PERMIT 1 - 9 7S C 5160 214' -218 40 ,. .•PrCiact Address lc() Valley Forgc , Coatn 'MLJ'Mesa TYPE OF CONSTRUCTION NEW '11❑ 'T ADD LJ ALTERATION LJ REPAIR Applicant's Mailing Address Ba18C DI �� CONVERSION ❑ DEMOLISH yp OTHER R —of C1 sss_"An A.P.# - 1 Zone Owner's Name MOnticello Comm Asan Phone 540-1097 DESCRIPTION OF WORK Fihergi aea, Comp Aapbal* S Main Building: Accessory Building: Z Address SameRoof E O TYPE OF PERMIT El GRADING LJ FOUNDATION NDATION ❑ STRUCTURAL T Front N • Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B I A Rear N Address ® OTHER ' Reroofing Roof CCLPhone974-30-70C Right • G • Contractor's Name San Mari nn PROJECT DESCRIPTION SQ. FT. 71DU OCCUPANCY $-1 R CONSTRUCTION TYPE S-N VALUATION$ E 00 S Left Address(mailing/2187 N Batavia, Orange 92665 E City,License No. 026085 • ZONE GRADING CU.YDS. ACRES Ping. Ref. # Park.Fees $ u LICENSED CONTRACTOR DECLARATION Remarks: I Parking Req./Provided 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing . _ R with section 7000) of Division 3 of the Business and P ofesslons Code, and Use of Building: F my license is in fu fo gsantl effect. _ License Class7 �Licen No. 9 S Planning Notes: M PLUMBING FEES E 'late 11-18-$3 Signature 1 "'-T / , ' N . ORKERS'COMPENSATION DECLARATION Bar Sink Showers . hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink , S of Workers' Compensation Insurance, or a certified copy thereof (Section- - 3800, Lab. 4)... 82 15045{ Fremont Indemnit Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. YYi' `company , ❑ Certifietl copy is hereby furnished _ Bathtubs Sewer Connection . Automatic Washer Transformer 0 15-50 KW Ce astl i¢tl ppy lewith the cit g Div si 50+ KW ' i Date -I"- Applicant- 1:1Clarifiers Solar Collectors Construction PoleSub. . . • I r ' • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher " -Solar Piping- Cooking Unit - ` Meter ❑up to 100 amps (Thissection need not be completed if the permit is for one hundred ($100)or ' less). - I I certify that.in the performance of the work for which this permit is issued I Solar Tank Dishwasher Meter Dover 100 amps , shall not employ any person in any manner so as to become subject to theDrinkin Fountains Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers ❑Gas DElectric Sub Panel . Date Signature - - ' NOTICE:If;after making this declaration, you should become subject to the Floor Sinks Urinal • Fan Motors 00.1 HP 01%-B 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. Inc.Solar 09-15 HP 016-15+ CONSTRUCTION, LENDING AGENCY - - I hereby affirm that there isa construction lending agency for the performance . Interceptors Water Heater Fixtures , Microwave of the work for which this permit -is issued- (Section 3097 Civ. C.) - Lender's Name - Kitchen Sink Water Service • Device Boxes Pole Light • Lender's Address - Lavatories OWNER BUILDER DECLARATION Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the P-Trap reason (Section 7031.5 Business and Professional Code: Any city or p - Switches Sign 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 to file a signed statement that.he/she is licensed pursuant to the provisions of Garbage Disposal Standing Sections :he Contractor's License Law(Chapter 9(commencing with Section 7000)of • Generator ❑0.5 KW ❑5-15 KW Division 3 of the Business and Professions Code).or that he/she Is exempt - , Trash Compactor 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 Reinspection Fee 3 1(_enalty of not more than five hundred dollars($500). pe $25 Issue Fee $' LJ I, as owner of the property or my employees with wages as their soleReinspection Fee $25 Issue Fee $'3 Icompensation, 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 0 sale. If, however, the building or improvement is sold within one year of corn- Duct-Under Ground Application Approved By Date ',lotion,the owner will have the burden of proving he/she did not build or Im- rove for the purpose of sale). Duct-Structural Refrigeration System • Application Issued By Ar A' '# • Date�y rXs"/ 0 I, as owner of the property,am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU • tractors to construct the project (Section 7044, Business and Professions Code: Duct-Ventilating SUMMARY OF FEES The Contractor's License Law.does.not apply to an owner of property who - - +f builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ ` 1'/20 SMIP $ , .577 tractor(s) license pursuant to the Contractor's License Law). • PLAN CHECK $ PERMIT 0 l am exempt under Section B.& P.C.for this reason • Firepl/Fact.Bit. ICBG# PLUMBING $ ISSUANCE $ Date - Owner Heating System& Ducting ' . PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL GRADING $ information Is correct. I agree to-comply with all city and county ordinances ELECTRICAL $ and state laws relating to building co truction, . d hereby authorize repre- MICROFILM $ sentatives of this city to enter u•i,to the a••• m:,.tioned property for • 1 - PLAN CHECK $ inspectigp purpyses. SignaturL. J.' R'1 J- - Date 11-18-91 MECHANICAL $ TOTAL FEE $ �� 'S Drivers' License or SS* • , • Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ a CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor a ..' - P(,,. &SPA . CQNSTRUCTION AND PLANNING ,i)..'1 " ' • - - - Date, Inspector' - Date Inspector APPROVALS Permit# - ti ,� APPROVALS Permit#_ • 1. Temporary Electrical Service or PoId I 52. Pool & Equipment Location - ti H 2. Soil Pige-Undrgrnd. j -. j 53. Steel Reinforcement I ^ -- - ' '3. Electrical Conduit J i1ity-Undrgrhd:i -''*J ' _ 54. Forms- '4. Electrical ConduitEUndrgtnd. - y . . 55..Electrical Bonding - -y u • r, _ a, y 5. 'Steel R?fiforcemept ' x. - - 2 =n . - 56...Rough Plumbing & Pressure Test ' ;>+• _ u r:: 4 „ n1 -; N • n1 t 6. �leLricaF'UFER 6rnd. ro 57.-APPROVAL TO COVER-GUNITE 7. Fn'ootings� x j , ' . , 58.- Electrical Conduit-Undrgrnd. • - sti :. 8: FgundaLon 0 .w -- ? ..59.,Gas Pipe, 0 Undrgrnd.,TestOf 9. Water Pipe-Undrgr�d - 60.' Backwash Lines, P-Trap, ❑ Undrgrnd. 44. CA 10. • SructuralFloor Systeepi a 61._APPROVAL.TODECK 11. Rnoperty Sewer Line& House Cdr ection -h -• - 62._Backwash & Receptor-Final ut 12. Sewer ap L • N tl - . 63. Heater & Vent-Final - `"1 ^ 1 13: Rbof Drains , w 10 of - 64. Plumbing System - Final 14. Rough�lumbing - r.+ - •y 65. Electrical-Final r, l 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 Ceilirig 69:POOL'/SPA SYSTEMS FINAL . 19. Rough Heating &-Air Conditioning , , FIRE DEPT. REQUIREMENT , 20. Rough Factors Fireplace - - , ; APPROVALS Permit# •21. Ducts, in Structure 70. Underground Hydro . 282. Ducts 16'entila g y- ; • 71. Product Piping 0 Gas 0 Oil •n . - . . - - . -- 2 . Gas ?ip@OjRough.4 Test 72. Underground Flush 7 -moi • _ 24. Roof Framing `' , , 1 , 73. Undergrnd.Storage Tank 0 Gas 0 Oil .y 1-u. 25. RoofiSheathing - 74. Overhead Hydro -26. T-Bar'Ceiling (Structural) & Monocoat : ' 75. Dry Chemical 27', Frarrq and Flashing • - - 76. Dry Standpipe ^28. Lathing & Siding t ' , 77. FIXED SYSTEM FINAL , _ 29. Insulation • 78. FIRE PREV. FINAL 3Q. Dr taall Nailing -`. HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat` 79. FINAL INSPECTION 32. Elect`iical Power Deter-Final 80. FOOD CERTIFICATE ISSUED -1 1 • ca3. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test • 36. Hood or Canopy ' 37. Final Factory Fireplace _ - 38. Final Plumbing - 39. Water Service-Final • - - • ' 40. Gas Service:Final 41. Solar Domestic-Final , 42. Backflow Preventer ' I • - 43. Backflow Irrigation , • . 44. Landscape Irrigation System , 45. Sound Attenuation i I I1 ,. ' I- • ' , 46. Handicap Regulations ' 1 - - •• i 47. FINAL STRUCTURE & BUILDING , ' 48. Special Requirements Completed i • 49. Electric,Release to Edison • ' - -- - - - -• - .1 . 50. Gas Release to•Southern California,Gas Co • 51. CERTIFICATE OF OCCUPANCY . I " _. ' _ - ' No. - ' Date - , ,\ ll Applicant nt to fill in all spaces except those within heavy border lines and sign all appropriate declarations. i50_69 IC/� I_ . : - n c1 CITY OF COSTA MESA • ‘ PE MIT NO. TRACT NO. LOT NO. BLDG.NO. CONSTRUCTION PERMIT • A - 9 8 a 7 5160 101-108 5 Project Address 150 Valley Forge . •Costa Mesa TYPE OF CONSTRUCTION LI NEW LI ADD U ALTERATION U REPAIR Applicant's Mailing Address Same E CONVERSION ❑ DEMOLISH al.J OTHER Reroof Class "An ".## I Zone Owner's Name Mo' t1 CamJk 110 Com 4SA Phone 5dO-lel f197 DESCRIPTION OF WORK w.•.cr �•yy _ c - o f s S Main Building: Accessory Building: Z Address save TYPE OF PERMIT U GRADING LJ1'OUNDATION U STRUCTURAL E Front N Arch/Eng. License No. r❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Address LT OTHER Reroofing A Rear N Contractor's Name Can mar inn Doo f ..CPhone4. 3070 PROJECT DESCRIPTION SQ. FT. 5900 OCCUPANCY R-1 C Right G Address(mailing) 2187 N. Batavia, Orange 92665 • CONSTRUCTION TYPE 5-N VALUATION$ 6500 S Left E ZONE GRADING CU.YDS. ACRES Ping. Ref. Park.Fees $ Q City License No. 026085 - LICENSED CONTRACTOR DECLARATION U Remarks: Parking Req./Provided I I hereby affirm 7 that I am licensedion under provisionsBusnProfessions i (commencing R with section 7000) of Division 3 of the Business and Professions Cotle, and Use of Building: E my license is in full rQr a and effect. License Class _____ IC: `-------- LIc e ry 2 PLUMBING FEES Planning Notes: M E Date 11 8.,,aR-R'2 Signature Bar Sink Showers 41 'ORKERS'COMPENSATION DECLARATION N hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink T of Workers' Compensation Insurance, or a certified copy thereof (Section - - S 3800, Lab. C.) Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. WP 82 15045,Tnpany Fremont Indemnity _ ' , Certified copy is hereby furnished. Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW Certifien coaxis filed with the city 9 Nisi Clarifiers 0 50+KW - - - Date 1 1- 1R-23 Applicant /-T • I-Cnif Solar Collectors Construction Pole Sub. EXEMPTION FROM WORKERS'COMPENSAT ION.DECLARATION Dishwasher Solar Piping (This section need not be completed if the permit Is for one hundred ($100)or P 9 Cooking Unit Meter pup to 100 amps- less) I certify that in the performance of the work 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 ❑Electric Sub Panel • Date Signature -- — - • NOTICE:lf,'after making this declaration,you should become subject to the Floor Sinks • Urinal Fan Motors 00-1 HP 0'f.-B 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. Inc.Solar 09-15 HP 016-15+ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures :Microwave of the work for which this permit is issued (Section 3097 Civ. C.) • Lender's Name Kitchen Sink - - Water Service Device Boxes Pole Light Lender's Address - OWNER BUILDER DECLARATION Lavatories • • Outlets Range I hereby affirm that 1 am exempt from the Contractor's License Law for the • P-Trap reason (Section 7031.5 Business and Professional Code: Any city or p , Switches Sign 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 . . GarbageDispo• sal to file a signed statement'that he/she is licensed pursuant to the provisions of P Standing Sections 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 Generator 00.5 KW 05.15 KW Trash Compactor • therefrom and the basis forthealleged 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). Reinspection Fee $25 Issue Fee $ 3 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 ❑ thereon, and who does such work himself/herself or through his or her own Zoning Approved By nate employees, provided that such improvements are not intended or offered for Canopy Type II ❑ sale, If, however, the building or improvement is sold within one year of com- Duct-Under Ground Application Approved By _ Date 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 System Application Issued By ! Date/�/7/ g3 LJ I, as owner of the property,am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU tractors to construct the project(Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES _ The Contractor's License Law does not apply to an owner of property who ❑ Multiple ❑ System Repair/Alteration builds or improves thereon,and who contracts for such projects with a con- Exhaust System BUILDING PERMIT $ S&'ro SMIP $ r.5 42 Pectoris) license pursuant to the Contractor's License Law). - PLAN CHECK $ PERMIT D 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# • PLUMBING $ ISSUANCE $ Date owner • Heating System&Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑0.100,000 BTU ❑100,000BT GRADING $ information Is correct. I agree to comply with all city-and county ordinances ELECTRICAL $ and-state laws relating to building constr Ion, Yeby authorize repro- MICROFILM $ sentatives of this.cityto enter upon aioned propertyfor PLAN CHECK $ _ inspection purposes. P / _ . Signature T. J. Reil Date 11-18-83 MECHANICAL $ TOTAL FEE $ • ��'SQ Drivers' License or SS# Reinspection Fee I $25 Issue Fee $ 3 PLAN CHECK $ S. CMF 0865-46 rev. 7/83 White-Building;Canary Accounting;Goldenrod- - - Assessor - ' c1 • CONSTRUCTION AND PLANNING X • - POt.._&SPA ..,APPROVALS Permit# • Date _ Inspector APPROVALS Permit# Date Inspector 11 •t1. Temporary Electrical Service or Pole! ,1 52. Pool & Equipment Location ' I 2. Soil Pipe-Undrgrnd. • ,1 ,i 53. Steel Reinforcement - y -.r r u - C 3..ElectricaluConduit tJtilityrUndrgr..ratha '- I' ' 54. Forms - 0 +. .,� ., r ,.� - - ;4.,Fflectr a bond u it runcdind. : • N w 55. Electrical Bonding • 5.�teel Rmlt� einforcem : - it) - : 56. 'Rough Plumbing & Pressure Test •4 1--I ^ !..4 --, - N-, 6.: lectrl:Cal UF ER 6fn-g. , ''� , 57. APPROVAL TO COVER-GUNITE • 0.1. i7tFootlgs q 58.1Electrical Conduit-Undrgrnd. ..-I, 8.?foundation � 'W- 59. Gas Pipe, 0 Undrgrnd.,Test w 9.INJater�(Ripe-Undrgmd.- }-1 - 60.-Backwash Lines, P-Trap, 0 Undrgrnd. to ,.i f- - i 10.structural Floor Systevn • O. 61. APPROVAL TO DECK 11.44roperty Sewer Line &,House Coopection 4.2! . 62. Backwash & Receptor-Final in m ..i :-I 12.,$ewer-Cap t-- U 6-I c, ea, a 63. Heater & Vent-Final I 13.ifdoof grains r j '"..0" u ti 64.'Plumbing System - Final- a sin 14. RougfJPlumbing lc; 'u0-1-. • 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 FactorylFireplace APPROVALS Permit# . *1 - 21. Ducts, in Strugure ' 70. Underground Hydro . .22. Duct4V2ntilating 2 - 71. Product Piping 0 Gas ❑Oil ,f3. Gas Pgrypk�Rough'&Rest 72. Underground Flush 24. Roof--Framing ? I 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. RoofItheathing 74. Overhead Hydro 26. T-Barreeiling (Structural) & Monocoat 75. Dry Chemical .•,7. ,F`1m�and Flashing 76. Dry,Standpipe 28. L thing & Siding i 77. FIXED SYSTEM FINAL 29. Insulation •• ' 78. FIRE PREY. FINAL l - 30. Dr,wn uall Nailing '' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coats 79. FINAL INSPECTION 32. Electrical Power Meter-Final- - , 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: • 34. Final Heating &Air Conditioning i , 35. Final Gas Pipe-Test ' • . ' . - - 36. Hood or Canopy - . - 37. Final Factory Fireplace . 38. Final Plumbing . i 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation , - 44. .Landscepe Irrigation System • , 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING - ' 48. Special Requirements Completed 49. Eleciric Release to Edison - I •- - 50. Gas Release to Southern California Gas Co • • . 51. CERTIFICATE OF OCCUPANCY' . -- No. ' Date SDApplicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. out CITY Or. •`')TA MESA PERMIT- NO. TRACT NO. LOT NO. BLDG.NO. 0 EE I c/l . / i CONST TION PERMIT i s - 98z/ 8' 5160 93-100 6 e Project Addr 150 Valley FnrgP rnCt-a Mesa TYPE OF CONSTRUCTION Li NEW U ADD U ALTERATION U REPAIR Applicant's Mailing Address Same ❑ CONVERSION ❑ DEMOLISH O OTHER Reroof-Class "A" A.P.# I Zone Owner's Name [`P COIBID hone DESCRIPTION OF WORK • •- • - • u• _ • • - MAIlt AE:sn-P 590-1097 S Main Building: Accessory Building: Z ROOF(}vpg E 0 Address sante TYPE OF PERMIT U GRADING Liu FOUNDATION U STRUCTURAL T FrontN Arch/Eng. License NO. 0 TENANT ElELECTRICAL ElPLUMBING 0 MECHANICAL B Rear - I Address .® OTHER Reroofing A • N Contractor's Name San Marino Roof Co shone 974 3070 PROJECT DESCRIPTION SQ. FT. 48.00 OCCUPANCY R-1 C Right K 0 R Address(mailing) 2187 N. Batavia, Orange 92665 CONSTRUCTIONTVPF 5-N VALUATIONS 6500 S Left E City License No. 026085 ZONE GRADING CU.YDS. ACRES Ping. Ref.'1'k Park.Fees $ U LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided I I hereby affirm that I am licensed under provisions of Charter 9(commencing R with section 7000) of Division 3 of the Business and Professions Code,and Use of Building: • E. my license is In full force and effect. License Class - Lk se NSS PLUMBING [ FEES Planning Notes: E Date t o—o3Signature • 1..2-21 E3�:5N IORKERS'COMPENSATION DECLARATION Bar Sink Showers T ,hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink S of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. WP A7 1 SOA58:ompany emni-ty Certified copy Is hereby furnished. Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW Certified copy is sled with the cit DI ilio . ❑ 50+KW ate 11-18-83 Applicant b Clarifiers • Solar Collectors Construction Pole Sub. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher (This section need not be completed if the permit is for one hundred ($100)or • Solar Piping Cooking Unit Meter ❑up to 100 amps - lecs). • Drinkin Fountains I certify that in the performance of the work for which this permit is issued I 9 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 ❑Electric Sub Panel Date Signature NOTICE:If,'diter making this declaration, you should become subject to the Floor Sinks Urinal • Fan Motors 00-1 HP D114-8 ' 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. Inc.solar 09.15 HP ❑16-15+ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures •Microwave of the work for which this permit is issued (Section 3097 Civ. C.) - - Lender's Name Kitchen Sink Water Service Device Boxes Pole Light Lender's Address Lavatories OWNER BUILDER DECLARATION Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the p-Tra • following reason (Section 7031,5 Business and Professional Code: Any city or p Switches Sign 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 DrainsGarbage Disposal Standing Sections 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 - Generator❑0-5 KW ❑5.15 KW Trash Compactor Division 3 of the.Business and Professions Code) or that he/she is exempt Pa 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 Reinspection enaity of not more than five hundred dollars($500). Reins pe Fee $25 Issue Fee $ 3 LJI, 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 I 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 nate employees, provided that such Improvements are not intended or offered for Canopy Type II ❑ sale. If, however, the building or Improvement is sold within one year of com- Duct-Under Ground Application Approved BY Date pletion, the owner will have the burden of proving he/she did not build or im- prrove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By A), se(/ mm/A72-A3 O I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUku�l�4LRY OF FEES ��)) The Contractor's License Law does not apply to an owner of property who /4/dfl SMIP $ l (/ builds or Improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT $ tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT 0 am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑0.100,000 BTU 0100,000 BTL GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws relating to building constr-� on,ani hereby authorize repre- sentatives of this city to enter upon A/s. abov� e •oned property for Inspection p poses ,/ r L 11-18-83 MECHANICAL $ TOTAL FEE $ J�S Signature .��L •ate Drivers' License or SS Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ \ CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor • - ' ' CONSTRUCTION AND PLANNING • POVL &SPA- APPROVALS APPROVALS Permit# • Date ', Inspector APPROVALS Permit # Date Inspector Temporary Electrical,Service or Pole-i ,-I • 52. Pool & Equipment Location u • ,' Joil Pipe-,Undrgrnd. `.j' ,1 53. Steel Reinforcement ' I 7 I ..) 3. Hectri alp onduii?Utlli -Undrgr�p I� 54. Forms 4. Electrical Conduit7Igdrarnd. m ,-•I - w 55. Electrical Bonding - J r5. 'Steel'Reinforcemenfll 'I • 0 ' 56.. Rough Plumbing & Pressure Test --I o '-1 '-r t+ • .c, - - ,-I 6. •Eleytrical UFER rnjl. 43 57. APPROVAL TO COVER-GUNITE _ 7) . O • '-4 7. I^otiigsr n - 58. Electrical Conduit-Undrgrnd. C1 8. 1pund3tion 0 .y - .*.i 59. Gas Pipe, 0 Undrgrnd., Test .a 1 ,n 9. Water Aipe-Undrg�r�ndr C 60. Backwash Lines, P-Trap, 0 Undrgrnd. MI r, ria 10. Structural Floor Sygem 0 61. APPROVAL TO DECK 11.-koperty Sewer Liner House Cgnnection '1 62. Backwash & Receptor-Final ' n ,• -' d 12..Sewertap `'1 rj 63 .-Heater & Vent-Final '--I 13. Roof Drains X 1-I �� ? _El • 64. Plumbing System - Final `i1 14. Rough Plumbing ', 65. 'Electrical-Final -3 in ._ f ''` 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 Factor Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 32. Ductrs�, Ventilating L 71. Product Piping 0 Gas 0Oil y r`L � 3. Gas Pipe;u Rougrh&-Tiest ' 72. Underground Flush 24. Rooffrining o - 73. Undergrnd.Storage Tank 0 Gas 0Oil 251 RooGjSheathing - 74. Overhead Hydro ' r.1 26. T-BarCeiling (Structural) & Monocoat 75. Dry Chemical .v /7. Fpert4 and Flashing 76. Dry Standpipe 28. L2thing& Siding 77. FIXED SYSTEM FINAL r 29. Ir1EuI tion . 78. FIRE PREV. FINAL V n, , • 30. Dj*all Nailing 13 ' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coag 79. FINAL INSPECTION 32. Electrical Power.Meter-Final 80. FOOD CERTIFICATE ISSUED 1 33. Final Electric y 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 1 • . . 