HomeMy WebLinkAbout3023 HARBOR BLVD - Building Permits • - Appllcan all a within heavy border lines and Sign all appropriate declarations.•
\,
CI' e.-OF COSTA MESA y CONSTRUCTION PERMIT - PERMI NO. ,/3�S TRAC O. LOT NO. U • i
ii �P o-ect Address 30 ,7 � ,4a fi G c. 431.--V � 7`
Applicant's Mailing Address Cc `BD�S �DY&e N- TYPE OF CONSTRUCTION U • w 0 ADD Li ALTERATION REPAIR
/1 J g 0 CONVERSION ❑ D • •LISH ❑ OTHER A.P.V/, _ Zone
Owner's Name V/� �v r' Phone gg -rn - - • OR K/USE OF BLDG.
Address ' ' l- •- r /T • !
"� 1•••• POOL &SPA I
CONSTRUCTION AND•PLANNING ..
APPROVALS Permit:# Date Inspector APPROVALS Permit# Date Inspector
1.:Temporary Electrical•SeTvice or Pole 52. Pool & Equipment Location t
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 Plumping & Pressure Test 1
Plumping
6. Electrical UF ER Grnd. 57. APPROVAI(!'TO COVER-GUNITE i
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation fe• - x,59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd,. - .60. Backwash(Lines, P-Trap, 0 Undrgrnd.
•10. Structural Floor System G_Y:4 �'-c`I LPL APPROVAL TO DECK
11. Property Sewer Line & House Connection • ' 62. Backwa fif&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 j "'
20. Rough Factory Fireplace APPROVALS Permit# J` '
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil r
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
/-727. 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
3LZas•ter-Brown-6oat - INAL INSPECTION $4 ..
/ 32. Electrical Power Meter-Final 7/g e ,i :0. F•OD CERTIFICATE ISSUED
`
11
\ 33. Final Electric a8 �, Notes
\ 34. Final Heating & Air Conditioning •r t
t
35. Final Gas Pipe-Test •
T
36: Hood or Canopy
37. Final Factory Fireplace '
38. Final Plumbing ' •
39. Water Service-Final
•40. Gas Service-Final t• 1,
/..111. Solar Domestic-Final -
.42. Backflow Preventer
43. Backflow Irrigation
_4!4/ Landscape Irrigation System i• -1-4,
45. Sound Attenuation / i
, •1
46. Handicap Regulations • „
.47:•FINAL,STRUCTURE & BUILDING -ti I,
-1: .
48. Special'Requirements Completed
49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co • • ;t
51. CERTIFICATE OF OCCUPANCYt , .
No hDate - I• ,
. 1
Applicant to fun in all spaces except those within heavy border lines and sign all appropriate declarations. 1,
P T NO. TRACT NO.• L T NO. UNIT NO.• _
'([CITY t A COSTA MESA CONSTRUCTION AUCTION PERMIT 41 (oZ �, o A P # 1341- 20-k , 02 , Zone C
oject AEdress `3V 13 yl"01K1��rtV�.Da. G�tR_7# Iu -pA48. S Main Building: Accessory Building:
i
.PI icant s Mailing Address 023 -`vOt&urk Olga 60-416 TYPE OF CONSTRUCTION NEW U ADD ALTERATION U REPAIR Front . Z
l�'OY& J d/'�/�P•/!�r -TIthli— Phone c;7-q)/c, ❑ CONVERSION' ❑ DEMOLISH ❑ OTHER )/•
O
t ne. Name DESCRIPTION OF I(•/e R. USE OF BLDG. +^f= •i• -L LL -a S• • i Il B N
�e A.�t_!' 7 A Rear
Address 0•"`� ��v �I I 11 �_ .0- '1/. -: iti : a_.,%al • N
Arch/Eng. - License No. TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL . , C Right , ` GAddress TENANT ® ELECTRICAL ❑ PLUMBING ❑ MECHANICAL S LeftPDE\0‘27;\
�.+� _ R
Contractor's Name (et>
Phone tL—Jl OTHER • I Ping. Ref.# Parking Req./Provided E
• PROJECT DESCRIPTION SQ. FT. OCCUPANCY O
Address(mailing) 1 Planning Notes: Ltd-t-co •w {-� -� �•wca 5 ,�.yS M
CON STRUCTION TYPE .VALUATION $ f\rli..I.V�. _,� �n _
City License No. - ZONE GRADI NG CU.YDS. ACRES V C/ (Laince Csn l s� bf'1 w•t, • T
LICENSED CONTRACTOR DECLARATION Cl S.