44. .Landscaperlrrigation System , 45. Sound Attenuation • i ' 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'. ' 4/ty Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ]l 6y 12/0,,/' F Ti h o.. cki Y OF-COSTA MESA • - • - - • - •' PER IT NO. TRACT-NO. . LOT NO. - BLDG. NO. CONSTIiUCTiON PERMIT - f t41 ry 5160 24$-306 24 Project Address L O Valley Forme Costa Mesa TYPE OF CONSTRUCTION LI NEW Li ADD Li ALTERATION U REPAIR Applicant's Mailing Address RAl11P ❑ CONVERSION ❑ DEMOLISH OTHEFRe_pQO€ Class "An A.P.7y, I Zone Owner's Name Mont ire 1 in J'nThTh ARRtpnone S40-1097 DESCRIPTION OFWORKFiherglegRf Comp . ARph _lt_ Roof],�,Q S Eain Building: Accessory Building: - Z• Q Address Same TYPE OF PERMIT ❑ GRADING LJ-FOUNDATION ❑ STRUCTURAL T Front - N • ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear. N Arch/Eng. License No. _ I • Address OTHER Reroofing • C Riht . .. G Contractor's Name can MaSino_PooE__Co Phone 974-3070 PROJECT DESCRIPTION SQ. FT. 95500. OCCUPANCY R-1 K g _ R Address(mailing) - - • CON ST RUCTION TYPE 5-N VALUATION $ 6500 S Left - E - . - > ..• _ - _ City License No. 026085 ZONE GRACING CU,YDS, ACRES Ping. Ref. Park.Fees $ . U LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided 1 I hereby affirm that I am licensed under provisions of Charter 9 (commencing - R with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: E. my license is in full faro ap ffect. License Class --+ L nse No. 49559 PLUMBING • FEES Planning Notes: M Da)1-1 R-83 Signature • - E YORKERS' COMPENSATION DECLARATION Bar Sink Showers N T • I hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink • • S of Workers' Compensation Insurance,•or a certified copy thereof (Section - • - 3800, Lab..G1_ $2 150458 yFrem nt Indemnity Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. WY Compan ❑ certified copy is hereby furnished. Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW , }[J Cer3l ed G4py tiled with the cit D vi i n.I'--/,p�� // CI50+ KW • Date 1 —18—p3 Applicanty� LL wed Clarifiers • Solar Collectors Construction Pole_Sub. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION - Dishwasher - Soler Piping - Cooking Unit - • Meter Dup to 100 amps - - • ' (This section need not be completed if the permit is for one hundred ($100) or less). DrinkingFountains ' I certify that In the performance of the work for which this permit Is-issued, , Solar Tank Dishwasher 'Meter ❑over 100 amps ' shall not employ any person in any manner so as to become subject to the - i Workers' Compensation Laws of California. - Floor Drains Swimming Pool w/Spa Dryers ❑Gas' ❑Electric Sub Panel Date Signature - NOTICE: If,'after making this declaration,you should become subject to the Floor Sinks . Urinal Fan • Workers' Compensation provisions of the Labor Code, you must forthwith - - Motors❑0-1 HP ❑1'/a-6 comply with such provisions or. this permit shall bee-deemed revoked. Gas Service , Outlets Water Closet F.A.U. Inc.Solar'❑9-15 HP 016-15+ CONSTRUCTION LENDING AGENCY. - - - I hereby affirm that there is a construction lending agency for the performance Interceptors. Water Heater Fixtures , • i Microwave of the work for which this permit. is issued (Section 3097 Civ. C.) - • Lender's Name Kitchen Sink . .. Water Service - Device Boxes Pole Light Lender's Address • - Lavatories • • OWNER BUILDER DECLARATION • - • -• Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the p—Tra following reason (Section 7031.5 Business and Professional Code: Any city or P 4 _ Switches Sign 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 StandingSections ' :. • 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 Generator ❑0.5 KW 05-15 KW Trash Compactor Division 3 of the Business and Professions code) or that he/she is exemptP 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 - • , p natty of not more than five hundred dollars($500).' Reinspection Fee $25 Issue Fee $'3 •LI I, as,owner of the property or.my employees with wages as their sole MECHANICAL Reinspection Fee $25 Issue Fee $'3 compensation, will do the work,and the structure is not Intended or offered • , 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 0 • sale. If, however, the building or improvement Is sold within one year of com- Duct- Under Ground Application Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By � f f Date!1/a'��� I, as owner of the property,am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-VentilatingSUMMARY OF FEES • The Contractor's License Law does not apply to an owner of property who C builds or Improves thereon,and who contracts for such projects with a con- ' Exhaust System 0 Multiple 0 System Repair/Alteration ., BUI LDING PERMIT $ fir' SMIP $ „5-0 tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT • ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# ' PLUMBING $ _ ISSUANCE $ Date Owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. ' $ ' I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,000 BT - GRADING $ information Is correct. I agree to comply with all city and:county ordinances - ELECTRICAL $ and state laws relating to building constru n,and hereby authorize repre- PLAN CHECK $ _ MICROFILM $ sentatives of this city to'enter' upon t bo e tioned property for //SO inspection pur oses. MECHANICAL $ TOTAL FEE $ 7S Signature '44. r7. Refill Date 11-1R—R-3 I Drivers' License or SS Reinspection111 Fee I $25 . Issue Fee $ 3 PLAN CHECK $ _ CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - • .CONSTRUCTION AND PLANNING - %" ^ , POOL &SPA . Date Inspector Date Inspector APPROVALS Permit# Li APPROVALS Permit# '•fTemporary Electrical Service or Pole 0 • j • 52. Pool & Equipment Location '2.,4Soil Pipe-Undrgrnd. ' °t w 1 , , - 53. Steel Reinforcement - i .3.,Electrical Conduit,Utility-Undrgrnd. • .n w . 54. Forms' . 4.yElectri al ConduitrPub rgrnd. - ,w j '55._Electrical Bonding ' 5:Steel Reinforcement • a.: 56. Rough.Plumbing & Pressure Test L'-I 6.Elect'acal UFER U`tnd.j : w 57.:APPROVAL TOCOVER-GUNITE ya 7.1'Footirtgstq U co 58.' ElectricaI.Conduit-Undrgrnd. • 8. Fo'undatibn 1 . pn - ' 59.'-Gas Pipe, 0 Undrgrnd., Test. r't 9. WatercPipe-Undrgrnd., h : ':60.• Backwash Lines,P-Trap, D Undrgrnd. A. 10.•��Structural Floor Syst n - • ,61.'APPROVAL-TO DECK ar 11.:kr°perty Sewer•Line •House Cagncction 62: Backwash & Receptor-Final.- H -4 12. ewer•Cap 9-' . . U C -- 63.. Heater & Vent-Final y 13.tRoof Drains I e: • 64:Plumbing System : Final - , 14. RougETlumbing 1' i1 '-I - 65.'Electrical-Final w 15 Rough -- Electrical-Conduit -'/I ! - -r 66.-Solar System-Final - - 16r Rough Electric Wiring - 1 -,, 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 FactoryfEireplace APPROVALS Permit# - , 21. Ducts, in Structure 70. Underground Hydro ' 22. Ducts, Ventilating i 71. Product Piping 0 Gas 0 Oil 22-5. Gas Pipt Rough &)Test • 72. Underground Flush L.24. Roof-Fra-Ming ` 73. Undergrnd.Storage Tank D Gas 0 Oil 25. RoofiSheathing - 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 1 "' 30. Dr" all Nailing. - v I HEALTH DEPT. REQUIREMENT • 31. Plaster Brown Coot c� . I 79. FINAL INSPECTION y 32. Electrical Power Meter-Final ' 80. FOOD CERTIFICATE.ISSUED 33. Final Electric Notes: ' 34. Final Heating &.Air Conditioning - 35. Final Gas Pipe-Test - , - 36. Hood or Canopy , 37. Final Factory Fireplace ; • I ' • 38. Final Plumbing - . - 39. Water Service-Final I • 40. Gas Serice1Final . ' I ' 41. Solar Domestic-Final. . ' , ; -i * . - 42. Backflow Preventer ! , 43. Backf low Irrigation I - , 44. ,Landscape Irrigation Systemi • 45. Sound Attenuation - ._ 46. Handicap Regulations ' ' . 47. FINAL,STRUCTURE & BUILDING I i 48. Special Requirements Completed , • • I49. Electric Release to Edison - .- . - • - - • 50. Gas Release to Southern California Gas Co ! 51. CERTIFICATE OF OCCUPANCY, , _ _ ' ' , No. - - Date • 1/� Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. �D 7 CITY L' COSTA MESA • PERMIT NO. TRACT NO. LOT NO. BLDG.NO. D�6'- I r- - /- tl ., I CONS4UCTION PERMIT A' - 8LS'O 5160 307-311 25 —��5-0 valley Foigt 'Costa Mesa U REPAIR Project Address TYPE OF CONSTRUCTION U NEW ADD U ALTERATION Applicant's Mailing Address Same 0 CONVERSION 0 DEMOLISH 4J OTHER Reroof-r1 a $ "A" A.P.45 I Zone Owner's Name Monticello Comm 4 ne 540-1097 DESCRIPTION OF WORe I hercjla_s, Comp, Acphalt S Main Building: Accessory Building: Z Address 0 Same TYPE OF PERMIT NI GRADING ti FOUNDATION STRUCTURAL E Front N Arch/Eng. License No. I❑I--�TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL B Rear N Address OTHER Reroofing Contractor's Name San Marino Roof CQhone974-3070 PROJECT DESCRIPTION SG. FT. 4000 OCCUPANCY C Right G Address(mailing) 2187 N. Batavia, Orange 92665 CONSTRUCTION TYPE 5-N VALUATION$_RS 00R 1 S Left E City License No. 026085 ZONE GRADING CU.YDS. ACRES Ping. Ref.SW Park.Fees $ 0 U LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided 1 I hereby affirm that I am licensed under provisions of Charter 9(commencing R with section 7000) of Division 3 of the Business a Professions Code, and Use of Building: E my license is in foil f59 and effect. 249559 - M License Class s. LI nse N PLUMBING FEES Planning Notes: Date 11-1 8-22a —.nature .A.2 E WORKERS'COMPENSATION DECLABar Sink Showers N T 1 hereby affirm that I have a certificate of consent to self-insure ora certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink S 3800, Lab. civp remont Indemnity Backflow Irrigation Sewer Cap ELECTRICAL FEES 82 15045$ Policy No. ompar liCertified copy is hereby furnished. Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW Certified copy is filed with the cit {r Di ion. El 50+KW Date 11-18-83 Applicant L Clarifiers Solar Collectors Construction Pole Sub . EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher (This section need not be completed if the permit is for one hundred ($100)or Solar Piping - - ' Cooking Unit Meter ❑up to 100 amps less). DrinkingFountains I certify that in the performance of the work for which this permit is Issued,I Solar Tank Dishwasher Meter Dover 100 amps shall not employ any person In any manner so as to become subject to te - Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa - Dryers OGas DElectric Sub Panel Date Signature ' NOTICE:If,after making this declaration,you should become subject to the Floor Sinks Urinal Fan • Workers' Compensation provisions of the Labor Code, you must forthwith - Motors❑0-1 HP ❑1 h-8 comply with such provisions or this permit shall be'deemed revoked. Gas Service Outlets . Water Closet • - F.A.U. Inc.Solar 09-15 HP 016-15+ CONSTRUCTION LENDING AGENCY ' I hereby'affirm that there Is a construction lending agency for the performance Interceptors Water Heater ' Fixtures I Microwave of the work for which this permit is issued (Section 3097 Civ. C.) _ Lender's Name Kitchen Sink Water Service Device Boxes 'Pole Light Lender's Address OWNER BUILDER DECLARATION Lavatories Outlets Range 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 - . Switches Sign 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 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 Division 3 of the Business and Professions Code) or that he/she Is exempt Generator 00-5 KW 05.15 KW Trash Compactor 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 Reinspection Fee 3 oenalty of not more than five hundred dollars($500). pB $25 Issue Fee $ I. as owner of the property or my employees with wages as their sole - Reinspection Fee 1 $25 Issue Foe $ 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 0 sale. If, however, the building or Improvement Is sold within one year of com- Duct-Under Ground Application Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- - 4,10e/ � / prrove'for the purpose of sale). Duct-Structural Refrigeration System Application Issued By £,1"/ Date/7✓7/$NS, O I,as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY 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 ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT $ t' r 0,0 SMIP $ • Su tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# PLUMBING $ ISSUANCE $ • Date Owner - Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 0o-100,000 BTU 0100,000BM GRADING $ Information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws relating to building cons ructio and hereby authorize repre- - • MICROFILM $ sentatives of this city to enter up�!the 'ova entioned property for PLAN CHECK $ Inspection purposes. - MECHANICAL $ TOTAL FEE . $ dy�0 Signature I,. .1. Rei 11 /� Date 1 1-1 $-R i • Drivers' License or SS yr -• Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - . 'A,r.ONSTRUCTION AND PLANNING - % POOL& SPA ' ' APPROVALS Permit# Date Inspector • APPROVALS Permit # Date Inspector 1 `i 4. Temporary Electrical Service or Poles �1 52. Pool & Equipment Location 1 2. Soil Pipe-Undrgrnd. 1 53. Steel Reinforcement , •.3.Electrical Conduit Utility-Undrgrndi - .�i 54.- Forms 0 1 .. .. 4:.Electgcal Conduitprfdiarnd. '4 H 55. Electrical Bonding 5:-6teelcReinforcemeht • a 56. Rough Plumbing & Pressure Test H 6•jElecFcal UFER- rnjl.-) . n 57. APPROVAL TO COVE R-GUNITE J 7:rFootmgs O 58. Electrical Conduit-Undrgrnd. • n1 3 • 8.tounaatrion 0 1 ft 59. Gas Pipe, 0 Undrgrnd.,Test 9..W ter'Pipe-Undrgrrnd o 60..Backwash Lines, P-Trap, 0 Undrgrnd. .t 1 .• n 10.,OStrucilLral'Froor SZsim • ., • 61. APPROVAL TO DECK -� 11 aProperty Sewer Line:& House Connection H 62. Backwash & Receptor-Final n ,. 12'nSewBr/Ca p y J 63. Heater & Vent-Final i 13.aRoof(Drains Li o 1'1 64. Plumbing System - Final c i 14. Rou6.9 Plumbing; '-1 4-,, 65: Electrical-Final .v 15. Roug`1 Electrical-Conduit - - 66. Solar System-Final 16. Rough Electric Wiring - 67'. Fencind& 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,Struc'tre 70. Underground Hydro q . 22. Ducts, Ventilatttttg 71. Product Piping 0 Gas 0Oil 3. Gas Pipe`,iRough & Tst • 72. Underground Flush ' 2fh4. Rooraming - 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof1 ySheathing J 74. Overhead Hydro 26. T-BanCeiling (Structural) & Monocoat 75.•"Dry Chemical r� • 7 7. Ft meland Flashing 76. Dry Standpipe 2?: L4hing& Siding 77. FIXED SYSTEM FINAL 29. Inkpla1tion 78. FIRE PREV. FINAL ~ .i . HEALTH DEPT. REQUIREMENT 30. Dr.9w311 Nailing � 31. .Plgite'7 Brown Coat," • 79. FINAL INSPECTION 32. Electrical Power Meter-Final I I 80. FOOD CERTIFICATE ISSUED 33. Final ElectricNotes: , 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 . $• _ _ No.. _ • ' . Date • Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. MESA • PERMIT NO. TRACT NO. LOT NO. BLDG.NO. U:65 IP/L"/ ` • 1-tom 'TION PERMIT 13 - 7$S 5160 /7.71S''/� 36 • Project Address 150 Valley Forge, Costa Mesa TYPE OF CONSTRUCTION ❑ NEW ❑ ADOALTERATION ❑ REPAIR Applicant's Mailing Address same ❑ CONVERSION ❑ DEMOLISH ] OTHERvp Li-ALTERATION I"A" "D A.P.# I Zone Owner's Name -Monticedl0 Comm Assn Phone 540-109 DESCRIPTION OF-WORK e- • •u • - • . - , - ROO�+y�, T+ UNDATION S Main Building: Accessory Building: ZO Address same • TYPE OF PERMIT ❑ GRADING (7 u ❑ STRUCTURAL T Front N Arch/Eng. _ License No. 0 TENANT ❑ LECTRICAL 0 PLUMBING ❑ MECHANICAL B I Address ® OTHER Reroofing A Rear - N •Contractor's Nan-Hagan Marino Woof Co Phone74-3070- - PROJECT DESCRIPTION SQ. FT. 9900 ,_ U'•L OCCUPANCY R-1 K Right GR Address lmailing171 R7 CONSTRUCTION TYPE 5—N VALUATION$ 6500 $ Left N_ Ratav:Qa QragrJP 92665E City License No. 0260 R S ZONE GRADING CU.YDS. ACRESRef.# Park.Fees $ Q -_ Ping. LICENSED CONTRACTOR DECLARATION - Remarks: Parking Req./Provided U I hereby affirm that I am licensed under provisions of Charter 9 (commencing R with section 7000) of Division 3 of the Business and Professions Code,and Use of Building: E my license Is in ful orcce�And effect. p License Class —J7L,)TrcN�249 PLUMBING FEES Planning Notes: M Date Signature �'/L� „( - E IORKERS'COMPENSATION DECLARATION Bar Sink Showers N ,hereby affirm that I have a certificate of consent to self-insure or a certificate S of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink S 3800, Lab. Cie 82 15045$ y 'remont Indemnity Backflow Irrigation Sewer Cap Policy No. ompan ELECTRICAL FEES ❑ Certified copy is hereby furnished. Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW . 1 Certitlep gopy fited_wlth the city, t�gyl Is�. 0 50+KW Date 111� 05 Applicant ,y/1 /�� Clarifiers Solar Collectors Construction Pole Sub. , EXEMPTION FROM WORKERS',COM 6 ENSATION DECLARATION Dishwasher Solar Piping (This section need not be completed if the permit is for one hundred ($100)orP 9 Cooking Unit Meter Dup to 100amps less). DrinkingFountains I certify't that in the performanceperson the work for which othis permit is Issued,toI Solar Tank Dishwasher Meter Dover 100 amps ort ' employ anyiperson in any manner so-as to become Subject to the Workers' Compensation Laws of California.orn ia. Floor Grains • Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel Date Signature - _ _ NOTICE:If,after making this declaration, you should become subject to the Floor Sinks Urinal . Fan Motors❑o-1 HP ❑i X-8 ' 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. Inc.Solar ❑9-15 HP 016.15+ CONSTRUCTION LENDING AGENCY i - - I hereby affirm that there is a construction lending agency for the performance InterceptorsWater Heater Fixtures :Microwave • ' of the work for which this permit is Issued (Section 3097 Civ. C.) . - Lender's Name - Kitchen Sink Water Service • Device Boxes Pole Light Lender's Address ' - Lavatories OWNER BUILDER DECLARATION - Outlets Range I hereby affirm-that I am exempt from the Contractor's License Law for the p—Tra following reason (Section 7031.5 Business and Professional Code: Any city or p, Switches Sign • 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 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 Generator ❑0-5 KW ❑5.15 KW Trash Compactor Division 3 of the Business and Professions Code).or that he/she is exempt p 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 Reinspection Fee enalty of not more than five hundred dollars($500). pB $25 Issue Fee $ 3 LJ I, as owner of the property or my'employees with wages as their sole - Reinspection Fee $25 Issue Fee $ 3 I 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 building or Improvement Issold within oneear of com- Duct-Under Ground pp Approved By Date y Application pr , the owner will have the burden of proving he/she did not build or im- shrove / ove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By /b. /✓/o i Date/ / U I, as owner of the property, am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU • tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUM /1 RY OF FEES The Contractor's License Law does not apply to an owner of property who - y builds or improves thereon, and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration . . BUILDING PERMIT $ • V_ SMIP $ 1--57) tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT ❑ I am exempt under Section B.&P.C.for this reason Firepl/Fact.Blt. ICBG 4 PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting • PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑O-100,000 BTU 0100,000 BT GRADING $ information Is correct. I agree to comply with all city and county ordinances - , • ELECTRICAL $ and state laws relating to building constr barn,an• heresy authorize repre- - MICROFILM $ sentatives of this city to'enter upon 27.bo� L property for PLAN CHECK ' $ inspection pyyrposey it � / - MECHANICAL $ TOTAL FEE $ 9'44(v Signature L. r1 . -R' _/� �� gate 11-18-83 Reinspection Fee Issue Fee Drivers' License or 55 pe $25 $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - - L . -- POO L &SPA • CONSTRUCTION AND PLANNING � � _ . PPROVALS tPermit# • ` Date i Inspector APPROVALS Permit# Date Inspector P Temporary Electrical•Service or Pole J-a 52. Pool & Equipment Location Soilpe-Unrgrnd. "`� 53. Steel Reinforcement .$lectr• rtal ConduitdJtility-Undrgrhd. w I 1 - - 54. Forms 4.cElecti} al Conduit-UnBrgrnd. -v • °J 55.-.Electrical Bonding '75:rSteel til einforcement•: V - 4 J -r 56..Rough Plumbing& Pressure Test •-t l.f H .,-i .. _, --6.' l ctr?icaIUFER tnd. n : 57. APPROVALTOCOVER-GUNITE o 7.'Footings x W I - 58. Electrical•Conduit-Undrgrnd. . .. 8.croundation An IR- .r 59.-:Gas Pipe, Undrgrnd.,Test ti 9.iWater2 .Pipe-Undrgrnd] ' r 61 . - -60. Backwash Lines, P-Trap, 0 Undrgrnd. ai n FI C - ., 10.,Structural Floor System ' 61. APPROVAL TO DECK •A 11.ilPropertySewer Line i. House it - '62. Backwash &-Receptor-Final 12.'SewerLCap V' a r� Q63. Heater & Vent-Final -I a, .M .�! t., a ! 2 J ; W 13. ;Roof`ltrains w - ;.++ ,64: Plumbing System - Final 14.4tougliPlumbing G II •, -,--I '65: Electrical-Final- ti �' 15: Rough Electrical-Conduit _ - 66: Solar-System-Final - 16. Rough Electric Wiring , ,' -' 67:••Fencing & Access Approval : 17. Rough Wiring Sign - I 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling , i - 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating & Air Conditioning : FIRE DEPT. REQUIREMENT 20. 'Rough Factor Fireplace I • APPROVALS Permit# Facto/ 21. 'Ducts, in Structure 70. Underground Hydro 22. Ducts", �eritilating - . . I 71. Product Piping 0 Gas El Oil ' .. 2 . Gas PipenRoujh& Test 72. Underground Flush 'I _ 24. Rddf Fe4rning - 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. RoofUSheathing• D - - . . 