L affirm that I am licensed under provisions of,charter 9 (Commencing Remarks:
with section 7000) of Division 3 of the Business and Professions Code,and - '
my license Is in full force and effect.
• ELECTRICAL FEES '
License Class License No.
Date Signature -.- PLUMBING I FEES Automatic Washer Transformer 0 15-50 KW
f'WORKERS' COMPENSATION DECLARATION • DOn$trUCtiOn POI¢Sub. ❑ $q F KW •
I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink ShowerslIlt.i
•
• of Workers' Compensation Insurance, or a certified copy thereof (Section - ,/)s- Cooking Unit Meter ❑up to 100 amps
3800, Lab. C.) - Backflow Preventer Ser{�'e Sink _ • -
Policy No. Company Backflow Irrigation Sew Cap - - • Dishwasher Meter ❑ove1 100 amps
8 Certified copy is hereby furnished. • •
Certified copy is filed with the city Building Division. BathtubsSewer Connection, Dryers ❑Gas ❑Elec ' Sub Panel
Date Applicant - rg Fan
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Motors ❑0.1 HP 01%-8
(This section need not be completed if the permit is for One hundred ($100) or-," - F.A.U. - Inc.Solar ❑9a5 HP 016-15+
less). _ Dishwasher Sohl1'- Piping ,-i _ -
I certify that in the performanc of the work for which this permit is Issued I
Fixtures
shall'not employ any perso n any mann r o as to become subject to the Drinking Fountains SolaDTank . - Microwave -
Workery copip-nia►j$n sof California ... -/ Device Box
Date ,�,'— //66 (la Signature wW�-1,� r Floor Drains Swimming Pool'w/Spa . Pole Light -
NOTICE: If,after making this declaration,you sho be me subject to the •e - { Outlets 3 ^1�
Workers' Compensation provisions of the Labor C de, you must forthwith Floor Sinks •
.. Urinal - .. �A Range - /
comply with such provisions or this permit shall be deemed revoked. '
-CONSTRUCTION LENDING AGENCY - Gas Service Outlets Water Closet •
Switches Sign
I hereby affirm that there is a construction lending agency for the performance Garbo a Dis Oso
'of the work for wh'c this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater - - g P Standing Sections
Lender's' Name •
Lenders Address - Kitchen Sink - Water Service Generator ❑0-5 K ❑5-15 KW Trash Compactor
��Ii1WNER BUILDER DECLARAT N -
i I hereby affirm that I am exempt from the Contractoros License Law for the Lavatories Auto-Wash •
following reason (Section 7031.5 Business and Professional Code: Any city or ., - -
county which requires a permit to construct,alter,improve,demolish or repair P-Trap . - Laundry Treys r t
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 Roof Drains - ti " 1 u
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 Reinspection Fee $15 Issue Fee
•
-.:I-therefrom and the basis for the alleged exemption. Any violation of Section - i ':� • �a�
7031.5 by any applicant for a permit subjects the. applicant to a civil
- _Weltya of not more than five nuntlred dollars($500). I • • • s•� DEVELOPMENT SERVICES REQUIREMENTS: '�_(/
onIC m,'as' owner of the property n my employees with wages as their sole Reinspection Fee' I •
$15 Issue Fee $ 3 !i.
compensation, will do the work,and the structure is not intended or-offered frrr Zoning Approved By Date
for sale (Section .7044, Business and Professional Code: The Contractor's - - • MECHANICAL FEES" . Building Approved By v _
License Law does not apply to an owner of a property who builds or improves Date
thereon, and who does such work himself/herself or through his or her own HoodTypeI 0 - Application Issued By
employees, provided that such improvements are not intended or offered for BOIIEIorDat
sale. If, however, the building or improvement Is sold within one year of coin. , Canopy Type II 0 Iµ ,
p: on the owner will have-the burden,of proving he/she did not build or im- Duct-Under Ground SUMMARY OF FEES
p.1- for the purpose of sale). • - BUILDING PERMIT $ SMIP O
W as owner of the property, am exclusively contracting with licensed con- Duct-Structural RefrigerationSystem $
PLAN CHECK $ ' 77 7� '
aPERMIT
actors to construct the project (Section 7044,Business and Professions Code: i
-ihe Contractor's License Law does not apply to an owner of property who Duct-Ventilating - ❑0-100,000 BTU ❑100,000 BTU PLUMBING $ ISSUANCE . $ .
builds or improves thereon.and who-contracts for such oroiecls with a con- - _ _ -
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 , System Repair/Alteration s` PLAN CHECK 25% $ ENERGY P.C.' $
swot of their Worker's Compensation insurance should be provided to me. i. GRADING $ '
Th. I am exempt under Section - B.& P.C.for this reason Firepl/Fact.Blt. ICBG# . Fire Dampers ): ELECTRICAL $ ,
PLAN CHECK •50%' $ MICROFILM ' $
Heating System& Ducting Registers i - !
Date Owner MECHANICAL $
-I hereby certify that-I-have read this a li ation and state that the above -- 00-100,000 BTU 0100,000 BTL— " - - .. •
TOTAL FEE $
Information is correct. I agree to comply with all city and county ordinances , •- 1 PLAN CHECK 25% $ ,� fJ'
and state laws relating to building construction, and hereby authorize repre-
sentatives of this city to e t r- upon the above-mentioned property for •
i '• ,
inspection piPO ozez�7 - -• • ' - '
Signature fT /7--y'4
--....Reinspection Fee $15 Issue Fee i $ 3 Drivers' License or.SS _ i' _ _ _ n
0865-46,rev.5/88 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor .meq- Jnn Z 013007100-00007103 TOTQL- 78.11" -
I •
.RUCTION AND PLANNING v. POOL&SPA
APPROVALS Permit# Date Inspector •APPROVALS Permit # - • Date Inspector
1r Temporary Electrical Service or Pole . 44 52. Pool & Equipment Location !
2 Soil Pipe-Undrgrnd. • 53. Steel Reinforcement - -
:it Electrical Conduit Utility-Undrgrnd. 54. Forms i '•
•
4; Electrical Conduitt`ndrgrnd. r/ 55.-E ctrical Bonding •
5,:Steel Reinforcement)` 56. Rough Plumbing & Pressure Test
r i
6: ElectricalUFERGrnd. 57. APPROVAL TO COVER-GUNITE _: ;I
7. Fdotings 58. Electrical Conduit-Undrgrnd. - •?
8. Foundation •••\i • -,_ 59. Gas'Pipe,-D Undrgrnd.,Test
9: Water Pipe-Undrgrnd. " 60. Backwash Lines, P-Trap, 0 Undrgrnd. i•.i
1O..Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection G 62. Backwash & Receptor-Final
12:1Sewer Cap
63. Heater & Vent-Final
13.-Roof•Drains •I 64. Plumbing System - Final
14t Rough Plumbing I 65. Electrical-Final
.:.15.'Rough Electrical-Conduit66. Solar System-Final
. C16. Rough Electric Wiring Ga,� 67. Fencing & Access Approval t•
•117. Rough Wiring Sign 68. APPROVED FOR PLASTERING
l8: Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
'191. Rough'Heating & Air Conditioning FIRE DEPT. REQUIREMENT
2d. 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 . verhead Hydro
' 26. T-Bar Ceiling (Structural) & Monocoat / ///// 75. Dry Chemical
' 27 Frame and Flashing 6/17 y/�//,.,,L, 76. Dry Standpipe
28. Lathing& Siding `fes ! ""/'� - 77. FIXED SYSTEM FINAL
29. Insulation - filf
78. FIRE PREV. FINAL
30. Drywall Nailing �; HEALTH DEPT. REQUIREMENT
31. PlasterBrown Coat / 79. FINAL INSPECTION
tlectrical Power Meter-Final t0. FOOD RTIFICATE ISSUED
33. Final Electric ' • 0A Cu��' otes:0
.. •• . _ .rditioning I
,
35. Final Gas Pipe-Test t /�
36. Hood or Canopy V
37. Final Factory Fireplace /3,Via;__
V38. Final Plumbing ' : I ,i l I 4
39. Water Service-Final , i/ V -"414e
,40. Gas Service-Final ,i 1
41. Solar Domestic-Final . , /
42. Backflow•Preventer-' �I•a /, _)-)
✓I '.Ii7j
43. Backflow.1rri �
gation.' r '�, I
(44. Landscape.l/rigation-System L-.1„.