74. Overhead Hydro a 2t. T:Bar•Ceiling (Structural) & Monocoat I 75. Dry Chemical . Fr Fr,419nijI and Flashing1 76. Dry;Standpipe • 2$. L thifig & Siding' . I 77. FIXED SYSTEM FINAL 29. •Insulation' . ! 78. FIRE PREV. FINAL 2. U 39. D?t'w l Nailing ° ' ' HEALTH DEPT. REQUIREMENT 31. Pleste{ Brown Cogto • 79. FINAL INSPECTION .t 32. Electrical Power`Meter-Final . 80. FOOD CERTIFICATE ISSUED 33. Final Electric , Notes: 34. Final Heating & Air Conditioning. i 35. Final Gas Pipe-Test • ' ' ' ' . • 36. Hood or Canopy 37. Final Factory Fireplace - ' ' 38. Final Plumbing ' i i ! 39. Water Service-Final • 40. Gas Service-Final 41. Solar Domestic-Final - • • _ _ - 42. Backflow Preventer " , 43. Backflow Irrigation i , 44. Landscape Irrigation System - I 45. Sound'Attenuation 46. Handicap Regulations . . x 47. FINAL STRUCTURE & BUILDING . - 48. Special Requirements:Completed - - i ' - ' , •49. Electric Release to Edison 4 ' - - - - -* . r- .1 - . - 50. Gas Release to'Southern California Gas Co , . ' • 51. CERTIFICATE OF OCCUPANCY - __ _ _ _ ' No. Date - ' ' • sS� 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. rl SGC 127 " i o' • I° Css'N aTRUCTION PERMIT 6 — 98'5",. .5160 230 150 ValleyForge, 4 ]]T Project AddressCosta mesa TYPE OF CONSTRUCTION U NEW ❑ ADD U ALTERATION "REPAIR Applicant's Mailing Address same ❑ CONVERSION ❑ DEMOLISH J❑ OTHER Reroof Class "A" c A.P.# I Zone Owner's Name MOnti Cello Comm ASST1_Phone540-1097 DESCRIPTION OF WORK •- • _ - • n• . - . . , - ROa�.}+p�'+n(7 S Eain Building: Accessory Building: ZO Address same TYPE OF PERMIT U GRADING LJ FOUNDATION U STRUCTURAL T Front N Arch/Eng. License No. r❑rT8a��[T[ENANT ❑ ELE ZRICAL C PLUMBING ❑ MECHANICAL B Rear I Address EMDTHER Reroofing A N Contractor's NameSAR Marino RoofCO. Phon�74 3070 PROJECT DESCRIPTION SQ. FT. 10, 700 OCCUPANCY R-1 C Right G Address(mailing) 21 ..37 NEata3,;a, Orangs_9_2665 CONSTRUCTION TYPE 5—N VALUATION S 6500 $ Left R E City License No. 026085 ZONE ' ' GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ O LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided • I I hereby affirm that I am licensed under provisions of Charter 9 (commencing R with section 7000) ofpr D.aivpidsion 3 of the Business an Professions Code,and Use of Building: E my license Is in full f6ce.37 effect. 2 9559 FEES Planning Notes: M License Class l.:Q.�77 Li se No PLUMBING E ,.,Gale 1-1$—ae4gnature Bar Sink Showers N iicilORKERS' COMPENSATION DECLARA ION - T -:hereby affirm that I have a certificate of consent to self-insure Or a certificate 'Backflow Preventer Service Sink S of- Workers' Compensation Insurance, or a certified copy thereof (Section • - 3800, Lab. C.) WP 82 1504m Fremont Indemnity Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. o pany ��y1 Certified copy is hereby furnished. f _ Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW W Certif le oP fitad ith the cit y . .. •ivisi• i , lei if — Clarifiers 0 50+KW Date Applicant •� — Solar Collectors Construction Pole Sub. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Solar Piping (This section need not be completed if the permit Is for one hundred($100)orP 9 Cooking Unit Meter ❑up to 100 amps less). DrinkingFountains I shall o thatm l the performancepersoninof the work for to this permit is issued, I Solar Tank Dishwasher Meter Dover 100 amps shall not employ anyiperson of any manner so as to become subject to the _ Workers;Compensation LawsaCalifornia. Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel Date Signature • NOTICE: If,after making this declaration,you should become subject to the Floor Sinks Urinal Fan Workers' Compensation provisions of the Labor Code, you must forthwith Motors❑0.1 HP ❑1'h-8 comply with such provisions or this permit shall be deemed revoked. . Gas Service Outlets Water Closet F.A.U. Inc.Solar 09-15 HP 01615+ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater • Fixtures of the work for which this permit Is issued (Section 3097 Civ. C.) Microwave Lender's Name ' Kitchen Sink - Water Service Device Boxes . Pole Light Lender's Address - OWNER BUILDER DECLARATION Lavatories . Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the P—Trap reason (Section 7031.5 Business and Professional Code:Any city or p . Switches Sign . 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 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 - Division 3 of the.Business and Professions Code) or that he/she is exempt Generator 00-5 KW 05.15 KW Trash Compactor 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). Reinspection Fee $25 Issue Fee $ 3 I, as owner of the property or my employees with wages as their solo — Reinspection Fee $25 Issue Fee $ 3 compensation, will do the work, and the structure Is not intended or offered ' MECHANICAL L FEES - ' for sale (Section 7044, Business and Professional Code: The Contractor's I PUBLIC SERVICES REQUIREMENTS: License Law does not apply to an owner of a property who builds or Improves t Boiler Hood or Type I ❑ 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 11 ❑ sale. If, however, the building or Improvement is sold within one year of corn- Duct-Under Ground • Application pletion, the owner will have the burden of proving he/she did not build or im- Pp Approved By p Date• / J orove for the purpose of sale). Duct-Structural Refrigeration System Application Issued.By 1�/H� Date 42+'6/e3 I,as owner of the property,am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU tractors to construct the project(Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property who v se) builds or improves thereon, and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ /07'oo SMIP $ tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# PLUMBING $ ISSUANCE $ Date Owner Heating System&Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above -❑0.100,000 BTU ❑100,000 BTL GRADING $ information Is correct. I agree to comply with all city and county ordinances - - ELECTRICAL $ and state laws relating to building constr tion,e d hereby authorize repre- sentatives of this city to enter upon ab - ntioned property for PLAN CHECK $ - inspection purposes.SiMECHANICAL $ TOTAL FEE $ �07/SD Drivers' se J. RainyU9b 'a�- 3 _ Drivers' License or.SS Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - _ , t CONSTRUCTION AND PLANNING - - X • ' - _ . POOL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector i. Temporary Electrical Service or Polei 152. Pool & Equipment Location •i - y . 2. Soil Pipe-Undrgrnd. y y 53. Steel Reinforcement 3.Electrical ConduitLUtility-Undrgrndi ' I 54. Forms .o 4., Iectf}y�al Conduit-Urtdrgfnd. 'f, " u - w • 55. Electrical Bonding ., 5.-Steel'Reinforcement • as v 56.. Rough Plumbing & Pressure Test -.4 6.. I*tricarlUFER %nd. .57. APPROVAL TO COVER-GUNITE :!, ' 7.`.-Footi stli C 12 -' 58. Electrical Conduit-Undrgrnd. 8. Foundation M -Li 59. Gas Pipe, 0 Undrgrnd.,Test lif JI 9.�Watereipe-Undrgrnd r V 60. Backwash-Lines, P-Trap, 0 Undrgrnd. _1 �1 . O 10: truc ural Floor System . 61. APPROVAL TO DECK y 4. 114Property Sewer Linec& House Connection H • 62. Backwash & Receptor-Final • in I ns m 12;.$ewer�'Cap i - 63u 11 . Heater & Vent-Final y 13.nhoof•brains a 'c LI 64. Plumbing System - Final �1 14. RougliPlumbing fi 65. Electrical-Final 1 7 15. Rough Electrical-Conduit - 66. Solar System-Final 'V 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 Factor's Fireplace APPROVALS Permit# Factor's 21. Ducts, in Struc4ure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil .n 33. Gas it:pcgRough &1 Test 72. Underground Flush 1 24. RoofFLFraming . , 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roofi,�heathing 3 74. Overhead Hydro J ' 2q. T-Bart/Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Fr metand Flashing 76. Dry Standpipe LaJ 288. tthig & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drayw' JI Nailing . HEALTH DEPT. REQUIREMENT 311. PI Step Brown Coal -, 79. FINAL INSPECTION 1 . 32. Electilcal Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning ' ' 35. Final Gas Pipe-Test • 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 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 & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison - • - - 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY i • No, Date • , r tioSo Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 63 12/":4 :: YIp- T CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. 11 CONSTRUCTION PERMIT le — 7F1/45-3 S' fin 192-198 42 ProjecrAddress a - - • • - • - - - - - TYPE OF CONSTRUCTION (_(NEWe�U ADD U ALTERATION U REPAIR •I Applicant's Mailing Address _games ❑ CONVERSION ❑ DEMOLISH ill OTHERRSrCS F Class RAn A.P.# 1 Zone Owner's Name Mont-hello Comm Assn phone 540-1097 DESCRIPTION OF WORK • - • _ •• II •• - - •• I - Boo ntJ S Main Building: Accessory Building: • Z 0 Address same TYPE OF PERMIT 0 GRADING FOUNDATION ❑ STRUCTURAL T Front N Arch/Eng. License No. TENANT peroorELEn IRigL ❑ PLUMBING 0 MECHANICAL BB - N Address Rear Contractor's Name Phone PROJECT DESCRIPTION SQ. FT- 7100 OCCUPANCY C Right G • San Marino Roof Co 974-3070 R-1 K R s 2187 N. Batavia, Orange 92665 CON ST RUCTION TYPES—N VALUATION$ 6500 $ Left E Address(mailing) ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park $ Q City License No. 086085 U LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided • I 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing • R with section 7000) of Division 3 of the Business a d Professions Code, and Use of Building: - E my license is in full force and effect. / in M License Class C-3 LI sse l 5�'9 PLUMBING FEES Planning Notes: • Date 11-18-83 Signature N IORKERS' COMPENSATION DECLARATION Bar Sink Showers T .hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink S of Workers' Compensation Insurance, or a certified copy thereof (Section - 3800, Lab. C. Backflow Irrigation Sewer Cap , ELECTRICAL FEES Policy No. 82 150458 companyFremo t Indemnitykl Certified copy is hereby fh the ed, AJt. ,f / Bathtubs Sewer Connection Automatic Washer Transformer 0 15.50 KW Cel T d with the city g 1 ism �a�. �-f-f- ❑ 50+KW - g`ll8y'j Clarifiers Solar Collectors Construction Pole Sub, Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Solar Piping - CookingUnit Meter Cup to 100 amps (This section need not be completed if the permit is for one hundred ($100) or P less). Drinking Fountains I certify that in the performance of the work for which this permit is issued, I 9 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 ❑Electric Sub Panel Date Signature — - - • NOTICE:lf,'after making this declaration,you should become subject to the Floor Sinks Urinal Fan Motors 00-1 HP ❑1%-8 • 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. Inc.Solar ❑9-15 HP 016-15+ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance interceptors. • Water Heater Fixtures Microwave of the work for which. this permit is issued (Section 3097 Civ. C.)- Lender's Name Kitchen Sink Water Service Device Boxes Pole Light Lender's Address Lavatories • - OWNER BUILDER DECLARATION Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the P—Trap reason (Section 7031.5 Business and Professional Code: Any city or p Switches Sign 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 • 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 Generator ❑Q5 KW ❑5-15 KW Trash Com ctor - Division 3 of the Business and Professions Code) or that he/she is exempt - -. pa 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 Reinspection Fee Uenalty of not more than five hundred dollars($500). pe $25 - Issue Fee • $ 3 I, as owner of the property or my employees with wages as their sole MECHANICAL Reinspection Fee ' $25 Issue Fee $ 3 compensation, will do the work,and the structure Is not intended or offered ' ' . FEES for sale (Section 7044, Business and Professional Code: The Contractor's . w 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 buildingor Improvement Is sold within oneyear of con- Duct-Under Ground P Application Approved By Date p merle the owner will have the burden of proving ho/she did not build or im- 55`` • rove for t the purpose of sale). Duct-Structural Refrigeration System Application Issued By AL r � / Dated ��3 I,as owner of the property, am exclusively contracting with licensed con- ❑Q100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property who . 7.) builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ 7/ •DO SMIP • $ S tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT 0 I am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ _ • ISSUANCE $ Date owner Heating System&Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,000 BTI. GRADING $ Information Is correct, I agree to comply with all city and county ordinances - ELECTRICAL $ and state laws relating to building construction,and hereby authorize repre- PLAN CHECK $ MICROFILM $ sentatives of this city to enter upon t abov a oned property for / inspection p poses • MECHANICAL $ 7�' �D Signature "La. J. Rei11 Z Date 11-18-83 TOTAL FEE $ Drivers' License or SS# Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev- 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - - CONSTRUCTION AND PLANNING k - POOL &SPA - - APPROVALS Permit# - Date inspector - APPROVALS Permit# Date Inspector 1-i y' , • ..„:I. Temporary Electrical Service or Polej £ t--4 52. Pool & Equipment Location .a 1 2.N.Soil Ripet9ndrgrnd. co 5 c� 53. Steel Reinforcement kJ I(ElectrcaTConduirUtiait�Undrgrndbd rA ..4 - 54. Forms in 4.''wlectal Conduitrenadr''gnd. of ti • -55. Electrical Bonding t: • -I C w - n 5.•Steel•Reinforcement' ,u a• 56. Rough Plumbing& Pressure Test 1 m co LA .. • ..i 6. 'EleitticaPUFER ' Ind. co _ 57.-APPROVAL TO COVE R-GUNITE ?b 7 v .. Ey - 7.-600tiOgs t ".-r - '.58. Electrical.Conduit-Undrgrnd. H C r" ,n 8. „oundation O •y • • �„ - • 59. Gas Pipe, D Undrgrnd.,Test C4 9. Water Pipe-Undrgrnd- 0 60. Backwash Lines, P-Trap, 0 Undrgrnd. y 10. truc'?ural Floor Syst` 1n C • 61.' APPROVAL TO DECKar 11. Property Sewer Line' House Cogbection ',t . 62. Backwash & Receptor-Final - O, n! u ' 12.LSewei?Cap �' 0 w - 63.. Heater & Vent-Final '� y U 7 1 y 13. tRoofl Drains I of • 64. Plumbing System - Final - • aa yr.) mi 14. Roti5i3 Plumbing V N -II - : 65. Electrical-Final co -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 Factor Fireplace APPROVALS Permit# 21. Ducts, in Stry ture-uc. 70. Underground Hydro ' • • I i 22. Ducts, VVentilatiing t-' 71. Product Piping 0 Gas 0 Oil 23. Gas Plj1 Rough 8i-Test 72. Underground Flush ' 24. Roof4Fr�•ming j . 73. Undergrnd.Storage Tank 0 Gas 0 Oil m 25. Roo?Sheathing 74. Overhead Hydro 26. T-bar Ceili•ng (Structural) & Monocoat 75. Dry Chemical n. Fr8n2e and Flashing 76. Dry Standpipe . V 28. LathJ ng & Siding77. FIXED SYSTEM FINAL 29. lr ation 78. FIRE PREV. FINAL 30. Drtyw0el1 Nailing r • HEALTH DEPT. REQUIREMENT •3i'. Plastfir Brown Coates • 1 79. FINAL,INSPECTION K 32. Electrical Power4leter-Final ' . ' 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning , 35. Final Gas•Pipe-Test - • It . 36. Hood or Canopy • - . 37. Final Factory Fireplace • ' - • 38. Final Plumbing ' . . - • 39. Water Service-Final • I 40. Gas Service-Final • 1 • 41. Solar Domestic-Final I - 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 - • , Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. Mir ESA ‘ PE MIT NO. TRACT NO. LOT NO. BLDG.NO. 0-E2 12/C?/rpt TI N PERMIT - $S4 5'16rI00 • 169-176 43 Project Address 150 VatLey 1-okge, Co4-ta Meea TYPE OF CONSTRUCTION LI NEW u ADD U ALTERATION U REPAIR Applicant's Mailing Address Same . ❑ CONVERSION ❑ DEMOLISH ® OTHER RPh nO6-C-t444 "A'1 A.P.# 'Zone Owner's Narria on.ttCd.&O Comm Assn Phone 540-1091 DESCRIPTION OF WORK F.16ehgIaAt Comrl_ ,AAph4tt S Main Building: _ Accessory Building: Z Address 4a mP E O • TYPE OF PERMIT ❑ GRADING FOUNDATION ❑ STRUCTURAL T Front • N Arch/Eng. License No. • TENANT ID ELECTRICAL PLUMBING ❑ MECHANICAL B I 4E1 �IiI Rear Address X.IZ OTHER Rekoolc ing - A NO Right G Contractor's Name San Makino Ito o6 Co Phone 974-3010 ' PROJECT DESCRIPTION. SQ. FT. F K •' p 900 OCCUPANCY R-1 2181 N. 'Ba.tavia, 04an a 92665 CONSTRUCTION TYPE 5-N VALUATION $ 6500. S Left E Address(mailing) 9 City License No. 02.6085 ZONE • GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ Q U LICENSED CONTRACTOR DECLARATION Remarks: ' Parking Req./Provided I I hereby affirm that I am licensed under provisions of Charter 9 (commencing R with section 7000) of Division 3 of the Business and Professions Code,and Use of Building: E my license is in WI f�rke and effect. - M License Class 11.. —i_Lic se 9 59 . • PLUMBING - Planning Notes: / .ai( FEES E mate17 /11/21 Signature Bar Sink Showers • N /ORKERS'COMPENSATION DECLARATION ' 1 hereby affirm that I have a certificate of consent to self-insure or a certificate • Backflow Preventer - Service Sink S of Workers' Compensation Insurance, or a certified copy thereof (Section - • - - 3800, Lab. gry, 82 150458 ,�kemont IndemnityBackflow Irrigation Sewer Cap • ELECTRICAL FEES Policy No. Y Compa Y ❑ Certified copy is hereby furnishe Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW �1 Cor,i)feepp ixxo x1k ii filed with the city itge/Divi io Dat Applicant Clarifiers Solar CollectorsConstruction Pole Sub. EXEMPTION FROM WORKERS'COMPENSATION:DECLARATION Dishwasher '� (This section need not be completed if the permit is for one hundred ($100) orSolar Piping Cooking Unit - Meter ❑up to 100 amps less). l DrinkingFountains I certify that in the performance of the work for-which this permit is Issuetl Solar Tank ' Dishwasher 'Meter ❑over 100 amps ' ' shall not employ any person In any manner soyas to become subject to the Workers' compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers ❑Gas• ❑Electric Sub Panel Date - Signature ' NOTICE: If,'after making this declaration,you should become subject to the ' Floor Sinks ' Urinal - Fan 'Motors 00-1 HP 0114-8 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 - t F.A.U. Inc.Solar 09-15 HP 016-15+ CONSTRUCTION LENDING AGENCY. - - . . , I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater • Fixtures Microwave of the work for which this permit is issued -(Section 3097 Clv. C.) - Lender's Name - Kitchen Sink • Water Service - Device Boxes Pole Light Lender's Address _ • OWNER BUILDER DECLARATION Lavatories Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the P—Trap reason (Section 7031.5 Business and Professional Code: Any city or p Switches' Sign 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 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 - • - Division 3 of the Business and Professions Code) or that he/she is exempt Generator 00-5 KW 05-15 KW Trash Compactor , 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 enalty of not more than five hundred dollars($500). Reinspection Fee $25 • Issue Fee $ 3 • 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 - employees, provided that such Improvements are not intended or offered for - ' Canopy . Type II ❑ Zoning Approved By - - Date sale- If, however, the building or improvement is sold within one year of com- Duct-Under Ground ' Application Approved By Date ofovethe owner wille ha le)the burden of proving he/she did not build or im- �ove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By ,O/Ar / Date I��/53 LJ I,as owner of the property,am exclusively contracting with licensed con- ❑0100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property whoCI r S builds or improves thereon, and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System R _epair/Alteration BUILDING PERMIT $ S y'ere.) • SMTP $ tractor(s) license pursuant to the Contractor's License Law). - PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reasonFirepl/Fact.Bit. ICBG# - PLUMBING $ ISSUANCE $ •Date Owner • Heating System& Ducting PLAN CHECK $ • ENERGY P.C. $ I hereby certify that I have read this application and state that the above '❑0.100,000 BTU 0100,000 BTU - GRADING $ _ ELECTRICAL $ and state laws relating to building co truction and hereby authorize repre- MICROFILM $ sentatives of- this city to enter u.`V the a;-•ve-mentioned property for PLAN CHECK $ / / inspection .urlyses. ;. p MECHANICAL $ J'9/J0 Signature : Date 1 1 / 1 8/8 3 TOTAL FEE $ ' Drivers' License or SS# _ Reinspection Fee $25. Issue Fee $ 3 PLAN CHECK $ • CMF 0865-46 rev. 7/83 White-Building;-Canary-Applicant;Pink-Accounting;Goldenrod -Assessor CONSTRUCTIONAND PLANNING x `1., h • POOL& SPA Date,,;. Inspector Date Inspector . , 'AP.PROVALS :Permit#•_ �_ " :APPROVALS Permit# - 1. Temporary Electrical Service or Pole--,. 52. Pool & Equipment Location • �2. Soil Plpr'ilndrgrnd. I [ 53. Steel Reinforcement `; C 3 nElectr al ConduFtoil -UndrgKnd - rn - - 54: Forms - U: • 4.Electr•cal Conduial dggrnd. • � - 55. Electrical.Bbnding • -�--i 5s'SteelcReinforcemeht • - .4- - L 56.- Rough Plumbing & Pressure Test .a •.5 ed n nr - - 6. 1e trical'UF,ER''G'rnd. - • `a• • -1. , 57. APPROVAL TO COVER-GUNITE 7-rFootifgs J R - r , 58. Electrical Conduit-Undrgrnd. .. V 8.tFioundation g•-•4 - .59. Gas Pipe, 0 Undrgrnd.,Test W 9. Water<Pipe-Undrgrnd - c - ' -60.'Backwash Lines, P:Trap, O,Undrgrnd:- 10.2Structural Floor �ys'4m - . 44 61 APPROVAL TO DECK 11.rProperty Sewer Lined` House Connection �. • - 62. Backwash & Receptor-Final • 12 Set/tier-Cap a v A 63' Heater & Vent-Final v - 13.4ioof Drains , en a . - 64.: Plumbing System - Final . C i cn'' ..4 . - - 14: RougPlumbing:7..N - y 65. Electrical-Final CO -15. Rough Electrical`Conduit • - -l' - 66. Solar System-Final - - 16. Rough Electric:N_iring, ' - 67: Fencing & Access Approval I 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 K -20. Rough Factor' ireplace. APPROVALS Permit# . 