;
45. Sound Attenuation
• 4 icap fatiens •
/'&S)
TURE & BUILDINGi.
K
49. Electric Release to EdisoOn 4 . -J 0
'2 50. Gas Release to Southern California Gas Co f -,-1
'7 . . kr)0
. 51. CERTIFICATE OF OCCUPANCY "•' ` 1 L.!
No. • ' Date -- 5 jJ 2 1J 17)1
Applica, ' - • - cept those within heavy border lines and sign all appropriate declarations.
CITY OFA COSTA MESA CONSTRUCTION PERMIT 1 PER NQ.0ii0e ',CT NO. LOT NO. UNITp�. A.P.# zone
Project Address a o iliaao/2 Bkcl D. U*104— A - (7/ -�i-1l� S Main Building: Accessory Building:
Applicant's Mailing7TllJAddress - " S NEW ADD U ALTERATION LI REPAIR E Front Z
srIJ P1 C ( _� Phone ❑ CONVERSION ❑ DEMOLISH ❑ OTHER • TB N
Owner's Name DESCRIPTION OF WORK/USE OF BLDG. A Rear I
Address
TYPE OF PERMIT U GRADING U UNDATION ❑ STRUCTURAL C Right N
Arch/Eng. License No. K G
Address
El TENANT ❑ ❑ R
ELECTRICAL PLUMBING MECHANICAL $ - Left
�H-•k- S/1kat P n.raf� ri'{d•YYti4 ❑ OTHER Ping. Ref.# Parking Req./Provided Q
Contractor's Nam LAK–Phone E
Address(mailing)/RC La)�i I PROJECT DESCRIPTION SQ. FT. OCCUPANCY M
PlanningNotes:
C5.3 16I R C ON ST RUCTION TYPE VALUATION$ T
City License No. ZONE GRADING CU.YDS. ACRES
LICENSED irm that
I DECLARATION ION ` / _/ O �.� - S.
hereby affirm7 that I am tlicensed under provisions f Charter 9 (Commencing4 Remarks: �/^l L7/'
•
with sectionnsis 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect. ELECTRICAL
License�qClass''^� o C-3 c' License I. - 7 I
Date./45±._1- Signature — – .r- PLUMBING I FEES Automatic Washer Transformer ❑ 15-50 KW
WORKERS'COMPENSATION DECATIOH /
Construction Pole Sub. • 0 50+ KW
'.hereby affirm that I have a certifica,- f consent to self-Insure or a certificate Bar Sink Showers
f Workers' Compensation Insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps
4800, Lab. C.) _
Policy No. _ Company Backflow Irrigation Sewer Cap Dishwasher , Meter Clover 100 amps
❑ Geri fled copy is hereby furnished. Dryers OGas ❑Electric Sub Panel
/Certified copy is filed with the city Building Division. Bathtubs Sewer Connection
DateApplicant Fan
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Motors 00-1 HP 01%.6
(This section need not be completed if the permit is for one hundred ($100)orF.A.U.