21: Ducts, in Structure ,� • 70. Underground Hydro - ' ,, 1 22. Du t,Oentilaf1ng'_ 71. Product Piping 0 Gas 0 Oil •23: Gas Pi peRough&,Test •- ' 1 72. Underground Flush • ?fl. R000tming o • 73. Undergrnd.Storage Tank 0 Gas 0011 25. RoofcSheathing - 74. Overhead Hydro - 2Jei 6. TBarteiling (Structural) & Monocoat - 75. Dry Chemical 27. Fr9 me and Flashing I , 76. Dry Standpipe 28. Lathipg & Siding• 77. FIXED SYSTEM FINAL' .. 1 ' 29. Insvletion 78. FIRE PREY. FINAL 30. D&yvall Nailing '} , HEALTH DEPT. REQUIREMENT ' 4, .y _ 31. Plaster Brown Coat . • - 79. FINAL INSPECTION , 32. Electrical Power teter-Final 1 i 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test - , i '. • - I ' 36. Hood or Canopy i I : , 37. Final Factory Fireplace ' _ ) , i • 38. Final Plumbing - 39. Water Service-Final • ' -• 40. Gas Service-Final ' ' 41. Solar Domestic-Final . . . _ - - 42. Backflow Pieventer ' . , ' _ 1 43. Backflow Irrigation i - - - I , 44. Landscape Irrigation System 45. Sound Attenuation • • • . 46. Handicap Regulations ' ` - - - 47. FINAL STRUCTURE &BUILDING ' • , ' • 48. Special Requirements Completed - • 49. Electric Release to Edison 1 -- - . - -- - • • 50. Gas Release to•Southern California Gas Co - . 51. CERTIFICATE OF OCCUPANCY. NQ. -- • Date - - . ' 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. - kv CONSTRUCTION PERMIT ,6--/6/36 f577160 85-92 10 11546 12/21/K G'_, _ j, Project Address 150 Valley Forge , Costa Mesa TYPE OF CONSTRUCTION e. IJ'WLW ❑ ADD LJ ALTERATION LJ REPAIR 1 Applicant's Mailing Address• same El CONVERSION ID DEMOLISH 13 OTHER RerOof-Class "Au A.P. _ [Zone Owner's Name MOTit1Ce 1 in rnmm A4 SLghOn64.0 .ao_9!197 DESCRIPTION OF WORK 1''ll]prgla-ms`s a Comp, AS alt ROOF - S Main Building: Accessary Building: ZO Address same TYPE OF PERMIT ❑ GRADING L_J FOUNDATION LJ F' ❑ STRUCTURAL T Front N • Arch/Eng. License No. .TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B I n Rear N Address `]P OTHER Reroofln C Right G Contractor's Nam Can Mari a Roof CoPhone PROJECT DESCRIPTION SQ. FT. 800 OCCUPANCY R —�___ _._�s+>�oo�P 974-3070 R 1 K Address(mailing) 7 s - • _ •5 - CON ST RUCTION TYPE 5-Nj] VALUATION$ 6500 S LeftE ZONE - GRAD!NG CU.YDS. ACRES Q City License No. 026085 Ping. Ref.# Park.Fees $ LICENSED CONTRACTOR DECLARATION Remarks: - Parking Req./Provided V I hereby affirm that I am licensed under provisions of Charter 9(commencing - R with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: E my license is in ful orcchPAnd effect. M 'cense Class �r77 =Ice No ' 2 9559 - PLUMBING Planning Notes: to 11-1R—R3;ignamre ' �•�� FEES E ,ORKERS'COMPENSATION DECLARATION• • Bar Sink Showers N I hereby affirm that I have a certificate-of consent to self-insure or a certificate T of Workers' Compensation insurance, or a certified copy thereof (Section Backflow Preventer Service Sink • S 3800, Lab. C.) WP 82 1504.�$p Fremont IndemnityBackflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. pang • ' • ❑ Certified copy is hereby furnished. Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW j{1 Certifiep o rl�fitep.y+ith the city D'`vin. ' 0 50+KW Date if P10-t53 Applicant (/ �� `� Clarifiers Solar Collectors Construction Pole_Sub. - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Solar Piping(This section need not be completed if the permit Is for one hundred ($100)or P 9 Cooking Unit • Meter Dui)to 100 amps less). Drinkin Fountains I certify that in the performance of the work for which this permit is issued g Solar Tank Dishwasher Meter Dover 100 amps shall not employ any person In any manner so as to become subject to the - I Workers' Compensation Laws of California. Floor Drains I Swimming Pool w/Spa Dryers ❑Gas ❑Electric ,Sub Panel Date Signature - NOTICE:If;after making this declaration, you should become subject to the Floor Sinks Urinal , Fan Motors 001 HP 01%-'B 1 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. Inc.Solar 09-15 HP 016-15+ G CONSTRUCTION LENDING AGENCY \ I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures :Microwave of the work for -which this permit. is Issued. (Section 3097 Civ. C.), • Lender's Name Kitchen Sink Water Service Device Boxes Pole Light Lender's Address • Lavatories OWNER BUILDER DECLARATION . - Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the P-Trap reason (Section 7031.5 Business and Professional Code: Any city or p Switches ' Sign • 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 • 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 - ' ' - . Division 3 of the Business and Professions Code) or that he/she is exempt .. - Generator 00-5 KW ❑5-15 KW Trash Compactor 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 coon Fee penalty of not more than five hundred dollars($500). Reinspection $25 Issue Fee - $ 3 - • _ 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 - employees, provided that such-Improvements are not intended or offered for Canopy Type II ❑ Zoning Approved By nate sale. if, however, the building or improvement is sold within one year of com- Duct-Under Ground Application Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- jj..�� strove for the purpose of sale). • - Duct-Structural Refrigeration System Application Issued By q/rAct ( Date l�"�3/� LJ I,as owner of the property,am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: 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 $ elk/00 SMIP $ .. .r0 tractor(s) license pursuant to the Contractor's License Law), PLAN CHECK $ PERMIT 0 I am exempt under Section B.&P.C.for this reason Firepl/Fact.Bit. ICBG#- PLUMBING $ ISSUANCE $ Date Owner Heating System&Ducting PLAN CHECK $ 'ENERGY P.C. $ I hereby certify that I have read this application and state that the above -00.100,000 BTU 0100,000 BT $ Information is correct..1 agree to comply with all city an county ordinances - •- ELECTRICAL $ and state laws relating to building constr ttlon, dd he y authorize repro- - MICROFILM $ sentatives of this city to'enter upon/,?:- / '- -me ionetl property ,for PLAN CHECK $ Inspection purposes. f ; MECHANICAL $ TOTAL FEE $ � 8'Sb Signature L. .1 Reilly /' Date 11-1-8-83 Drivers' License or SS • • Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ • SIIIIIIIIk CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - _ CONSTRUCTION AND PLANNIN. � 1-00L &SPA • APPROVALS Permit# Date - Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical+Service or Pole{ , . LA ' - - "52. Pool & Equipment"Location . - .- '-4 • • 2. Soil Pipe-Undrgrnd. - '� ; r ,� "-,!�; , ' 53..Steel Reinforcement "3. Electrical ConduitLUtility-Undrgrt1.{id' V - - 54. Forms - - 4.4Iectr4alrConduitrU ir5fnd. -3) .. ' .-4 . W , _ ' 55. Electri'cal.Bonding ' - ,N 5.�Steel Reinfoicem&gt°> -u - i - ' 56. Rough Plumbing.& Pressure•Test • y 6. Iect-al,UFER Gtnd. - -. • • - " 57. APPROVAL TO COVER-GUNITE "' 7..koptings . ' ,, t~i _ = 58: Electrical Conduit-Undrgrrid. 8.t; oLndation O 4 ' 59. Gas Pipe,.0 Undrgrnd.:Test • 9.[WWater tipe-Undrgrnd.- ji60. Backwash Lines, P-Trap, 0 Undrgrnd. :4 'm .,, 7) ' m , - . - 10. Structural Floor Sry's'm Q 61. 'APPROVAL-TO DECK - °' 11.3roperty Sewer Line T& House Coryrection ti :' " 62. Backwash & Receptor-Final CV - 12.lewer',Cap v N " %63: Heater &Vent-Final - ;i w -4 13.•FRoof'D;rains �1 -4 W -'1 - `64. Plumbing System - Final- i , 14.aioug'.:plumbing 1 .- -65. Electrical-Final 15. Rough Electrical-Conduit - - - 66. Solar System-Final - 1,-6. .Rough Electric Wiring - 67: Fencing &Access Approval - 1/7. Rough Wiring Sign • 68. APPROVED FOR PLASTERING d8. Rough Electrical-T Bar Ceiling - - 69. POOL/SPA SYSTEMS FINAL : 19. Rough Heating & Air Conditioning : FIRE DEPT. REQUIREMENT 20. Rough FactoryyQy fireplace APPROVALS Permit# 2Ducts, in Structure 70. Underground Hydro n 22. Duct riti lati rig 71. Product Piping O Gas OOil .j3. as BipgRoughi&,Tebt - i 72. Underground Flush _ V 44 - N • 24. ROcerarning _? -. 73. Undergfnd.Storage Tank 0 Gas 0 Oil 25. RootSheathing .. ' 74. Overhead Hydro ' T 26. T.Bar'Ceiling (Structural) & Monocoat - - • 95. Dry Chemical 27. Frame and Flashing, i 76. Dry Standpipe , - 26. CTa{�thing & Siding , 77. FIXED SYSTEM FINAL, . ' 29. Insulation 78. FIRE PREV. FINAL I 30. Dyvvell Nailing : r. - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat• ' 79. FINAL,INSPECTION 32: Electrical Power Meter-Final' " • I 80. FOOD CERTIFICATE ISSUED • 33. Final Electric . -i Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test , , " ' 1 36. Hood or Canopy ' 37. Final Factory Fireplace - I ' 38. Final Plumbing ' ' , ' 1 • - ; 39. Water Service-Final 40. Gas Service-Final • 41. Solar Domestic-Final I ' _ - _ - _ 42. Backflow Preventer I . • 43. Backflow Irrigation . " , 44. ,Landscape Irrigation System - . 45. Sound Attenuation i • ; , _ ; 46. Handicap Regulations , 47. FINALSTRUCTURE& BUILDING 48. Special Requirements Completed - , 1 - • ' , 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY , - - -_{- ' "" _ No. - • Date ' - • - I I yy , Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 12147 1E/ ":/ - CL, CITY OF COSTA MESA PERMIT NO. 6 "- ����� TRACT NO. 5160 LOT NO. 1]7R4 BLDG.NO. �� CONSTRUCTION PERMIT J (�, ' Project Address 150 Valley Forge , Costa Mesa TYPE OF CONSTRUCTION Li NEW' L1,401D LJ ALTERATION Ll REPAIR 1 Applicant's Mailing Address same • ❑ CONVERSION E DEMOLISH ® OTHER oof—C1av;TA" A.P.# I Zone Owner's Name Monticello Comm Assn Phone540-1 097 DESCRIPTION OF WORE.;hergl ARs, Comp, Asphalt - ROOf1nII, S Main Building: Accessory Building: Z Address - - - TYPE OF PERMIT , ❑ GRADING IJ FOUNDATION ❑ STRUCTURAL E Front N Arch/Eng. License No. ❑ TENANTELECTR��,CaAL ❑ PLUMBING ElMECHANICALMECHANICAL B • I • Address • ®OTHER roofing A N Contractor's Name San Marino Roof Co Phong74-3070 PROJECT DESCRIPTION SQ. FT. 4800 OCCUPANCY R-1 C Right ' • G R Address(Mailing) 91317 natayia, Orange 92665 CON STRUCTION TYPE 5-N VALUATION$ 65t-in $ Left E -026085 ZONE GRADING CU.YDS. ACRES Pin Ref.# Park.Fees $ Q City License No. 9- - LICENSED CONTRACTOR DECLARATION Remarks: • Parking Req./Provided U I hereby affirm that I am licensed under provisions of Charter 9 (commencing B with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: E my license is In full f Ce effect. �sppC License Class —�� s Li nse No�9l.a-a9 PLUMBING FEES Planning Notes: - M Date 11-18-83 Signature E DRKERS'COMPENSATION DECLARAT ON T Bar Sink Showers N iiiiiiiereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink I S t".. Workers' Compensation Insurance, or a certified copy thereof (Section - - 3800, Lab. C.j_ 82 15045$ ,F,,remo t Indemnity Backf low Irrigation Sewer Cap ELECTRICAL - FEES Policy No. -WY ompa ' kiCertified copypis$hereby furnished. �� Bathtubs • Sewer Connection Automatic Washer • Transformer 0 15-50 KW CBr11fie11 opy,i flied with the cit ng i on Date l-LJi-213 Applicant Clarifiers Solar Collectors . Construction Pole Sub. ❑ 50+KW EXEMPTION FROM WORKERS'CO PENSATION DECLARATION Dishwasher • - Solar Piping - (This section need not be completed if the permit Is for one hundred ($100) orP 9 Cooking Unit Meter ❑up to 100 amps, less). - - I certify that in the performance of the work 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 te Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa. s I Dryers ❑Gas ❑Electric Sub Panel Date Signature _ — NOTICE:If,'after making this declaration,you should become subject to the Floor Sinks Urinal Fan Motors 00.1 HP 0114-8 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. Inc.Solar 09-15 HP 016-15+ CONSTRUCTION LENDING .AGENCY • - - I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures of the work for which this permit is issued (Section 3097 Civ. C.) - - 'Microwave , Lender's Name Kitchen Sink Water Service Device Boxes - Pose Light t.ender's Address ' OWNER BUILDER DECLARATION - - Lavatories - Outlets Range • 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 - Switches Sign 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 DrainsGarbage Disposal Standing Sections 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 - livision 3 of the Business and Professions Code) or that he/she is exempt - - I Generator ❑0.5 KW ❑5-15 KW Trash Compactor nerefrom and the basis for the alleged exemption. Any violation of Section I{— — 1031.5 by any applicant for a, permit subjects the applicant to a civil uenalty of not more than five hundred dollars($500). • Reinspection Fee $25 Issue Fee $ 3 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 CIthereon, and who does such work himself/herself or through his or her own Zonin A roved 8 employees, provided that such improvomonts are not Intended or offered for Canopy Type II ❑ p 9 PP Y Date safe. If, however,the building or Improvement is sold within one year of com- Duct-Under Ground • Application Approved By Date pletion, the owner will have the burden of proving he/she did not build or Im- arove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By MI/ Date12/e=oV? LJ I, as owner of the property, am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES The Contractor's IJcense 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❑ System Repair/Alteration BUILDING PERMIT $ V r00 $ •Co $MIP tractor(s) license pursuant to the Contractor's License Law). - PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt.ICBG# PLUMBING $ ISSUANCE $ Date Owner Heating System&Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 BTL GRADING $ information Is correct. I agree to comply with all city and county ordinances -' ELECTRICAL $ and state laws relating to building constructlo.,and her-: authorize repre- MICROFILM $ sentatives of this city to'enter upon the,n.ova-me ,C property for PLAN CHECK $ �'s—� inspection purpose$ ' / / MECHANICAL $ Signature 1+• J. Reilly 2_,....1s ell-18-83 Reinspection Fee TOTAL FEE $ Drivers' License or SS Se ' P $25 Issue Fee $ 3 PLAN CHECK $ Sk. CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - - -- CONSTRUCTION AND PLANNING 1 - PO(. .. SPA • Date - Inspector' Date -Inspector APPROVALS 'Permit# y � ' - APPROVALS Permit # 1. Temporary Electrical Service or Pole( :.L ' - , 52. Pool-& Equipment Location �i 2. Soil Pipe-Undrgrnd. _ - �-� - - 53. Steel Reinforcement - - '3. iElectrleal'Conduit Uti.11itN-UndrgrAc :a _• "' - 54: Forms ,_4.clectrfial tonduitrCkr?nd. y . _ ,. ' - . - ,55. Electrical Bonding a 5., -a. v o • _ 56. Rough Plumbing & Pressure Test , .-1 4--1 H - n 6.]IeeltRcal UPER 64 4. '- m • 57. APPROVAL TO COVER-GUNITE - : y 7.L-Fo3ti5 s ' tv "4‘..2 v. iq _ 58. Electrical Conduit-Undrgrnd. 8.i!oundation . ' O•6 y - ..59. Gas Pipe, O Undrgrnd.,Test .4 9."WaternPipe-Undrgrnd^ 60. Backwash Lines, P-Trap, 0 Undrgrnd. • 0 10^Structmral Floor S9stt„.3m - h • - 61. APPROVAL TO DECK O) 11. 'roperty Sewer Line.gS House Co�rjpection H 62. Backwash & Receptor-Final m •1 n, R! n, . r+ ' .. i 12.;Sewerr(Cap - v a . • 63. Heater & Vent-Final vl 1 1 1 W - r • . - - 1 13.cAoof-Brains (..I) -p R . - 64. Plumbing System- Final 'n n .--. .1 .4 ! 14. Roughh;Plumbing `o U t?, 65. Electrical-Final w 15.-Rough Electrical-Conduit - - 66. Solar System-Final - , `16. Rough Elebtric 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 Factoi4 Fireplace APPROVALS Permit# ;1 • 21. Ducts, it Strugure 70. Underground Hydro •i rt 2. Duct?), Vbntila - ing- . 71. Product Piping 0 Gas •O Oil m :2 Gas Wpe Rougi &IS(est^ 72. Underground Flush 24,'I3,bbfi raino ing -. • . _ 73. Undergrnd.Storage Tank O Gas O Oil 25. Roof.Sheathing - 74. Overhead Hydro 26. T-BanCeiling (Structural) & Monocoat - - - . - • 75.• Dry Chemical 2-1. Fralfneland' Flashing 76. DryStandpipe 28. Lathing &Siding - 1 77. FIXED SYSTEM FINAL r.�T - 29. Insulation, I • 78. FIRE PREV• FINAL 30. Dr�Avjll Nailing ', en HEALTH DEPT. REQUIREMENT 31'. Plaster Brown Coat t 79. FINAL.INSPECTION 32. Electrical Power Meter-Final ' 80. FOOD CERTIFICATE ISSUED . 33. Final Electric .� 1 I • Notes: 34. Final Heating & Air Conditioning ' 35. Final Gas Pipe-Test • . . - I ' I . " 36. Hood or Canopy 1 • 37. Final Factory Fireplace -- 38. Final Plumbing ' . • 39. Water Service-Final ' 40. Gas Service-Final : • 41. Solar' Domestic-Final 42. Backflow Preventer i , 43. Backflow Irrigation 1 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 - - 4.fp Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 5 CITY OF COSTA MESA - - PERMIT NO. TRACT NO. LOT NO. BLDG.NO. CONSTRUCTION PERMIT - e 3 2 5160 L69-76 13 - ' Project Address 150 Va le For• e .Costa Mesa TYPE OF CONSTRUCTION NEW ' ADD U ALTERATION LI REPAIR 12/1 -� �i ^ Same - ❑ CONVERSION ❑ DEMOLISH ® OTHER Reroof=Class "A11 Applicant's Mailing Address A.P.# I Zone DESCRIPTION OF WORK Fi her la412 co , act hal+ Owner's Name MOritise� l0 Comm Assn Phone 540-10 7 "� p 5 Main Building: Accessory Building: Z Address same Roof�nq E 0 TYPE OF PERMIT ❑ GRADING u FOUNDATION U STRUCTURAL T Front _ N Arch/Eng. License No. ❑ TENANTip ELECTS.' ID PLUMBING ❑ MECHANICAL B I Address ES OTHER eroor1ng A Rear N Contractor's Name San Mari nn Rnnf CO Rhona 74-1070 , PROJECT DESCRIPTION SQ. FT. 4800 OCCUPANCY R-1 C Right G KR • Address(mailing) s • - • • - • • - ' . . CONSTRUCTION TYPE 5N VALUATION$ 6500 • S Left E City License No. 0260 RC ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ Q LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided U I hereby affirm that I am licensed under provisions of Charter 9 (commencing R with section 7000) of Division 3 of the Business and Professions Code,and Use of Building: • E my license is in fuldorcpaqntl effect. License Class " J7 0�.�-�Licen No. 2 9559 - PLUMBING FEES Planning Notes: E --te Signature t�'�[f Bar Sink Showers N IRKERS'COMPENSATION DECLARATION T .,ereby affirm that I have a certificate of consent to self-Insure or a certificate Backflow Preventer Service Sink S of Workers' Compensation Insurance, or a certified-copy thereof (Section 3800, La ) • Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy Np ' 82 150458 Company Fremont Indemnity kJCertified copy Is hereby furni5hetl Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW ccrrrt{l(iep Fop i filetl with the city g lwsl Date-Li-18=0� Applicant Clarifiers Solar Collectors Construction Pole Sub. 050+KW EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher - - - (This section need not be completed if thepermit Is for one hundredSolar Piping Cooking Unit Meter Eon to 100 amps p ($100) or P 9 less). I certify that in the performance of the work f ch this permit Isissued,I Drinking Fountains Solar Tank Dishwasher Meter Dover 100 amps shall not employ any person in any manner so• as'as to become subject to the Workers' Compensation Laws of California. _ Floor Drains' Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel • Date Signature _ • NOTICE:If,after making this declaration,you should become subject to the Floor Sinks Urinal • Fan ' Workers' Compensation provisions of the Labor Code, you must forthwith 'Motors HP ❑1K-B comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets CONSTRUCTION LENDING AGENCY' - Water Closet F.A.U. Ina Solar 09-15 HP 016-15+ I hereby affirm that there Is a construction lending agency for the performance Interceptors • Water Heater Fixtures Microwave of the work for which' this permit Is Issued (Section 3097 Civ. C.) _ Lender's Name - Kitchen Sink '- Water Service - Device Boxes Pole Light Lender's Address Lavatories • OWNER BUILDER DECLARATION Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the P—Trap reason (Section 7031.5•Business and Professional Code: Any city or p Switches Sign 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 3-) file a signed statement that he/she is licensed pursuant to the provisions of le 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 - Generator 00-5 KW ❑5.15 KW Trash Compactor 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 Reinspection Fee I 3 penalty of not more than five hundred dollars($500). , Pe $25 Issue Fee $ 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 11 ❑ sale. If, however,the buildingor improvement is•sold within oneyear of com- Duct-Under Ground Application Approved By Date pletiOn, the owner will have the burden of proving he/she did not build or Im- [l pLove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By del / Datea-A3--Vela• LJ I,as owner of the property, am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUWARY OF FEES The Contractor's License Law does not apply to an owner of property who - —�s builds or Improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ f/J'C� SMIP $ •`S v tractor(s) license pursuant to the Contractor's License Law). - PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ _ I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BT - GRADING $ Information Is correct. I agree to comply with all city and county ordinances - ELECTRICAL $ . and state laws relatingto building constru tion,an hereby authorize repre- MICROFILM $ _ sentatives of this city to enter upon t abo a toned property for PLAN CHECK $ p inspection PurpDoses. [pt MECHANICAL $ TOTAL FEE $ Alifs 0• ,s-e Signature se J. Reilly _ Reinspection Fee $25 Issue Fee ' `111a111. CMF 0665-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor .. • - - - - CONSTRUCTION AND PLANNING k P. _& SPA - - APPROVALS- Permit# I. Date--1 • Inspector APPROVALS Permit #- Date • Inspector Li , . 1: Temporary Electrical Service or Pole r X' y -. 52. Pool & Equipment Location . 2. Soil PipeaIndrgrn i. .o a 53. Steel Reinforcement -I CJr ,.-) - ,eI w - 3.'-I£lectridaf'ConduinUtility-Undrgrhd. - - 54: Forms .. ' . a + T. n o it i . • . 4.'Electr9al ConduittiJkargtnd. • Q) • `-4 - 55. Electrical Bonding ., '-5.ISteel'Reinforcement • o - • .a, _ • 56. Rough.Plumbing & Pressure Test '4 y y ,_r UF - ° 57. APPROVAL TO COVER-GUNITE -4 O.,;`,, iJ 7 ✓ , 7.ti omti9s ta _ - - 58. Electrical Conduit-Undrgrnd. r ' I 8. ound"anon 00 -1-I 59: Gas Pipe, 0 Undrgrnd.,Test '1 3. 9.rWaterapipe-Undrgrnd 61 • _ :, 60.'Backwash Lines, P-Trap, 0 Undrgrnd.- • ....1 10.-Structural Floor Systam • • C . 'Rt.'APPROVAL TO DECK `'' 11.)roperty Sewer Lihe`& House Connection n X62.. Backwash & Receptor-Final .--j 12.r$ewer Cap t' - a) - 1 ,� 763. Heater & Vent-Final ,i 13.GRoofDrains .1 to - ry " 64. Plumbing:System - Final - i� r•I .- .� ... d - _. 14. RougjPlumbing p 3 - ;n 65. Electrical-Final L. 15. Roug�jrElectrical-Conduit - ', " 66. Solar System-Final c- . 16. Rough ElectriSWiring - + - 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 • =r . 20. Rough Factor Fireplace • APPROVALS Permit# 21. Ducts, in StryViture 70. Underground Hydro • 32. Duds Vtntila; ng v71. Product Piping 0 Gas 0 Oil 13. Gas 91pggRough&,Test 72. Underground Flush li . 24. Roof".Fr Lming 73. Undergrnd.Storage Tank 0 Gas 0 Oil t _ 25? RoofVSheathing 74. Overhead Hydro 26 T-Bar-Ceiling (Structural) & Monocoat ' ' 75. Dry Chemical ' 211. Ftme and Flashing 76. Dry Standpipe 28: La hing& Siding 77. FIXED SYSTEM FINAL il 29. Insulation - . 78. FIRE PREY. FINAL 30. Dr%wn71 Nailing 31 • ' , HEALTH DEPT. REQUIREMENT • 31. Plaste Brown Coat° 79. FINAL-INSPECTION . --e . 32. Electrical Power�Meter-Final 80. FOOD CERTIFICATE ISSUED ' 33. Final Electric - Notes: • 34. Final Heating& Air Conditioning I I 35. Final.Gas Pipe-Test • 36. Hood or Canopy I . 37. Final Factory Fireplace I ' 38. Final Plumbing r 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 I 47. FINAL STRUCTURE & BUILDING - 48. Special Requirements Completed - - 49. Electric Release to Edison i - ' r 50. Gas Release to.Southern California Gas Co , 51. CERTIFICATE OF OCCUPANCY • _ - No. - - Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. tCITY OF COSTA MESA c° PERMIT NO. T C NO. LOT NO. BLDG.NO. b CONSTRUCTION PERMIT /3 -/e/33 100 6�6A $l 14 • Project Address 1 _ - - • • - u - _ TYPE OF CONSTRUCTION LI NETDD ALTERATION U R EPAJ R Applicant's Mailing Address same ❑ CONVERSION CI ®.0.A DEMOLISH OTHER Reroof-Class A A.P.# ` Zone Owner's Name hon{LQn— Q DESCRIPTION OF WORK Fiberglass, Camp ,' Asphalt 10a • S Main Building: Accessory Building: Z •Address amE - ROOf.l21 TYPE OF PERMIT ❑ GRADING LLII FOUNDATION CI T • SFront N i Arch/Eng. License No. - ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear Address [ OTHER I Reroofing A N Contractor's Name Phone 7 PROJECT DESCRIPTION SQ. FT. •6600 OCCUPANCY C Right G San Marino Roof inq 974-_D70 R-1 K Left R Address(mailing) 912_7 Bat- tss'ia, Orange 32665 CON STRUCTION TYPE 55-N VALUATION$ 6500 . S E ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ Q City License No. 026085 . U LICENSED CONTRACTOR DECLARATION Remarks: _ Parking Req./Provided • I • I hereby affirm that I am licensed under provisions of Charter 9 (commencing - R with section 7000) of Division 3 of the Business and Professions Code,and • . Use of Building: E my license is in full f ce effect. � M License Class a—� �y�—.. }}//ense 4 5 9 PLUMBING I FEES Planning Notes: E Datel ll l —1_18-83 Signature Q J Bar Sink Showers N iRKERS'COMPENSATION DECLARATION - - T may affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink• - S in Workers' Compensation Insurance, or a certified copy thereof (Section - 3800, Labor) 82 150458 Fremont IndemnityBackf low Irrigation • Sewer Cap _ ELECTRICAL FEES Policy No. Company - ' W Certified copy is hereby furnished. // - Bathtubs Sewer Connection' Automatic Washer I Transformer 0 15-50 KW Certi(je co. is f' with the cit pivi io . ❑ 50+KW • Date Ll—ltl—kfS Applicant //. Clarifiers • Solar Collectors Construction_Pole Sub. EXEMPTION FROM WORKERS'COM ENSATION DECLARATION Dishwasher • • (This section need not be completed if the permit Is for one hundred($100)or $Olar PIp109 - 'Cooking Unit .Meter ❑up to 100 amps - less) - I certify that in the performance of the work for which this permit is issued, I Drinking Fountains Solar Tank I DishwasherMeter 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 ❑Electric Sub Panel Date • Signature - -- NOTICE:If,'after making this declaration,you should become subject to the , Floor Sinks Urinal Fan, 'Motors❑0-1 HP ❑1'/a-8 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 U F.A, . CONSTRUCTION LENDING AGENCY - - t - - - Inc.Solar ❑9-15 HP ❑16-15+ I hereby affirm that there is a construction lending agency for the performance ' Interceptors Water Heater Fixtures :Microwave of the work for .which this, permit is issued (Section 3097 Civ. C.) • - Lentler's Name Kitchen Sink Water Service Device Boxes Pole Light Lender's Address - OWNER BUILDER DECLARATION Lavatories' , " Outlets Range 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 • • _ Switches Sign county which requires a permit to construct,alter,improve,demolish or repair "any structure, prior to its issuance,also requires te applicant for such permit Roof Drains Garbage Disposal ' Standing Sections 'o file a signed statement that he/she is licensed pursuant to the provisions of . le Contractor's License Law(Chapter 9(commencing with Section 7000)of . (vision 3 of the Business and Professions Code) or that he/she Is exempt Generator 00-5 KW 05-15 KW Trash Compactor .nerefrom and the basis for the alleged exemption. Any violation of Section • - 7031.5 byany applicant for a' permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). Reinspection Fee I $25 i Issue Fee $ 3 • • L.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 building or improvement Is sold within one year of com- Duct-Under Ground Application Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- y� prrove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By A) -/f7 / nate/.74.4..9,41s LJ I,as owner of the property,am exclusively contracting with licensed con- ❑0(00,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES The Contractor% 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 ❑ System Repair/Alteration • BUILDING PERMIT $ l�r00 •SMIP $ CO tractor(s) license pursuant to the Contractor's License Law). -- PLAN CHECK $ PERMIT 0 I am exempt under Section - B.& P.C.for this reason Firepl/Fact.Bit. ICBG# • PLUMBING $ ISSUANCE $ Date owner' Heating System&Ducting PLAN CHECK $ ENERGY P.C. , $ i hereby certify that I have read this application and state that the above ❑0.100,000 BTU 0100,000BT • GRADING $ information is correct. I agree to comply with all city and county ordinances - ELECTRICAL ' $ and state laws relating to building construction,and hereby authorize repre- MICROFILM $ sentatives of this city to enter upo he ab e- tioned .property for PLAN CHECK $ inspection purposes. Signature ] Date MECHANICAL $ TOTAL FEE $ f/v 6- Signatu License of 5s Reilly E y' 11 18 83 Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-45 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - - - - .- - _ - CONSTRUCTION AND PLANNING ' s:' PC &SPA . _ •APPROVALS Permit# •-t Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole% ,~.1 ' 52=.Pool & Equipment Location .d .-2. Soil Pipe-Undrgrnd. . - 1 . . a• W 53. Steely Reinforcement J 3. lElectridal Conduit,Utility-UndrgrndI . - - 54.. Forms 4. Elects' al CondditrOldr'g1nd. y o - 55. ElectricalBonding - - .y .-5. tgiteel l_pinforcemeilt • ro . • :-..,-3. - 56. Rough Plumbing & Pressure Test ti , n, ., ' 6. :ilectr cal2UFER Gfn . • • • 57. APPROVAL TO COVER-GUNITE • `r . . • ' u n 7. IFttotirms ' •r 58 .• Electrical.Conduit-Undrgrnd. o 8! 9oun4tion • O' 59..Gas Pipe, 0 Undrgrnd.,Test' o•' 91 WateriPipe-Undrgrnd.' S - 602'Backwash.Lines, P-Trap, 0 Undrgrnd. La rl ..+ . 10. S„tructral Floor Syst}'im y - - 61. APPROVAL TO DECK CU.a. 11. •Rroperty Sewer Line I& House Connection '1 T . 62.; Backwash & Receptor-Final N ,!i . , n 01 V 12. Spwer- ap Z. a) r • Cy g-1 _ - 63....Heater & Vent-Final .--I � , rt.' l 41 t 13. Hoofl�rains I m 64.- Plumbing System - Final'- ti 14. RougfiPlumbing =' - - '65.- 'Electrical-Final • ut 15. Rough-Electrical-Conduit - - 66. Solar System-Final - 1.6. .Rough Electricpiring �' 67. Fencing-&-Access Approval )7; Rough Wiring Sign ' • • . 68. ;APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling 69.'POOL/SPA SYSTEMS FINAL :19. Rough Heating &tAir Conditioning . FIRE DEPT. REQUIREMENT 20. Rough Factory:Fireplace I APPROVALS Permit# 7 21. Ducts, in Structureri 70. Underground Hydro 32; Ducts, entilat�ng' 71. Product Piping 0 Gas 0 Oil , 13. has Pigg RougF&;Te$t 72. Underground Flush 24. R6of{Framing ) • ., , 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25: NoolcSheathing - 74. Overhead Hydro 26. T-Bar•Ceiling (Structural) & Monocoat 75.'Dry Chemical 23•. FF-We and Flashing 76. Dry Standpipe 28. §th ig & Siding 77. FIXED SYSTEM FINAL 29. .Itisutation - 78. FIRE PREV. FINAL -, 30. D:rar Zall Nailing ;Do ' ' ' • HEALTH DEPT. REQUIREMENT -3 . Plaster Brown Coal a `gi I 79. FINALINSPECTION • 32. Electrical Power Mbter-Final ' 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: , 34. Final Heating & Air Conditioning • 1 , . i • 35. Final Gas Pipe-Test - • - , • 36. Hood or Canopy - ' , _ • 37. Final Factory Fireplace - , 38. Final Plumbing 39. Water Service-Final ' ' • 40. Gas Service-Final I 41. Solar Domestic-Final ___ ' _ 42. Backflow Preventer 43. Backflow Irrigation • - • - • - - 44. Landscape Irrigation System , ; 45. Sound' Attenuation 1 • i I ' - 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING - ' ' 48. Special Requirements Completed ' 49. Electric Release to Edison : - - - , . . 50. Gas Release to'Southern California Gas Co „ ' 1 : ' 1 51. CERTIFICATE OF OCCUPANCY • - , _ _ _ .. . No. Date '- ...� Fri /0 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. . CITY OF COSTA MESA MIT NO. TRACT NO. LOT NO. BLDG.NO. i0 CONSTRUCTION PERMIT • • i 5. - /e/312 C , gn 58-62 • 15 I85p IN' '•/ _ Project Address 190 Valley Forge , Costa Mesa TYPE OF CONSTRUCTION NEW,,,_ DD Li ALTERATION LI REPAIR - _ Applicant's Mailing Address. Same ❑ CONVERSION ❑ DEMOLISH CCWW__11 OTHER Arm -nen As..* Zone 260€�1 Owner's NameMnfti Cel 10 COMM Assn Phone540-1097 DESCRIPTION OF WORK Fiherglass, romp, Asphalt Roo0 r S Main Building: Accessory Building: Z •Address came J Cil- TYPE OF PERMIT ❑ GRADING IFOUNDATION STRUCTURAL I T Front N Arch/Eng.— _License No. ❑ TENANT IIIELECTRICAL IDPLUMBING 111MECHANICAL B - I Address OTHER A Righear - N Reroofing c Right G Contractor's Nam g za ri Mrinn Rnnf r`rrohone974-3070 PR ECT DESCRIPTION SQ. F 6000 OCCUPANCY R-1 K • Address(mailing) s - _ • 0 • s lo - • • • CONSTRUCTION TYPE 5-11f VALUATION$ 6500 S Left E City License No. 026085 ZONE - GRADI NG CU.YDS. ACRES Ping. Ref.# Park:Fees $ Q U LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided I I hereby affirm that I am licensed under provisions of Charter 9 (commencing - • R with section 7000) of Division 3 of the Business and Professions Code,and . Use of Building: my license is in full ffrc4.apd effect. E "^ense Class' ll.• 377 or_—LI nse Z49Jyq..� ,9 PLUMBING FEES Planning Notes: M 11-18-83Signature !N t/�t�Q E .JRKERS'COMPENSATION DECLARATION Bar Sink Showers T I hereby affirm that I have a certificate of consent to self-insure or a certificate S -of Workers' Com p ensation Insurance, or a Certified Copy-thereof (Section Backflow Preventer Service Sink _ t S 3800, Lab. C.) Backflow Irrigation • Sewer Cap ELECTRICAL FEES Policy No. WP 82 7504S28mpany dr11• e t • = ut • y — Certified copy is hereby furnishes R' • f I Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW )i. Certified copy is filed with the cit ` II in• • vi ..n. 0 50+KW Datell—L8-$3 • Applicant ��e,. _41!„. • Clarifiers Solar Collectors Construction Pole Sub. EXEMPTION FROM WORKERS',COMPENSATION DECLARATION • Dishwasher Solar Piping • CookingUnit • -Meter Dupto 100 amps (This section need not be completed if the permit is for one hundred($100) or P less). - I certify that in the performance of the work 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 I Dryers ❑Gas ❑Electric Sub Panel ' ' Date - Signature . — NOTICE:;caner making this declaration,you should become subject to the ' ^Floor Sinks Urinal • Fan • 'Motors 00-1 HP ❑1'%-8 Workers: Compensation provisions of the Labor Code, you must forthwith - .- comply with, such r provisions or this permit Shall be deemed revoked. Gas Service ' Outlets. . • CONSTRUCTION LENDING AGENCY • .Water Closet F.A.U. Inc.Solar ❑9-15 HP ❑16-15+ I hereby affirm that there is a construction lending agency for the performance Interceptors ' Water Heater Fixtures t Microwave of the work for which this permit is issued (Section 3097 Civ. C.) - Lender's Name Kitchen Sink Water Service , - Device Boxes • 'Pole Light Lender's Address • OWNER BUILDER DECLARATION Lavatories ' • - Outlets Range 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 ' Switches- ' Sign county which requires a permit to construct,alter,improve,demolish or repair 'ly structure, prior to Its issuance, also requires the applicant for such permit - Roof Drains • • Garbage Disposal Standing Sections a file a signed statement that he/she Is licensed pursuant totheprovisions of he Contractor's License Law(Chapter 9 (commencing with Section 7000) of - Generator ❑0.5 KW ❑5-15 KW .Trash Compactor Division 3 of the Business and Professions Code) or that he/She is exempt - _ p 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). Reinspection Fee , $25 Issue Fee $ 3 • UI, 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 am 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 hot Intended or offered for --- - - Canopy Type II ❑ sale. If, however, the building or Improvement Is sold within one year of com- Duct-Under Ground Application Approved By Date 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 System Application Issued-By •.10,7 /ty 7 / Date 42SCS • U I, as owner of the property, am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating ' I , SUMMARY OF FEES COhe Contractor's License Law does not apply to an owner of property who - - BUILDING PERMIT $ 6(2.00 SMIP + J builds or Improves thereon, and who contracts for such projects with a con- Exhaust System 0 Multiple ❑ System Repair/Alteration - $tractor(s) license pursuant to the Contractor's License Law). - PLAN CHECK $ PERMIT ❑ 1 am exempt under Section —B.& P.C.for this reason Firepl/Fact.lilt.ICBG# PLUMBING $ ISSUANCE $ Date owner Heating System& DuctingP - PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑0.100,000 BTU 0100,000 BT ELECTRICAL $ GRADING $ Information is correct. I agree to comply with all city and county'ordinances - and state laws relating to building cons uctlo 4 •nd ereby authorize repre- - - MICROFILM $ sentatives of this city to'enter' upof he a'., - entioned property for PLAN CHECK $ inspection purposes. TOTAL FEE $ (� Signature Date 41k 11—�'g—$'� • MECHANICAL $ - ��C L. J. Reilly ,�� Reins Reinspection Fee $25' issue Fee $ 3 PLAN CHECK $ Drivers' License or 55 CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - - _ _ • - ' CONSTRUCTION AND PLANNIN < - . - JL& SPA . . Date 'Inspector - Date Inspector APPROVALS' ,Permit# " - _y APPROVALS. Permit# 1 • : 1: Temporary Electrical Service or Poled moi, , 52.- Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd. : co - . a , - 53. Steel Reinforcement 1 LI - ' 3.-Electrical ConduitLUtility-Undrgr'i w - - ' 54. Forms - - "-t . 4.;Electrt¢al Conduiti1 ndrgrnd. a� • - ti - a - . 55. Electrical Bonding in in.5.,.. teel bReinforceme t ti J - -` ` - -• . 56.- Rough Plumbing & Pressure Test 6.7Elattrical:UFERErnd.cco - '`j - ' 57. APPROVAL TO COVER-GUNITE N 7. ootiRgsg1 U • rqi: - 58. Electrical•Conduit-Undrgrnd. Ib' U B.,Foundation p•vp: - 59. Gas Pipe, O:Urdrgrnd.,Test 9. WaterNPipe-Undrgrnd.' Z 1 - 60. Backwash Lines, P-Trap, O Undrgrnd. 10.CStructural Floor System - O , 61. APPROVAL TO DECK - 11.`,Property Sewer-Liner& House Connection H _ '' - 62. Backwash &-Receptor-Final - • -v 12._$ewertCap t< �'' . .0 j' q ' 63. Heater & Vent-Final y 13.'Roof rai w �-ns ' - • 64. Plumbing System - Final • I .J Plumbing(...- '.i 14. Rough Plumbingr - 65. Electrical-Final 15. Rough Electrical.Conduit - , * - '66. Solar System=Final - - 1'6. Rough Electric,p icing67. Fencing & Access Approval 17. Rough Wiring Sign _ •_ 68. -APPROVED'FOR PLASTERING )18. Rough Electrical-T Bar Ceiling . . i 69. POOL/SPA SYSTEMS FINAL ' 19. Rough Heating'& Air Conditioning FIRE DEPT. REQUIREMENT ,20. Rough FactoryiSireplace, APPROVALS Permit# • 21. Ducts, in Structure 70. Underground Hydro . 22. Ductsf Ventilating ,� 71. Product Piping O Gas O Oil 23. Gas 806-Rough &,Test 72. Underground Flush 24. RoofrFvaming 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. %ofiSheathing74. Overhead Hydro • 26. T-Barteiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. LaRhrng & Siding - ' - 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL m . 30. DriNvwall Nailing ' ,-o ' • i ' HEALTH DEPT. REQUIREMENT .y t -. . . . 31. Plaster Brown Coft O - 79. FINAL INSPECTION . 32. Electrical Power Meter-Final I 80. FOOD CERTIFICATE ISSUED 33. Final Electric - , Notes: • 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test - • 36. Hood or Canopy ' 37. Final Factory Fireplace I - . - , 38. Final Plumbing ' - - 39. Water Service-Final I 40. Gas Service-Final . ' - • • 41. Solar Domestic-Final, - 42. Backflow Preventer , , , 43. Backflow Irrigation ' - ' - 44. Landscape Irrigation System , ' - . 45. Sound Attenuation . - 46. Handicap Regulations I , . .- - • 47. FINAL STRUCTURE & BUILDING , - , , ' ' , 48. Special Requirements Completed 1 r - ' 49. -Electric Release to Edison • - -- - - ' , - - 50. Gas Release to;Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY _ ' ' No. Date ' �_ • ' ' AV CITY Applicant to fill in all spaces except those within heavy border lines and-sign-all appropriate declarations. Ap CITY OF COSTA MESA pE IT NOq TRACT NO. LOT NO. BLDG.NO. „ . CONSTRUCTION PERMIT — / 7S ' icor 3 321 - 27 E'=7 I - Project Address 150 Va11 y Pnrge, Cnci-a MPga TYPE OF CONSTRUCTION Li NEW L ADD L-I ALTERATION -LI REPAIR Ik Applicant's MailingA re55 _Same ❑ CONVERSION ❑ DEMOLISH � OTHERReT•OOf Class"A" AP # Zone Owner's Name ni-i Mnrel 1 n Cnmm k • Ase 540-1097 DESCRIPTION OF WORK - c - - u ss. . _ e a - J i�1q S Main Building: Accessory Building: Z Address Ramp TYPE OF PERMIT LI GRAo00f LI FOU NDATIOry ❑ STRUCTURAL E Front 0N Arch/Eng.- License No. ❑ TENANT ❑ ELECTRI AL ❑ PLUMBING ❑ MECHANICAL B I Address ®OTHER Rer_ _ lung A Rear • N Contractor's Name San Mari nn Rnnf CO phona74-3070 PROJECT DESCRIPTION SQ. FT. 4000 OCCUPANCY R-1 C Right • G r CON ST RUCTION TYPE 5-N VALUATION $ 6500 $ Left R Address(mailing) 2187 jy;Tia Yapia, Or-antic' 99665E City License No. 096085ZONE GRADING CU.YDS. - ACRES Ping. Ref.4 Park.Fees $ 0 LICENSED CONTRACTOR DECLARATION - Remarks: Parking Req./Provided U I hereby affirm that I am licensed under provisions of Charter 9 (commencing R with section 7000) of Division 3 of the Business an• Professions Code, and Use of Building: E my license is In fyll fypp and effect. . . - License class G -- • - ‘Ici. seNo. ; w. - ' PLUMBING . I FEES Planning Notes: E Date_I 1 -11 R-R3 Signature Bar Sink Showers N WORKERS'COMPENSATION DECLARATION T I hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow!reventer Service Sink S of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C 82 15045 Fremo t Indemnity Backflow irrigation Sewer Cap ELECTRICAL FEES Policy No. ompany , 92 Certified copy Is hereby furnishe Bathtubs Sewer Connection Automatic Washer 'Transformer 0 15-50 KW Certifie opy is filed with the city I n DI 15 Date11-1ti—R3 Applican •t G�C�+ Clarifiers • Solar Collectors Construction Pole Su b. 0 50+KW EXEMPTION FROM WORKERS'COMPENSATION DECLARATION ' Dishwasher - Solar Piping (This section need not be completed If the permit is for one hundred($100) or Cooking Unit Meter Sup to 100 amps less) i certify that in the performance of the work 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 ❑Electric Sub Panel Date Signature — - NOTICE: If,'af ter making this declaration,you should become subject to the Floor Sinks Urinal Workers' Compensation provisions of the Labor Code, you must forthwith ' '- Motors 00-1 HP ❑1'h-8 comply with such provisions or this permit shall be deemed revoked. . Gas Service Outlets Water Closet - F.A.U. • Inc.Solar ❑9-15 HP ❑16-15+ CONSTRUCTION LENDING AGENCY - I hereby affirm that there is.a construction lending agency for the performance Interceptors Water Heater Fixtures 'Microwave of the work for which this permit is Issued (Section 3097 Civ. C.) Lender's Name Kitchen Sink Water Service Device Boxes Pole Light Lender's Address OWNER BUILDER DECLARATION Lavatories _ Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the p_Tra following reason (Section 7031.5 Business and Professional Code: Any city or p Switches Sign 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 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 Division 3 of the.Business and Professions Code) or that he/she is exempt - Generator 00-5 KW 05-15 KW Trash Compactor 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). Reinspection Fee . I $25 Issue Fee $ 3 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 I 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 building or Improvement Is sold within one year of com- Duct-Under Ground Application Approved By Date pietion, the owner will have the burden of proving he/she did not build or Im- - rove for the purpose of sale). Duct-Structural Refrigeration SysteApplication Issued By A• h'7 / Date 1/�,t9-153 m I, as owner of the property,am exclusively contracting with licensed con- tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating 00-100,000 BTU ❑100,000 BTU SUMMARY 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 ❑ System Repair/Alteration BUILDING PERMIT $ y0'00 SMIP $ , CO tractor(s) license pursuant to the Contractor's License Law): PLAN CHECK $ PERMIT 0 1 am exempt under Section - B.& P.C.for this reason Firepl/Fact.alt. ICBG 4 PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting ENERGY P.C. $ PLAN CHECK $ - I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,000 BTU GRADING $ Information is correct. I agree to comply with all city and county ordinances ELECTRICAL . $ and state laws relating to building construe on,and hereby authorize repre- MICROFILM $ sentatives of this city to enter upon abo m> tioned property for PLAN CHECK $ inspection p ase Signature �• 3• Reilly a,=/ '/ Dat�.l-18-83 MECHANICAL $ TOTAL FEE $ 0+`�O Drivers' License or.55 • Reinspection Fee I $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor . - - - _ CONSTRUCTION AND PLANNING - • ., ' ` ' . - POOL& SPA . APPROVALS Permit# • Da•te, Inspector •APPROVALS Permit # Date Inspector \ H y ' 1``Temporary Electrical Service or Pole' •_,i - 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. a - I ' 53. Steel Reinforcement • D 3. Electrical ConduitU-ltilit -Undrgrrrdto w - 54. Forms F. 4. Electrical.onduit7Undr�nd. `i - 55. •Electrical Bonding - Y; Gl 5. Steel-Reinforcement-.ni - - o f - - ' 56.-(Rough Plumbing & Pressure Test - y a ;i m in w r 6. Electrical UFER 'tr 1. - ru ' • 57. APPROVAL TO COVER-GUNITE ' ti . VI 7. Footi lgs ' q . . t 58. •Electrical Conduit-Undrgrnd. _ 8. IF.oundatidn O -:, , tri 59. Gas Pipe, 0 Undrgrnd., Test a. 9. WateriPipe-Undrgrnd 9. - • 60..Backwash Lines,P-Trap, 0 Undrgrnd. a 10. Siructylral Floor Systit'n O .61. APPROVAL TO DECK , 11. 'Property Sewer Line & House Connection 't - 62. Backwash &'Receptor-Final. �, 19 ' Cu ,l y • 12. 'Sewe;Cap . , 1,z v : to CI w 63. Heater & Vent-Final i 13. ,Roof;drains W r7 v. m r I ^ r 64.. Plumbing System - Final I 14. `Foug'S'Plumbing✓o 'u , • 65. Electrical-Final 15. Rou Electrical-Conduit - - - 9b- 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 Factort Fireplace APPROVALS Permit# ' c.21. Ducts, in Structure 70. Underground Hydro 22. Ducts?VjntilaJing iJ71. Product Piping 0 Gas 0 Oil '23A Gas Pipe Rough&Nest - 72. Underground Flush 24.' RAtf r'ism ing =0 73. Undergrnd.Storage Tank 0 Gas 0 Oil -S - 25. RooftSheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat . - ' 75. Dry Chemical 2j. Fri,'me and Flashing , 76. Dry Standpipe 28: Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing = HEALTH DEPT. REQUIREMENT J. last!! Brown Coat ' , 79. FINAL INSPECTION . 32-. Electrical Power,Iuleter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final:Heating & Air Conditioning' 35. Final Gas Pipe-Test ` •• 36. Hood or Canopy • ' • • 37. Final Factory Fireplace . 38. Final Plumbing . • ' " ' • 39. Water Service-Final 40. Gas Service4Final 1 ' 41. Solar Domestic-Final • 42. Backf low Preventer • ' /43;Backf low Irrigation I44 Landscape Irrigation System . 45. Sound Attenuation - ' 46. Handicap Regulations • - 47. FINAL STRUCTURE & BUILDING . 48. Special Requirements'Completed ; I 49. Electric:Release to Edison - - - - -- - I 50. Gas Release to Southern California•Gas Co 51. CERTIFICATE OF OCCUPANCY . , No. - ' Date . . . •q PROJECT ADDRESS: 150 VALLEY FORGE RD UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05412i rthigEWSNAME; MONTICELLO ASSOCIATION ADDRESS; 150 VALLEY FORGE RD PERMIT NO: B 054127 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT 540-1097 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REROOF W/FIBERGLASS SHINGLE. W/BUILT UP SQ FT: 5, 187 ADDRESS: UNIT: CLAIM VALUE: 5, 187. 00 CALL—VALUE: 5, 187. 00 GROUP OCC: R-3 / PERMITTEE: CRANK BROTHERS ( 714 ) 548-5569 ADDRESS: 126 COMMERCIAL WAY COMMENTS: SMOKE DETECTOR REQUIRED IN THE HOMES C.M. CA 92627 ********************** ****iX+t***M****+ *** **>E**+E1k**Tr****x******1°*************** LICENSED CONTRACTOR DECLARATION: I hereby affix at I am licensed under provisions of C r 9( mmencing with Section ZONING REQUIREMENTS 7000)01 Division 3 of the Business and Professions Code my license is in lull tome and SETBACKS CITY LIC.: �OA/59 �S/TATT/E tic.: 40867 - SS: C. Dale/ /—/ signature:_ _ MAIN BUILDING ACCESSORY BUILDING ' OMPENSATIONDECLARATION: I hereby af all have a certificate of consent to sell-insure or a certificate of Workers' FRNT: FT IN REAR; FT IN FRNT; FT IN REAR; FT IN Compensation Insurance.or a certified cop thereof 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: 285-91UNITvO ae, , EXP.DATE: 01 /01 /92 COMPANY: STATE FUND PARKING REQ. PROV: PARCEL: 00000000 ZNE: REF NO: r' Certified opy2s herebyerfurnished. EX Certified copy Jorlh the hit Buildingngr/ivi ion. - PLANNING NOTES> • ate: I/ Y-9L_ Applicant •7 Pie .AN. *******************************************************************iE*!F********* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION; (This section need not be completed if the permit is for one hundred($100)a en). DEVELOPMENT SERVICES REQUIREMEWTS 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. ZONING APPROVED BY ,• DATE: Date: Signature: NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code,you must lot111wdh empty with such provisions ar this permit shall be deemed revoked. _- CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; , /' '' DATE: 9' '—' %/ which this permit is issued(Seam 3097.Civ.C). *******************************• ***** 1yy} ******.*****************.************if*ih LENDER: *************************************** ************************************** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMB ING ELECTRIC MECHANIC FIRE SHIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of 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/she is licensed PERMIT 81 , 0 0 52 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business .. SM I P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN - , any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE .4 I. as owner of the properly or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 81 . 52 0. 00 0, 00 81 . 52 81 . 52 . 00 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 employees.provided that such improvements are not intended or offered for sate.If,however the building or • - improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED: 81 . 52 OVER/SHORT: • 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC "MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 81 . 00 ` . 52 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon ,•'. - andwhocontractsforsuchprojectswithacontractor(s)license pursuant to the Contractors'stale License Law).l am aware **-*******************************************.***********.*.***.**.**.*.**.**,*.**.******.* that proof of their Worker's Compensation insurance should be provided to me. ❑ am exempt antler Section: B.&P.C. I N D I V I D U A L. r• F E E BREAKDOWN for this reason: TYPE QTY DESCRIPTIO 'N% UNIT COST TOTAL COST °d101 Owner SFR 5187 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 5, 187. 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and r 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: — Applicant: .r, I hereby teddy that I have read this application and state I it the bove information is correct.I agree ••ply with a city and county ordinances and state laws relating to building construction am here y authorize representatives of ihl • ler upon 1 hove-mentioned property lot inspection purposes. 1.. = �' Y . .. Date:_ Signature: i� O1 00,09137011-11.1•0?9.7 ... Drivers License or Social Security e: 047! i.•' .SA.-.'4 - , 1641.46 White—Building;Green—Cade Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor S CONSTRUCTION AND PLANNING POOL ,.PA r(LAPPROVALS 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 UF ER Grnd. ,, 57. APPROVAL TO COVER-GUNITE T. Footings T - 58. Electrical Conduit-Undrgrnd. i. r 8. Foundation .. 59. Gas Pipe, D Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10.-Structural Floor System - 61. APPROVAL TO DECK ' , 1'. Property Sewer Line'& House Conna Connection / 62. Backwash & Receptor-Final 12. Sewer Cap i ,• , 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing - _ 65. Electrical-Final s 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 Electricaf-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20.•Rough Factory Fireplace '.1:''• *, APPROVALS' Permit # - • 21. Ducts, in-Structure . -. - 70. Underground.Hydro • 22. Ducts, Ventilating. • . 'r 11. Product:Piping 0 Gas DOil 23-GasPipe-Rough &'Test , , .. ,, 72. Underground Fl• u-sit:- : 24.-Roof Framing • :73;Undergrnch Storage jank 0 Gas 0 Oil 25. Roof Sheathing , ; • - n • '• - : 14.-Overhead Hydro - - 26. T-Bar Ceiling (SUsamurai) & Monocoat 75. Dry Chemical _ 27. Frame and Flashing; 1 • ' r • • . 76. Dry Standpipe _ L.28. Lathing•& Siding • •• . tt •• „ •` 77.. FIXED SYSTEM.FINAL- 29. Insulation - " ; 78: FIRE PREV. FINAL r -30. Drywall•Nailing • HEALTH,DEPT. REQUIREMENT . 31. Plaster grown Coat - ;; ,79.'FINAL INSPECTION ' - • 32. Electrical Power Meter:Final .. .4 a ;80..FOOD CERTIFICATE ATE ISSUEDI tessifn (� 33. ,Final Electric `• - - •Notes: 8 _�/ �,/ 34. Final He•ating'& Air Conditioning, 1 f - , (` - - fff -�'+� -`�' 35.'Final Gas Pipe-Test _ ' • a ,36. Hood or Canopy - - - - .. •• 37..Final Factory Fireplace ,. . it fi .38. Final Plumbing . . I t ,a 39. Water Service-Final - - ' ' '' ,40. Gas Service-Final '. - ,• - - . 41. Solar Domestic-Final - 4.42.-Backflow Preventer •.1 (' , . .. - - 43. Backflow Irrigation ' T - - ' 44. Landscape Irrigation System i 2. r - • t , 45..Sound Attenuation - - -' .. , ,. •t . 46J-landicap Regulations - • y 47. FINAL STRUCTURE & BUILDING F-� B -v ; 48.'FINALPLANNING ' . 49, Electric Release to Edison i - • • 50.,Gas Release to Southern California Gas Co . - • - 51. CERTIFICATE OF OCCUPANCY . - _ No. Date .� p1111 .4 150 VALLEY FORGE RD UMT: CITY OF COSTA MESA — BUILDING PERMIT NE NAMEIPIt7moN: TOTAL PROPERTY MANAGEMENT PERM NO: B 073759 ADDRESS: 1801 SKY PARK CR. #L PERMIT NO: B 073759 PLAN CHECK NO: N GOVT: N SUPP: N IRVINE, CA 92714 APPL.MAIUNG ADDRESS: CONSTRUCTION TYPE: VN PERMIT TYPE : STR PURPOSE: OTH ARCHITECT ORENGNEER: UC.NO.: JOB DESCRIPTION : T/OFF, SHEATH & REROOF CLUBHOUSE SQ FT: 2, 999 ARCH.OR ENG.'S ADDRESS: UMT CLAIM VALUE: 2, 999 . 00 CALC—VALUE: 2, 999 . 00 GROUP OCC: R-3 / CONTRACTORS NAME: STOUT ROOFING INC ( 310 ) 923-6775 CONTRACTOR'S MARES P 0 BOX 4309 COMMENTS: SMOKE DETECTORS ARE REQUIRED PER 91 UBC ADDRESS DOWN EY CA UC.NO.: 402536 +E*************lee*****ic-* -**********+EW***********N-iE****+E*+E***+E*****+ESE*********+E+A-** 90241 UMT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury That I am licensed under provisions of Chapter 9 SETBACKS (commenting with Section 7000)of Division 3 of the Business and Professio Code,and my license o in full force and effect. crrvuc.Ng: 059377Llc.cuss: C 39 uc. 402 36 ECP: 10/9 MAIN BUILDING ACCESSORY BUILDING (Ii� I� � RNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Date: D Contractor: FT FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contract moss Law la the lollowTg reason(Section 7031.5 Business and Professions code:Any city a county which requires a permit to cometmcL alter,improve, PARKING REQ: P ROV: PARCEL: 00000000 Z N E: REF NO: • lemolnh,or repair any structure.prior to its issuance,also requires the applicant for such semen to file a signed statement thin he or she PLANNINGNOT ES) licensed pursuant le the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 of the ' Jusiness and Professions Code[or that he or she is exempt therefrom and the basis la the alleged exemption.Any violation of Section > / 7031.5 by any loan ler a mit sir a the y app per bpct applicant toaavil oenaltYoftrot more than five hundred dollars[4500)). ***************.**************************************************************** o I,esowmerof the propertyor my employees With wages as their sole compersatioe,will do the work.and the structure is not intended D E V E 'L OPMENT SERVICES R E Q U I R E M E N T S or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not appy to an owner of property -. who bolds or improves thereon.end who does such work himself or herself or through his or her own employees,provided that such CC improvements are not intended or offered for sale.t,however,the building or improvement is sold within one year of completion,the ZONING APPROVED• BY DATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale), ❑ I.as owners the Property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and BUILDING APPROVED BY : DATE: ' Professions Cada:The Contractors License Law does not appy to an owner of property who builds or improves thereon end who contracts for such projects with a contraaor(s)licensed pursuant to the Contractors License Law). - / ❑ I am exempt under Section: B.A P.C.,for this reason: APPLICATION ISSUED BY: DATE: �: ******************************* ** ************************************* ** Dat. Omer: LEGALIZATION:N FEE SUMMARY STRUCTURAL SEGMENT:Y I do hereby candy that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and 05534,and that l or any future baldingoocepant will/wit not(circle one)need to comply with said stale codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING pa rWrmonor construction or modification from the A4 OuaityManagement District.Residential construction appicetions are exempt from these PERMIT 54 . 00 . 50 Date: Apd 0n0 PLAN SMIP/NON RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE ❑ lhamand Yak mamaiamndtmdconsent aoseD+ a sell-insure s okecanpensam.apodedfabysedm37oodmeiabo BUILDING—DIV—> PERMIT ISSUE PLAN CHECK TOTAL PAID DUE Code,for m the penfosrroedthe work l«wlr<Ih this penmhai®see. TOTALS----> 54 . 50 0 . 00 0 . 00 54 . 50 54 . 50 . 00 pI have and willmaint°n workers'compensation insurance,m s required by Section 3700 of the LabCode,for the performance of the X' work for which this permit is issued.My workers'mm nation insurance carrier end policy number ere: Carrier: STATE EXPIRES REVENUE DIVISION TOTALS > COLLECTED : 54 . 50 OVER/SHORT: . 00 Policy Number: 04494U00046of 10/19/95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This section need not be completed I the perms is for one hundred dollars($1001 or less.) 54 .00 . 50 • candy that in the performance of the work for which this permit is i shall not employ any person in any manner so as to became subject to the workers'compensation taws of California, that if I should becom bjed to the' ******************************************************************************* cornPQ� ion(prOvi''i ns of Section 3700 of the Labor Code,I shall I rt IM h those INDIVIDUAL F E E BREAKDOWN Date: M/• [ Applicant: Warning:Failure to secure workers'compensation coverage Is unlawful,and shell subject anemployer to crit nal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars(S104OOO),In addition to the coat of compensation damages es provided for In Section3706ofTheLaborCode,Intenn,andattorney'sfees. SFR 2999 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2 , 999 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a construction lending agency for the . END OF FEES pedomia ce of the wk for which the permit is issued(Section 3097.Civ.C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is coned.I agree to campy with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned properly cerin onpapoesa. DARLENE BURFORD a Pri / Date: ic-11" / Signature of• .r/AgenUAppncah/weeds i _, Ur 'n_.r'.h+:?t 7' 3�i 4 c 14.ic' ,. ,._ (5151d6.WP) White-Building 8 Safety;Green-File:Canary-Applicant;Pink-Revenue;Goldenrod-Assessor • CONSTRUCTION AND PLANNING POOL. . PA Date Inspector Date Its-Spector Permit# APPROVALS Permit # l 1. Temporary Electrical Service orPole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - -- 53. Steel Reinforcement ' t .47 i.r •-•3. Electrical Conduit Utility-Undrgrnd. 54. Forms 'S4: Electrical Conduit•Undrgrnd. ` ./ 55. Electrical Bonding / 5.'Steel Reinforcement 56. Rough Plumbing & Pressure Test i. 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE ' - -`7.• Footings - - 58. Electrical Conduit-Undrgrnd. , ,c. , 8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test - 9..Water Pipe-Undrgrnd. ',-. 60. Backwash Lines, P-Trap, D idrgrnd. t) 10. Structural Floor System • . / L61. APPROVAL TO DECK-'- --) a 1.1. Property Sewer Line & House-Connection 62. Backwash & Receptor-Final' •,..,,) ', -12. Sewer Cap ; 63. Heater & Vent-Final sI 13. Roof Drains = 64. Plumbing System - Final '�• 14. Rough Plumbing ..,y.si 65. Electrical-Final ;4 ) 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 ElectricafT Bar Ceiling' '\ - 69. POOL/SPA SYSTEMS FINAL .r. 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. .Rough Factory Fireplace . �. * tAPPROVALS- : 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 ' t- 24. 'Roo€Framing' _ - 73 • , Undergrnd.StorageTank 0Gas ❑Oil r • , 25. Roof Sheathing -• .,. .47 5-_951�4,, f 74,-Overhead Hydro. . - •26.-T-Bar Ceiling.(Structurall & Monocoat _ 75.OrChemical - y - • 27. Frame and Flashing _ . -' - - 76. Dry Stanipipe- . . . - - 28. Lathing& Siding - .. " • 77- FIXED SYSTEM-FINAL - i 29. Insulation - - - 78. FIRE PREY. FINAL - 30. Drywall Nailing - - 'HEALTH DEPT. REQUIREMENT 31. Plaster Brown-Coat = _ : , - 79, FINAL INSPECTION 32. Electrical-Power Meier-Final ' V" 80., FOOD CERTIFICATE ISSUED. - 33. Final Electric ., _ .." ,1 , 1 Notes: - . 34. FinarHeating & Air Conditioning - •_ +',U /r - 35. Final-Gas Pipe-Test - - /' T -, 36. Anodic( Canopy -- • - '" - - 37. Final Fireplace' - . r'':-.7 - - 38. Final Plumbing - _ 39. Water Service-Final r - , :-40. Gas Service-Final . _ 41. Solar Domestic-Final ' , _ . ,: 42. Backflow Preventer - pi. 43. Backflow Irrigation t r -' - - 44. Landscape Irrigation System •• ' - " - - 1 45. Sound Attenuation .. 46. Handicap Regulations - 2 - _ 47. FINAL STRUCTURE & BUILDING /8�y 51 6-eil 48. FINAL PLANNING' . - 7 49. Electric Release to Edison • 50. Gas Release to Southern California-Gas Co /----). - 51. CERTIFICATE OF OCCUPANCY No Date 03/03/1994 17:20 310921n757STOUT ROOFING TNC PAGE 02 w IMPORTANT NOTICE REROOFING PROJECT Dear MontkxUo Homeowners & Residents: Phase I of the re roofing project is scheduled to begin on Monday, October 31, 1994. Enclosed you will fine a map of Monticello showing the buildings to be included in Phase I which have been numbered. You will also note to the side of the map is listed the building number and the expected work dates. If there is a change in the schedule due to bad weather, you will receive a change of schedule notice on your door. Prior to the beginning of the re.roofng, representatives hum Stout need toonn a brief 5 minute interior esanunation of each unit. They will be at Monticello on Thursday, October 27th from S..00 p.m.until 8:00 pm and again on Saturday,October 29th from 1040 am.until 12:00 p.m. They will be knocking on the doors of the units involved in Phase I of the project requesting admittance into the units. They will have identifiation with them showing they are with Stott Roofing Contractors. Please allow them to make a quick check of your interior. This inspection is for your protection and that of the Association and contractors involved. The following precautions will need to be taken during the time the tontrsaon are working on your bwldinw 1. Any kms in your attic sea are going to get very dirty and dusty. These items should be removed or covered during the time of the work. 2. My items in your page, including your vehicle, are going to get very dirty and dusty. Vehicles should be removed from the gauge during working hours and any hems covered. 3. Any kms on your patio will also get very dusty and should be covered or removed. 4. Pictum baptism on your interior walls and any valuable decorative items which could be knock' own should be moved to a safe plea. Roof removal and laying of plywood can cause the building to shake and we don't want any personal belongings being broken or damaged. The roofing contractors will be working between the hours of 8:00 a.m. and 6:00 p.m. on week days. Them will be some loud noise as times. We are sorry for the inconvenience but it is jun pan of the job. Most buildings will be completed within 1-2 days so the inconvenience will not last too long for each building residents. The roofing contractors will be applying asphalt during the new roof construction. The fumes 03/03/1994 17:20 3109230757 STOUT ROOFING INC PAGE 03 from the asphalt are somewhat obnoxious but not harmful or toxic. Lastly that City of Costa Mesa's building code requires each unit to have smoke alarms installed in each hallway and in each bedroom. They am requiring that homeowners install any missing smoke alarms to bring the units up to city code. This is required for the City of Coria Mesa to sign off on the approval and completion of each building. See the attached section for the City's Building Code. During the time of the contractors work days,a supervisor Lions Stout Roofing as well as the inspector from Independent Roofing Consultants will be at Monticello. If you have any serious problems,you an contact Total Property Management between the hours of 8:30 a m. to 540 pa or locus the supervisor on the property. This is for serious problems only. Please do not interrupt the contractors work unless it is a serious problem. Any questions or complaints will be handled through Total Property Management's a utomer service department. Total Property Management an then coma the roofing or consulting companies to obtain answers to general questions if necessary. Please do not call to complain regarding noise,inconvenience due to the roofers or roofing materials and/or equipment. We ask that residents realize they an not be helped and should only effort youpfor a short period of time. At this time, Phase II of the project has not ban planned. We will send out future notices once Phase II is ready to begin. If you are not part of Phase I, you may want to chak your smoke alarms to make sum you are in compliance with city code. This way you will be ready when your building is scheduled for re-roofing. Everyone's patience and cooperation during this project will be greatly appreciated. BOARD OF DIRECTORS MONT ICELLO COMMUNITY ASSOCIATION 03/03/1994 17:20 3109230757 STOUT ROOFING INC PAGE 04 - -- 1 U> 1.0 .04 nu .000 r . ! i 1991 UNIFORM BUILDING CODE 1209-1210 in nonaprinklaed Group R,Division I Occupancies,corridors tenting an accu- pant toad of 10 or more shall he separated from corn don and other arca on adja- cent floors by not less than approved fixed wired glass set in steel frames or by 20.minute smoke-end dean-control assemblies which arc automatic closing by smoke detection. iSmoke Detectors and Sprinkler Systems See. 1210.(a)Sake Detectors. I.General.Dwelling units,congregate real- deices and hotel brlodging house guest rooms that are used for sleeping purposes I shall be provided with smoke detectors.Detectors shall be installed In accordance I with the approved manufacturer's instructions. 1 2.Additions.alteradoasorrepalstoGroup R Occupandes.When the valu- adon of an addition,alteration or repair to a Oroup It Occupancy exceeds S 4000 and a permit is required,or when one or more sleeping rooms are added or created In existingGroupA Occupancies,smoke detectors shall be installed in accordance with Subsection 3,4 and S of this section. 3.Power warm In new construction,required smoke detectors shall receive their primary power from the building wiring when such wiring is served from a commercial source and shall be equipped with a battery backup.Tedacetorshall emit a signal when the bauexles am low.Wiring shall be pennants and without a disconnecting switch other titan those required for overvuneat protection.Smoke detectors may he solely battery operated when installed in existing buildings:or in buildings without c i...dal power or in buildings which undergo alterations, repairs or additions regulated by Subsection 2 of this section. --,t--- 4. Loes"na within dwelling units.In dwelling units,a detector shall be in- stalled Ineathsl--yu_mom and ata •. meentrall lens -• in •eaim•ororarea .tar n, es • • :tai .�•,ir" ',�'p- -• th.c.wdling unities more ' =NS ' one story and In dwellings with basements,a detector shall be Stalled on each story and In dr batmen.In dwelling utota where a story orbasanent is split into two or mom levels,the smoke detector shall be installed on the upper level,except that when the lower level contain a sleeping area,a detector shall be installed on each lent.When sleeping rooms neon an ttpperlevel,the detector shali be placed at the ceiling of ma upper level in close proximity to the stairway.in dwelling units where the ceiling height of a mom open to the hallway serving the bedrooms ex- I I, eeeds that Mite Itallomy by 24 indus ormore.smoke detectors shall bc Installed in I 1 the hallway and Inthe adjaensm. tmoDedectosshallsoundanalarmaudibleinall , 1 sleeping areas of the dwelling unit in which they are located. ill;, S,Leaden indfldeatydwellingmlts,congregatereldencesandhotels.In I 1 efficiency dwelling salts,haiti suites and lnhottl w4connsaze residence' w- ;3 11 Ingrooms,deleanndrsUbeloeatodontheceilingorwallofthemainroamoreach III r sleeping room.When sleeping rooms within an efficiency dwelling unit or hotel I, suite are on an upper level,the detector dial!be pieced at the ceiling of the upper OH i level in close proximity tothe wirway.WF�actuated,the detector shariwundan :Ij1� alarm audible within the sleeping sea of the dwelling unit,hold suite or sleeping realm In which it is located. I if ii} ro �1 107 'II TIT • \� PROJECTADDRESS: 150 VALLEY FORGE RD UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 061692 OWNER'S NAME:MONTECELLO H/0 ASSOC. r ADDRESS:SAME PERMIT NO: P 061692 PLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE; V—N PERMIT TYPE; PLU PURPOSE; OTH 2618282 ARCHIENGINEER: REG.NO.: JOB DESCRIPTION : GAS PIPE REPAIR @ POOL METER SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-1 / PERMITTEE:DIAL ONE AA ALL ROOTER ( 714 ) 540-8400 ADDRESS: 3042 ENTERPRISE F COMMENTS ; X C.M. CA 92626 ***********************************************�t+r****ce�6�E�F**+est*�E�P******�E�E******* DC SED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7 01 of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS CITY LIC.:Q3g163 STATE 11C.467194 CLASS:C36 Date: L111 1t ffl Signature MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby a rm that I have a certificate of consent to self-insure or a certificate of Workers' FR NT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN Compensation Insurance.or a certified copy thereof(Section 3800. Lab.C). LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING RE • PROV: PARCEL: 13952612 ZNE; REF NO: 7 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING N TES> > Date: Applicant: *************************'1f*********************-IE**)E**IP************************* JEMPTION FROM WORKERS'COMPENSATION DECUBATION: (This section reed not he completed if the permit is for one hundred(5700(or less) D E V E L O P M E N T S E R V I C E S " R E Q U I R E M E N T S ertify 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 bject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATEte: /7 '93 Signature: L... /✓��A x _.. NOTICE:If.alter making this declaration.you sho ¢come subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. /— CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY:_ e DATE '^r� `Z9),� which this permit is issued(Section 3097.Civ.C). **************************4 .` x - 'ie ' - ************* A****J ** LENDER: ************************* .****** *************************f(************* ADDRESS: LEGALIZATION:N F E E SJMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRI MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish.or PERMIT 5, 00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 20,00 I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 5, 00 20 , 00 0 . 00 25, 00 25 , 00 , 00 does not apply to an owner of a property who builds or improves(hereon,and who does such work himself/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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED- 25 . 00 OVER/SHORT• 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 25 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such protects with acontraclor(s)license pursuant to the Contractors'State License Law).lam aware ,*.*.*.**.*..**.**.**.*..*..K**.*.*.************************************************************ that proof of their Worker's Compensation insurance should be provided to me. o I am exempt antler Section: B.8 P.C. INDIVIDUAL F E E BREAKDOWN for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST D ate: Owner: PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 5 , 00 5 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and slate that the above information is correct.I agree to comply with all city and county ordinances and stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned perty forC (Z inspection purposes. deit D are / : [ "53 Signature: O 1 0100137063-00137063 TOT 25.00 Driver's License or Social Security A: DATE: 04/12/93 TIME: 10:44 164146 White—Building:Green—Cade Entorcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor I,.- CONSTRUCTION AND PLANNING POO. _ SPA APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector P 1. Temporary Electrical Service or Pole • - 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. • - 53. Steel Reinforcement • 1' 1 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � I 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding J 5. Steel Reinforcement 56. Rough Plumbing& Pressure Test I 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings i' 58. Electrical Conduit-Undrgrnd. te iii 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. - • 60. Backwash Lines, P-Trap, 0 Undrgrnd. ,O 10. Structural Floor System _ 61. APPROVAL TO DECK v1 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 1 I 12. Sewer Cap 63. Heater & Vent-Final I 13. Roof Drains 64. Plumbing System • Final {i 14. Rough Plumbing 65, Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final a 1 16. Rough Electric Wiring 67, Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 7 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 D Oil I 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical i 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PRE.. FINAL _ j 30. Drywall Nailing i 1 HEALTH DEPT. REQUIREMENT I 31. Plaster Brown Coat . 79. FINAL INSPECTION 32. Electrical Power Meter-Final I 80. FOOD CERTIFICATE ISSUED I H , 33, Final ElectricI Notes: 34. Final Heating&Air Conditioning i 1 35. Final Gas Pipe-Test V� G60 I 36. Hood or Canopy ! i 37. Final Factory Fireplace I 38. Final Plumbing 46-6Thc@t -- 39. Water Service-Final I 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer . Iiii I 43. Backflow Irrigation i ' 44. Landscape Irrigation System I 45, Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING I t I _a 48. FINAL PLANNING I I 49, Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ) Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. VIt CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT N0. BLDG.N0. ' CONSTRUCTION PERMIT —/0/33 5160z�.1-9 5p 3R - Project Address 1 Sfl Valley Fnrge r Costa Mega TYPE OF CONSTRUCTION LJfNEY •itD U ALTERATION L-I REPAIR - I NEI I --/ ' s Applicant's Mailing Address ' BaIOP ❑ CONVERSION D DEMOLISH ® OTHER Reronf-r-Las-q-11-A" A.P.# 1 Zone n ( nlr A sn Phone DESCRIPTION OF WORK Owner's Name MOLyt.lf raj.�-----_�1 540-1097 p r A3 Halt Roof p S Main Building: Accessory Building: Z Address SW1P O TYPE OF PERMIT ❑ GRADING FOUNDATION ❑ STRUCTURAL T Front N Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Address ® OTHER Reroofing Contractor's Nam Can Mrin ao Roof Co Phone 974-3070 PROJECT DESCRIPTION SQ. FT. •4RIQ OCCUPANCY R-1 C Right G - R Address(mailing) _ _ - _ • - _- _ CONSTRUCTION TYPE 5—N VALUATION$ 6500 S Left E • ZONE GRADING CU.YDS. ACRES Pin Ref.# Park.Fees $ U City License No. 026085 - g LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided I I hereby affirm that I am licensed under provisions of Charter 9 (commencing - R with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: • E my license is in 4,11 intro ants effect- - - Ucenie Class 1 ) CC Ma enso PLUMBING FEES Planning.Notes: - M Date ll-18-8 19nature �i,� E WORKERS'COMPENSATION DECLARATION Bar Sink Showers • N 'hereby affirm that I have a certificate of consent to self-insure or a certificate T f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink -_ S 3800, Lab. C-]_ Backflow Irrigation Sewer Cap ELECTRICAL FEES 82 15045$ Policy No. WF' oral nyFremont Indemnity Certified copy is hereby furnished. : Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW Certifi o fil ith the dirt Dlvl n. --- + rap p �•��'� ( Clarifiers Construction Pole Sub. ❑ 50 KW Date -1-1---1-0—113 Applicant ) / Solar Collectors EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Solar Piping - - - (This section need not be completed if the permit Is for one hundred ($100) or P 9 Cooking Unit Meter ❑up to 100 amps less). DrinkingFountains I all no that in the performance in of the r for which this permit is issued, I Solar Tank Dishwasher _ Meter Dover 100 amps orl ' employompeany person of any manner so as to become subject to the Workers' Compensation Laws of California. Floor Drains Swimming Pool w/SpaDryers ❑Gas DElectric 'Sub Panel Date Signature - NOTICE:If,-after making this declaration,you should become subject to the Floor Sinks • Urinal Fan Motors 00-1 HP 01%-8 Workers' Compensation provisions of the Labor Code, you must-forthwith - - - - comply •with such provisions or this permit shall be deemed revoked. Gas Service Outlets CONSTRUCTION LENDING AGENCY Water Closet F.A.U. Inc.Solar ❑9-15 HP ❑16-15+ I hereby affirm that there Isa conatructlon lending agency for the performance Interceptors Water Heater Fixtures of the work for which this permit is issued (Section 309.7 Civ. C.) - Microwave Lender's Name - - Kitchen Sink Water Service Device Boxes Pole Light Lender's Address - OWNER BUILDER DECLARATION Lavatories - Outlets Range I hereby affirm that I am exempt from the Contractor's License law for the P—Trap reason (Section 7031.5 Business and Professional Code: Any city or p - - Switches Sign county which requires a permit t0 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 • 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 : - ')ivision 3 of thea Business and Professions Code) or that he/she is exempt Generator 00-5 KW 05-15 KW Trash Compactor ierefrom and the basis for the alleged exemption. Any violation of Section - .031.5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee $ 3 enalty of not more than five hundred dollars($500). pe $25- Issue Fee compenssat on ownerof doe the property or and the structurre sisnot inh tended ort their ed MECHANICAL I FEES Reinspection Fee • $25 Issue Fee $'3 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 nate employees, provided that such Improvements are not Intended or offered for - - Canopy Type 11 ❑ sale. If, however, the buildingor improvement Is sold within oneyear of com- Duct-Under Ground - d Application Approved By Date plebe for the owner will have the burden of proving he/she did not build or im- Duct-Structural ,N rove the r of the property,oer. Refrigeration System Application Issued ray ���! Date�3�3�srl� t rs owner tr ct the eroject 5em exclusively contracting with licensedionode- ❑o-100,000 BTU ❑100,000 BTU tractors t construct the project(section 7044,Business and Professions Cada: Duct-Ventilating $U M RY 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 BUI LDING PERMIT $ ,0 0 SMTP $ ' St) tractor(s) license pursuant to the Contractor's License Law). - PLAN CHECK $ PERMIT 0 I am exempt under Section B.8 P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting PLAN CHECK $ _ ENERGY P.C. $ iI nformation is(correct.II have ree read complywithapplication . sdacounty the ❑0-100,000 BTU ❑100,000 BTL— ELECTRICAL GRADING $ and state laws relating to building construction, a.•y 'eby authorize repre- sentatives $ of this city to enter upon •,•• ab• y�boned property for PLAN CHECK $ MICROFILM $ • � inspection p posess.. Signature TOTAL FEE $ ALS'n5- �• J • Reilly «f w� Date 11-18-83 - MECHANICAL $ Drivers' License or SS Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ a CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - CONSTRUCTION AND PLANNING - :4 - POO, SPA APPROVALS Permit# Date Inspector - APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole--1 ..i - 52.. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. -fes C3 • 61 -I 53. Steel Reinforcement 3. 131ectriv'cal Conduit'lrltait�Undrgrndc .n - 1 54: Forms . 'l ,n .--4 •4 n r.) .4 ' 4. Electrical ConduiA?drggnd. -,'- y r'`' • - 55.-Electrical Bonding m , 5. Steel Reinforcemecit:Y v • D. J - • 56. Rough Plumbing & Pressure Test .y - ti s+ . ,--I I 6. ',F,Jectrica luUFER di nth. - '�� - 57:APPROVAL TO COVER-GUNITE :•40 at 7. IFotnii s 0 t, i 58. Electrical Conduit-Undrgrnd. U n el el 8. Fpundation <3 4 - y - 59. Gas Pipe, 0 Undrgrnd.,Test CA 9. Water[Pipe-Undrgrnd+ N - - 60. Backwash Lines,P-Trap, 0 Undrgrnd. y 10. Structdral Floor System • ? - 61. APPROVAL TO DECK y 11. property Sewer Line & House Connection •t - 62. Backwash & Receptor-Final ,n n, ti 1.-1 ' 12. Sewer'-Cap y 0 0, C - H-i I„ ,� sr-1 63.`Heater & Vent-Final 13. 'Roof Drains • Il di • r 64. Plumbing System - Final ro . n) "-4 o r .. 9 r-, n 1 14. RoughiPlumbing ` rJ '� 65. Electrical-Final -o ,,t 15. RougicElectrical-Conduit - . - - 66. Solar SYstem=Final J 6. Rough Electric Wiring - - - -67. Fencing & Access Approval 17. Rough Wiring Sign .68. APPROVED FOR PLASTERING 18. Rough Ele'ctrical-T Bar Ceiling I 69. POOL/SPA SYSTEMS FINAL '19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT • 20. Rough Factory,:Fii-eplace APPROVALS Permit# , a� 21. Ducts,in Struciyre 70. Underground Hydro 22. Duct.ti V2ntilatf g 71. Product Piping 0 Gas 0 Oil ' 2-r.- P pe�jRoughj$ Tjst ' 72. Underground Flush ar , 24. Roof-Frit-flingchI"> - 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25.JoofcIheathing ;-, 74. Overhead Hydro 26. T-Bar Ceiling (Structurall. & Monocoat- = 75. Dry Chemical 27: Fra')nand Flashing • 76. Dry Standpipe . , 28. Lathing& Siding • 77. FIXED SYSTEM FINAL 29. Insulaiion 78. FIRE PREV. FINAL 30. DPt,1;ql Nailing OHEALTH DEPT. REQUIREMENT 31. PlastenBrown Coag I 79. FINAL INSPECTION 32. Electrical Power,Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final'Heating & Air Conditioning, 35. Final Gas Pipe-Test - 36. Hood or Canopy - .• 37. Final Factory Fireplace ' 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final ' 41. Solar 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 ,. - i 51. CERTIFICATE OF OCCUPANCY • - _ No. Date - _ p _ zp p�1, 5 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. D -r CITY OF COSTA MESA - PERMIT NO. TRACT NO. LOT NO. ' BLDG.NO. - - CONSTRUCTION PERMIT g — /0/3 4 5160q�� 237-244 3(9 Project Address 150 Valley Forge rnnta Mpga_ TYPE OF CONSTRUCTION U NeviI�liaADD Li ALTERATION LJ REPAIR ••-•' ' ' ' ❑ CONVERSION ❑ DEMOLISH y0 OTHER _ Applicant's Mailing Address same ' e _ - rt ' It A.P.# I Zone Owner's Name Mnni-i re 110 f'tjptm Aa4n Phone S40-1097 DESCRIPTION OF WORK Fiberglass, omp . Asp alt BO�rf••Ag S Main Building: Accessory Building: Z Address son - TYPE OF PERMIT ❑ GRADING L I FOUNDATION ❑ STRUCTURAL T Front N Arch/Eng. License No. ❑ TENANT IT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Address ® OTHER Reroofing A Rear N Sanr no Roof Co Phond174 1O7O R-i K Right R Contractor's Name MariR PROJECT DESCRIPTION SQ. FT. $3nO OCCUPANCY Address(mailing,1 R7 N Ratavi a , Orange 92665 .0CONSTRUCTION TYPE S—N VALUATION$ 6550(1 S Left E City License No. 02-60$S ZONE GRADING CU.YDS. ACRES - - • Ping. Ref.# Park.Fees $ Q • U LICENSED CONTRACTOR DECLARATION Remarks: Parking Heq./Provided I I hereby affirm that I am licensed under provisions of Charter 9 (commencing - R with section 7000) of Division 3 of the Business and Professions Code,and Use of Building: - E my license is In full f ce•�pp effect. / ��qr�r� M License 1Class-1 �—�7 Cr°5a ense Ned -•'9 _ PLUMBING FEES Planning Notes: E Date_71- R-23 Signature � G[/i. \//-[L/.�e ((/' Bar Sink Showers N WORKERS'COMPENSATION DECLARATION T 'hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink S a Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. .C.l- 82 l5O 478 Fremont Indemnity Backflow lrrigatio_n Sewer Cap • ELECTRICAL FEES Policy No. WY Company Fremont • PCertified copy is hereby furnished. Bathtubs Sewer Connection • Automatic Washer Transformer ❑ 15-50 KW Certified copy I (�edfcgh the ci vi ' n. ❑ 50+KW ate 11S9—a applicant Clarifiers Solar Collectors Construction Pole Sub. _ EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher - Solar Piping (This section need not be completed if the permit Is for one hundred($100) or P 9 Cooking Unit Meter ❑up to 100 amps less). DrinkingFountains I certify that in the performance of the work for which this permit is Issued I 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 ❑Electric Sub Panel Date Signature NOTICE: If,'after making this declaration, you should become subject to the Floor Sinks Urinal • Fan Motors 00.1 HP ❑1'A-8 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. Inc.Solar 09-15 HP 016.15+ CONSTRUCTION LENDING AGENCY • I hereby affirm that there Is a construction lending agency for the performance Interceptors Water Heater Fixtures 'Microwave of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Kitchen Sink - Water Service Device Boxes Pole Light Lender's Address Lavatories OWNER BUILDER DECLARATION Outlets • Range I hereby affirm that I am exempt from the Contractor's License Law for the p_Tre following reason (Section'7031.5 Business and Professional Code: Any city or p Switches Sign ' 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 ' 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 _ - ;,IAivision 3 of the Business and Professions Code) or that he/she is exempt Generator 00.5 KW 05.15 KW Trash Compactor herefrom 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 enalty of not more than five hundred dollars($500). , Reinspection Fee $25 Issue Fee $ 3 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 ❑ 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 buildingor improvement Is sold within oneyear of com- Duct-Under Ground ' d Application Approved By Date gpletion,ove thetowner se have the burden of proving he/she did not build or forim- LJrovethe purpose of sale). Duct-Structural Refrigeration System Application Issued By ,� / Date/a47"-Vg"--‘ I, as owner of the property, am exclusively contracting with licensed con- ❑6100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY 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 1:1 Multiple ❑ System Repair/Alteration BUILDING PERMIT $ o '� SMIP $ cs^ tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.RU. ICBO# PLUMBING $ ISSUANCE $ Date _ Owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑O-100,000 BTU 0100,000 BT GRADING $ information is correct. I agree to comply with all city and county ordinances - ELECTRICAL $ and state laws relating to building constr. Ion a•d h•reby authorize repre- PLAN MICROFILM $ inspection of this city to enter upon f abs 1 It honed property for MECHANICAL CHECK $ a purQQ..ores. / ( MECHANICAL $ 54.3.6 c� I' Signature '1... J. Reili 4 Date_11-18-83 - TOTAL FEE $ Drivers' License or SS# ('''' • Reinspection Fee I $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor • - _ - _ . 'CONSTRUCTION AND PLANNING • •< • _ POOH SPA ' APPROVALS Permit `- Date Inspector APPROVALS Permit 46 - Date Inspector 1. Temporary Electrical Service or Polej 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd.N - ro ,r t - 53. Steel Reinforcement 1 3. 'Electr cal4ConduitMUttility-Undrgrlld J 4 i, 54. Forms ,0 -'I iz r..� .Jr _ I 1 •- .4.hectilal'bonduitrUndrgind, • '� ti w 55. Electrical Bonding x 5. Steel'Reinforcement co a • i 56. Rough Plumbing & Pressure Test .-1 6.%le&fPcal UF ER Gt 4. ro - 57. APPROVAL TO COVER-GUNITE 'u 7. `FootiNgs M 58. Electrical Conduit-Undrgrnd. � 8. foundation 00 - '21 . 59. Gas Pipe, 0 Uridrgrnd.,Test y 9. WaterrPipe-Undrdrndl M - .60. Backwash Lines, P-Trap, 0 Undrgrnd. 'A , 1 y 10. Structural Floor Sys{�m , . 61. APPROVAL TO DECK ti 11. open Sewer Line;& House Co"nection '' ='. f3 Y ❑ 62. Backwash & Receptor-Final: 12. SeweriCap L.-- d' •u C - '63. Heater &;Vent-Final `I a n. ,u a t .i 13. Roof Drains w .o , R - 64. Plumbing System - Final ;N 14. 'Aougl?Plumbing o •• - 65. Electrical-Final 15. Rouh Electrical-Conduit 9 66. Solar System-Final :1.6. Rough Electric Wiring - - 67. Fencing & Access Approval 1-7. -Rough Wiring Sign - , I 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling • - - - 69.E POOL/SPA SYSTEMS FINAL lb. Rough Heating &Air Conditioning - . FIRE DEPT. REQUIREMENT ' ' . 20. Rough Factory;Fireplace• APPROVALS Permit# - „t • 21. Ducts, in Struure 70. Underground Hydro 22. Duct, Ventila ting - 71. Product Piping 0 Gas 0 Oil 2'3. Gasl�jipgRoug},&Test 72. Underground Flush . r:-I 2 dbHFi ming - , 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roo'SRathing 74. Overhead Hydro v 26. T-Ball Ceiling (Structural) & Monocoat i - • • - 75. Dry Chemical 2t Framy and Flashing 76. Dry Standpipe i0 28. •L�Tht�g & Siding• ' 77. FIXED SYSTEM FINAL . 29. Insulation 78. FIRE PREV. FINAL 7 30. Di7f$11 Nailing - - HEALTH DEPT. REQUIREMENT 3.t. Plaster Brown Coat-j 79. FINAL INSPECTION . 32. Eleptiical Power M:t`ier-Final • I ; I 80. FOOD CERTIFICATE ISSUED 33. Final Electric • ' Notes: • 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test • 36. Hood or Canopy • • 37. Final Factory Fireplace - - . 38. Final Plumbing ' 39. Water Service-Final - 40. Gas Service-Final • 41. Solar Domestic-Final , - i ' 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' • ' , SO ,— Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA . / PERMIT NO. IB%CI NO. I LOT NO. BLDG.NO. ' I� CONSTRUCTION PERMIT _/O/� S1 U `,14.99-210 44 Project Address 150 Valley Forge . Costa Mesa TYPE OF CONSTRUCTION Li NEW LJ ADD IJ ALTERATION Li REPAIR- ApplicaE's Mailing Address same - ❑ CONVERSION ❑ DEMOLISH ® OTHER Reroof Class A A.P..# Zone - Owner's Name Monticello Comm ASSlthone 540-1 097 DESCRIPTION OF WORKFiberg1 ass, Cnmp , Asphalt Roof 1.p S Main Building: Accessory Building: • Z Address game L�_ E 0 TYPE OF PERMIT El❑ GRADING FOUNDATION ❑ STRUCTURAL T Front N Arch/Eng. License No. ® TENANT xe iootJUUCA ❑ PLUMBING ❑ MECHANICAL BA - N Address ingRear Contractor's Name San Mani nn ROnf r7f)hone 974 3-070 PROJECT DESCRIPTION' SQ. FT. 10, 700 OCCUPANCY R-1 C Right G KR Address(mailing) . _ _ _ • _ CON ST RUCTION TYPE 5—N VALUATIONS 6500 $ Left E City License No. ___02.60$rj• ZONE - __ GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ U , LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided I I hereby affirm that I am licensed under provisions of Charter 9(commencing R with section 7000) of Division 3 of the Business a rofessions Code,and Use of Building: E my license is In f I f rcis and effect. M License Class y--+J Lic se PLUMBING ' FEES Planning Notes: E pate 11-1R-R3 Signature 4,/, N 'YORKERS'COMPENSATION DECL RATION Baf$ink ShOW¢fs _ T iereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink S Workers' Compensation Insurance,•or a certified copy thereof (Section - 3800, Lab. C,]_ 82 15045 yFremon Inde lty_ Backflow Irrigation Sewer Cap ' ELECTRICAL FEES Policy No. W1' ompan -- -- - ❑ Certified copy is hereby furnished. J Bathtubs Sewer Connection Automatic Washer Transformer III15-50KW �{1 Certiy'ep coappyy is 1{ / Iep with the city ui v lo r ��/�}� Date 11-16-213 Applicant - .4 IKL(�:! Clarifiers Solar Collectors I Construdion_Pole Sub. 050+ KW I EXEMPTION FROM WORKERS'COM NSATION DECLARATION Dishwasher Solar Piping (This section need not be completed if the permit Is for one hundred($100)or P 9 Cooking Unit Meter ❑Up to 100 amps less). I certify that in the performance of the work 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 ❑Electric Sub Panel Date _Signature — — NOTICE: If,'after making this declaration,you should become subject to the Floor Sinks Urinal Fan. Motors 0o-1 HP 01%-8 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. Inc.Solar ❑9-15 HP 01615+ CONSTRUCTION LENDING AGENCY - I hereby affirm that there is a construction lending agency for the performance ' Interceptors Water Heater Fixtures 'Microwave of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Kitchen Sink Water Service Device Boxes Pole Light Lender's Address Lavatories OWNER BUILDER DECLARATION Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the P—Trap reason (Section 7031.5 Business and Professional Code: Any city or p Switches Sign 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 to file a signed statement that he/she is licensed pursuant to the provisions of -• • 'he Contractor's License Law(Chapter 9(commencing with Section 7000)of Wision 3 of the Business and Professions Code) or that he/she is exempt - Generator ❑0-5 KW 05-15 KW Trash Compactor erefrom and the basis for the alleged exemption. Any violation of Section . .031.5 by any applicant for a permit subjects the applicant to a civil - • , penalty of not more than five hundred dollars($500). Reinspection Fee $25 Issue Fee $ 3 • D 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 IIIthereon, 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 buildingor improvement is sold within oneyear of com- Duct-Under Ground P Application Approved By Date plebe r h owner will have the burden of proving he/she did not build or Im- - Lf t Love for the purpose of sale). _ Duct-Structural Refrigeration System Application Issued By / Datsl/l ��/ LJ I, as owner of the property, am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY 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 ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ to 7.O'D SMIP $ '.$� tractor(s) license pursuant to the Contractor's License Law). - PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ ISSUANCE $ • Date owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $ • I hereby certify that I have read this application and state that the above • ❑0.100,000 BTU 0100,000 BTL GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ andstatelaws relating to building construction,and hereby authorize repre- PLAN CHECK $ MICROFILM $ sentatives of this city to enter upon .e a/ TOTAL $o e- i••ntioned property for - fi�Drr �I Inspection purposes. , I MECHANICAL $ 07.5_C1 Signature L. J. Rei 11 . . _ Date 11-18-83 Drivers' License or SS 5g Al - • CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - . . • CONSTRUCTION AND PLANNING: el - ' . POC SPA Date Inspector Date Inspector APPROVALS Permit#' i APPROVALS Permit# - , 1. Temporary Electrical Service or Poled y - - 52 Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - • „,--) .1 y% - 33 • 53: Steel Reinforcement 3. Electral•ConduitUtityUndrgrnd:O m a 54.- Forms, 4.,ElectrralThonduitgUffdrggnd. ,-.1 55. Electrical Banding -• .5-,.Steel Reinforcement • ) 0 56.. Rough Plumbing & Pressure Test 6. `'�Ie�tr'cal UF I n _ - pi ` 57. APPROVAL TO COVER-GUNITE %' 4 T.tPoOYings O W - 58. Electrical Conduit-Undrgrnd. 8. 1F�ouod'ation • x0 'w • 59. Gas Pipe, D Undrgrnd.,Test • :,/' '-t + 9. Water4ipe-Undrgrnd.• 'l 60.. Backwash Lines, P-Trap, 0 Undrgrnd. ,1, • 1 10FatruAral Floor Sysf,c n 61. APPROVAL TO DECK - ,i 11..Property Sewer Line Sc.House Cognection '' - 62. Backwash & Receptor-Final • e n n, H 12. Sewer Cap i !..1 4 -' 63. Heater & Vent-Final 'i 13. (Roof Drains -� .'D ' a 64.-Plumbing System - Final :.---3 14. Roug5 Plumbing �� I'r • .h 65. Electrical-Final_ 15.15.-RoughElectrical-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 4- 20. 20. Rough Factor Fireplace APPROVALS Permit# _ 21. Ducts, in Strugture 70. Underground Hydro ..,1 2. Ductnsl, ntilaiing. • 71. Product Piping 0 Gas 0 Oil -j3. Gas Pjp jRough & Test , ' 72. Underground Flush U. Rdot Fratning ,? 73- el . Undergrnd.Storage Tank 0 Gas D Oil 23. RoottSheathing 74. Overhead Hydro 73S. T-Ba Ceiling(Structural) & Monocoat 75. Dry Chemical 27. Fame and Flashing 76. Dry Standpipe '28. Lathing& Sidinftig I 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Dreyll Nailing ;CiI • I HEALTH DEPT. REQUIREMENT .31. Pl41 aster Brown Coat 3 79. FINAL INSPECTION 32. Electrical Power I'1eter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric I 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 i 43. Backflow Irrigation _ . : 44. Landscape Irrigation System - - _ 45. Sound,Attenuation . • 46. Handicap Regulations, , , ' i , 47. FINAL STRUCTURE & BUILDING • ' 48. Special Requirements Completed - - I I 49. Electric Release to Edison -' •, 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY __ _ No. - ' Date ' r ' • i s s Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 520B 4/01/87 "CITY 1� TR�/hf _.^ LOT NO. UNIT NO. - {n - I CITYO COSTA-MESA O STRU TION PERMIT -LLL : 7if? ((/U • Project Address I O a F-y e. Applicant's Mallin. Ad•ress CoTYPEr11 OF CONSTRUCTION LI NEW I1,ADD U ALTERATIDN H REPAIR '1 q I. C, u i 1 • • Phone LJ CONVERSION ❑ DEMOLISH ❑ OT A.P.# T / —//. "1 //(p / /.!e// /OC- LZone �'� Owner's Name =• a CYOL, /!/ llr7 I J Address L a. arc - q'2-‘26 DESC IPTION OF RK/USE OF BLDG. lit !i �-A L' + I , "n \S 5 7 a ���yyyIII d S Main Building: Acce sort'Building: Z Arch/Eng. .ak Irl .. ' ip /�Lica, se No 10)12 TYPE 0 PERMIT LI GRl�ING� FOUNDATION RIS RUCTURAL T Front 0 Address Ws a2 1 aCI•a •sN Q__Les Pa Ire- 0 TENANT ❑ ELECTRICAL PLUMBING 0 MECHANICAL B Rear N Q Z - • - . ,rte her' onergi-24d 0 OTHER A Contractor's Name,,-q, t - C Right N Address(mailing) t `t'�• • s 11+ .SanY,� PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G 3/777 CONST RUCTION TYPE VALUATION$ 1�DO s Left City License No. ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping. Ref. # Parking Req./Provided E I hereby affirm that A am licensed under provisions of Charter 9 (commencing Remarks: Cert i1 /may �� .W ` Planning NOLs: /n / /� !-,f , �� M with section 7000) of Plvislon 3 of the Business and Professions Code, and �•�+ ` QVC/ T•- �Gt •e.tsrfai, .yl`,V��/y.:'�{jl.(- ( sJ �A T my licenses In full for -and effect. ( V/ l /s a... -/- /-•,.1/,t �I psis yyl on /t s p /�_ License lass — L - se No4 S I ./)�(J/t-/ (WI/ 97 mon i / 1-C�(/ j(Jf Cr////6 S T // Dat • yignat ' • 1 r.. �,., PLUMBING FEES I / WORKERS'.COMPENSATION DEC"A' 1 ION Bar Sink Showers hereby affirm that -have a certificate of consent to self-insure or a certificate ELECTRICAL FEES f Workers' Compensation Insurance, or a certified copy thereof (Section `_ .{� Backflow Preventer Service Sink Automatic Washer Transformer 0 15.50 KW 3800, Lab. C.).,_ v _ Policy No. 77n.�p (O Company S IG FA Backflow Irrigation - Sewer Cap0 50+ KW Construction Pole Sub. It- acertified'copy Is hereby:turnisehed. - W Certif"ed co y is filed with the ity Bu'Iding DI n. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date P✓�+-_� Applica Q�..•j EXEMP IOY ON FROM WORKERS' OMP ION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps (This section need not be completed if th permit Is for one hundred ($100)or less). - Dishwasher Solar Piping Dryers ❑Gas ❑Electric 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-i HP ❑i'h-8 Workers' Compensation Lawof California. _ Date Signature Floor Drains Swim , g Pool w/Spa F.A.U. r— Inc.Solar Qg-15 HP ❑16-15+ NOTICE:If,after making this declaration, you should become subject to the — Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks inal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY > t5 Water Closet Device Boxes 'I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. C,) Water Heateretlets RanLender's NameOu9Lender's Address Water Service Switches Sign OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Auto-Washfollowing reason (Section 7031.5 Business and Professional Code: Any city orGarbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair Laundf Tra sany structure, prior to its issuance, also requires the applicant for such permitY y Generator ❑0-5KW ❑5-15KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions ofthe 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 __ • enalty of not more than five hundred dollars ($500). U 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 (Secion 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 V 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 g / Bate V(,7 sale. If, however, the building or Improvement Is sold within one year of com- — Canopy Type II 0 Zoning Approved By YJ`� L _pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground f prove for the purpose of sale). Building Approved B Date ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration Syste Application Issued ByData, 2.Is/S7 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 ' ❑0-100,0 U ❑100,000 BTU SUMMA OF EES •�-� builds or Improves thereon, and who contracts for such projects with aeon- - S_V• tractor(s) license pursuant to the Contractor's License Law). I am aware thatExhaust System 0 Multiple 0 em Repair/Alteration BUILDING PERMIT $ 2.C.2 .S' SMTP $ proof of their Worker'§ Compensation insurance should be provided to me. PLAN CHECK $ `7 PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System& Du - g Registers ENERGY P.C. $ PLAN CHECK 25% $ I hereby certify that I have read this application and state that the above 00-100 000 B 100000 BTL GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws relating to building construction, and hereby authorize repre- MICROFILM $ sentatives of his city to ter upon the above-mentioned pro erty for - PLAN CHECK 50% $ inspection p roses. to ter l� j MECHANICAL $ 3 •"33 1`}L�.9,F13/ ` TOTAL FEE $ e Signature Dam Drivers' Licen S# Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ \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 UF ER 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 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 c- '_26. T-Bar Ceiling (Stru tura!) & Monocoat - 75. Dry Chemical 27. Frame and F ing 76. Dry Standpipe • 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT t 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 381-Final Plumbing - - 39. Water Service-Final 40. Gas Service-Final • 41,. Solar Domestic-Final . , - 42. Backflow Preventer • 43. Backflow Irrigation r '44. Landscape Irrigation System '45. Sound Attenuation �r' /� v .746. Handicap Regulations CP81 t .t �.,, - r n944-60, 47. FINAL STRUCTURE & BUILDING �-- i� Ppppp�'TWO"' v f _r-'777r���g (�, 48. Special Requirements Completed FK , Z , !_'l SeS 11 49. Electric Release to Edison r /178 S- c ,g SCJ ' .. PC 50. Gas Release to Southern California Gas Co l 11 ' 51. CERTIFICAT•E.OF OCCUPANCY • No. _ Date 1 i • i50 Vel ley . large • ?Par a ."-1 P® raa"-1 3D CITY OF I: Mrt- tic/ PLANNI DEPT. WcBWJECT TO LOG. DEPT. TEG. DY 4. .. iATELalr, 011 .'•11 Of PLANNING rkg p % 011.1 4' -Jj V /9 ) Emir NI City of Costa Mesa Building Dept. .t.:ke BY / - DAT 19.1,Q> T ESE PLANS MUST CE ON JOB AT ALL TIMES MAKE • NO CHANGES WITHOUT PRIOR APPROVAL OF DEPT. THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL OF PLA AND SPECIFICATIONS SHALL NOT RE CONSTRUED TO BE A PER I FOR, OR AN APPROVAL OF. APff VIOLATION Of ANY OF THE Pi OVISIONS OF THIS CODE. 40 PERMIT PRESUMING TO GIVE AUTH 'RELY TO VIOLATE OR CANCEL PROVISIONS Of THIS CODE •HALL BE VALID, EXCEPT IN SO FAR AS THE WORK OR USE WHKC IT AUTHORIZES IS LAWFUL. i TEE ISSUANCE OF .A PERMIT BASED UPON PLANS AND • SPECIE ATIONS SHALL NOT PREVENT THE :WILDING OFFICIAL FROM HEREAFTER REQUIRING THE CORRECTION OF ERRORS IN SAID LANS AND SPECIFICATION'S OR FROM PREVENTING BUILDIT G OPERATIONS BEING CARRIED ON THEREUNDER WHEN IN VIO TION OF THIS CODE OR Cf ANY OTHER ORDINANCE OF THE CI . f • 11 f a.3 ' . Mt "..... ._.. . .: _ ... .. 3 �5 • APPROVED. City of Cosa Mesa Building opt. BY DAT SKI 19 F. THESE PLAN MUST BE ON JOB AT All TIMES MAKE NO CHANGES WITHOUT PRIOR APPROVAL OF DEPT. GRANTING OF A FEW,%. OR APPROVAL OF THE'ISSUANCE OR F JdiiNG ' J PLANS AND SPECIFICATIONS Si!AI L NO1 LE CONSTRUED TO BE A PERMIT FOR, OR AN APPROVAL GF, AN'VIOLAT'ON OF ANT OP THE.PROVISIONS OF THIS COUE.KG PERMIT PRESUMING TO GIVE AULHORITi TO VIOLATE OP CANCEL THS PROVIS ONS OF THIS CODE SHALL BE VALID. EXCEPT IN SO FAR A5 TFG WORK OR USE WHICH IT AUTHORIZES IS LAWFUL. I THE ISSUANCE OF A PERMIT BALE!: UPON PIANS NS AND SPECIFICATIONS SHALL NOT fi.[V::•: ThE d•.:+'UII:G OFFICIAL FROM THEREAFTER 6EOUiRING THE CORRECI!OI•I OF ER;ORS IN II SAID PLANS AND SPECIFICATIONS OR FROM PREVENTING BUILDING OPERATIONS BEING CARRIED ON THEREUNDER WHEN IN VIOLATION OF THIS CODE OR OF ANY OTHER ORDINANCE OF THE CITY. • I . 'a2 ra4 POLE ( / rCI. ra- raL-ffh1e- Ats5!J • 1 T4t' EhILS 47. do,oa' !'91 - / FLAC/ POLE 1 I ,,"" .C4- lxc E �G `1esrse eES/1t/ 1 - 7E,v5&E ST do,ceofCI ,/ oRis-i NsAL- WE-T' II I S;aw701Ite /'/ .-7 0.p. ,{, 5 IIo D IIS/ot/R/e s "Lev s .2 II , t kit; . /B 4i z �LuytPac f ' .G. , coni cr ic/Ci• ,-,---\e„ass-x0-24,:" \:K rill „rip I .110-.*--_ lir:- til ��0 Pip C. A <<. I I 1�v > • • ;?ate No. 10183 s•. _ 2 00o pit_co sc7�lr ,y I I,1. . 4044 G. I I I d I + ! ILIJ �'1—' . . .. •eY.r •t_ �;=*i 7/. 2=o .• �, Mat anal••wa aleisn....1 sat a m g t BERNARD C. ADAMS � . b MMC. Kn..1 tiw seinen fwf 1n •.l V ^ (y-- 1.-•is dM .q �Illa ,wi ! C. AGMS �a a . I . I . c •. I •" •I a . . . ..I .I•. 1,... , 5 , • i . -. GA[ CLirrid .f ' U � - ' --1- _ • • 74 rnpN w/LiD &Ala p-A4- I 70 inn, WOD P3 A ,t V 7.€0003 ?Lear P=Oo x 701.1 x..* o 3 .,. 57„ Cv 60i 7049e , 00a> . pl. 57.- [Pa33 : 2o1C, - L-'i •- 5 7° #-g 30 1= 1730 VOLE- 1X 72 x05 K 1;.p = 3 or 1-M l n 4Fr-L_3s z r� = e 6'24 /� 6 i�x •?/267-3% =182.p '11•11• ; ZSSi 1 2 • x : 1‘7C•1340p X --J- 17- gP, 2G'o .Q- �� TRY 2 F4 3 - CI ii • ... TRY 2 f x 4'-o DP. P74. 5= /50 - 2fif. 33A3•754 ' ja-'I'. ,,: 15o x2Y. 1. 33x 473 : s : A - -2.34 pc n , '.3Co A: 2.34 x 263 5, � n- 53 532 = • 4.22 •Cly t='(/ c - : in;.4i7A...; = 7- � J : .0,1 7. Ji.4. 4,xlq /p A. JJ�1 n 2- l -Z.1-a- ii s' X 4.. ...a 1,--74. . • . a,�Ec6 C. > ' d: c. s J1 . IA :s0 - 7 , J.t7., d - o.0 w = .130 t "2. st .oqe o/4 did = 6,435in ' 2: •rya J4- 1.4 : -7. 0,5 d d f1-,=. 5/r21 K12 ./7•oS % G!5/v7 14, 4'223'1 x / a /6-- iQs • 13b3 gr.-/ - '- - 2A1.1 w .6.,:oo. • #; ; 4bocaAA I.3 = 2U, LQt 3PRO E® City of Costa Mesa Building Dept. - BY 74o- -; DAT O 19_2 THESE PLANS MUST BE ON JOB AT ALL TIMES MAKE NO CHANGES WITHOUT PRIOR APPROVAL OF DEPT. THEI ISSUANCE OP G.ANTINC: O° A PERMIT OR APPROVAL OF . PLANS AND SPECIFICATIONS SHAIL 2,:-.4 3`CO'iSfRUED TO BE A PERMIT FOR, OR AN APPROVAL,GF. AF:Y V:JI:.TION OF ANY OF THE PROVISION'_OF THY;CODE.NO PEhMI`PRESUv,ING 10 GIVE ' s ALITHORITi TO VIOLAT' OR CANCEL PROVISIONS OF THIS . CODE SHALL BE'VAUD, E.'.CEPT IN 50 FAR AS TH2 WORK OR USE - ' • WHICH IT AUTHORIZES IS LAWFUL. ' THE ISSUANCE OF A PERMIT BASED UPON PIANS AND SPECIFICATIONS SHALL NOT PREVENT THE BOOING OFFICIAL FROM THEREAFTER REQUIRING THE CORREC PION OF ERRORS IN SAID PLANS AND SPECIFICATIONS OR FROM PREVENTING BUILDING OPERATIONS 3EINO CARRIED ON THEREUNDER WHEN' IN VIOLATION OF THIS CODE OR OF ANY OTHER ORDINANCE OF • • ' THE CITY.