less). Dishwasher Inc.Solar 09-15 HP ❑16-15+
ar '
I certify that in the performance of the work for which this permit is issued I Fixtures -
shall not employ any person In any manner so as to be ome subject to the Drinking Fountains So Tank !' Microwave
Workers' �nPenspti9n taws? of California, / / ,
Date �4 �//\ % ignature, ' �. .�� Device Boxes Pole Li ht
Floor Drains Swi • ing Pool w/Spa 9
NOTICE: If,after making this declar4n,you should be.t e subject to the Outlets Range
Workers' Compensation provisions he Labor Code, u must forthwith / Floor Sinks Urinal lir0• 9
comply with such provisions or Is permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY , Gas Service L Outlets Water C - Q- O Switches Sign
I hereby affirm that there is a construction lending agency for the performance
Garbage Disposal StandingSections
of the work for which this permit is issued (Section 3097 Civ. C.) ^
Interceptors Water Hea �C 3
Lender's Name
Lender's Address - - Kitchen Sink if Water Servs Generator 00.5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories / Auto-Wash a 0
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair P–Trap ' Laundry Trays
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 Roof Drains
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 Reinspection Fee $15 Issue Fee $ 3
:re(rom 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
penalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS:
• 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 Zoning Approved By Date
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By
License law does not apply to an owner of a property who builds or improves /1 DatO
thereon, and who does such work himself/hersolf or through his or her own Boiler Hood or Type ❑ Application Issued By /v/j�/J.- Dal
employees, provided that such improvements are not Intended or offered for -
sale- If, however, the building or improvement is sold within one year of tom- Canopy Type It 0 SUMMARY OF FEES
pietion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground
prove for the purpose of sale). BUILDING PERMIT $ SMIP $
❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT
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 ' 00.100,000 BTU 0100,000 BTUPLUMBING $ I I, DO ISSUANCE $
builds or improves thereon. and who contracts for such protects with a con- ENERGY P.C. $
tractor(s) license pursuant to the Contractor's License Law). I am aware that ,Exhaust System 0 Multiple ❑ , System Repair/Alteration - PLAN CHECK 25% $
proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING .$
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG* Fire Dampers MICROFILM $
PLAN CHECK 50% $
Date Owner Heating System& Ducting Registers MECHANICALT
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BT
$ TOTAL FEE $ / �� t�
information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $
and state laws relating to building construction,and hereby authorize repre-
sentatives of this city to enter u,on the above-mentioned property for
in •
Sspection purposes.
Reinspection Fee I $15 Issue Fee $ 3 D1 00044655—D0044656 Tr7 11,,,-
0865-46.rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor DATE: 10/1 1/39 TME: h:DD
:CONSTRUCTION AND PLANNING ' y/ PO , SPA
,;F APPROVALS Permit# Date In APPROVALSPermit# Date Inspector
1. Temporary Electrical Service or Pole q52. Pool & Equipment Location
i
, 2. I Pipe-Undrgrnd. 1',y ..- - 53. Steel Reinforcement II)
ljElec Tical Conduitfttil ty-Undrgrnd. 0, .54..Forms le
Electrical ConduitUndrgrnd. 67 a-
43 55. Electrical Bonding �4
u
•�,Stec?! Reinforcement - 7 56. Rough Plumbing & Pressure Test ill
6. Electrical UFER,GTnd 57. APPROVAL TO COVER-GUNITE
4 ii Rel 1/1j2
7-( Footings j G 11 '. 58. Electrical Conduit-Undrgrnd. AL"?
8u Foundation `4-.1 Q A� 59. Gas Pipe, 0 Undrgrnd., Test ` y
9; Water Pipe-Undrgrnd. .14. [ 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural FloorSysstem 0#a tet 2 61. APPROVAL TO DECK
1 Property Sewer.Line & House Connection t • 62. Backwash & Receptor-Final 1 r
1 . x
/' . 12> Sewer Cap q '; r / 63. Heater & Vent-Final r I ,;
Y
13`.'Roof Drains '- 64. Plumbing System - Final •
14. Rough Plumbing _ 65. Electrical-Final
444
Rough Electrical-Conduit' ) 66. Solar System-Final
,•
16. oughRElectric Wiring i 67. Fencing & Access Approval
k e(q
C .,.• ough Wiring Sign t` 68. APPROVED FOR PLASTERING
11.8. ough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
X79. ough Heating & Air Con oning U FIRE DEPT. REQUIREMENT
I
:30. ough Factory Fireplace APPROVALS Permit#
1 Lucts,
.
21. in Structure t
n 70. Underground Hydro
22. Ducts, Ventilating 1 .1 71. Product Piping 0 Gas 0 Oil
51. Gas Pipe-Rough & Test A) 72.�Underground Flush
24. Roof Framing J V 73. Undergrnd.Storage Tank 0 Gas 0 Oil
• 25(Roof Sheathing 1.A"11��1` 74. Overhead Hydro -;
26- T-Bar Ceiling (Structural) & Monocoat /' 35..Dry Chemical
t
27. Frame and Flashing ifi(176. DryStaPdpipe
28. Lathing & Siding �� SY?
r 77. FIXED PEM FINAL
29. Insulation .1. 78. FIRE PREV. FINAL ,
it
30. Drywall Nailing 9 HEALTH DEPT. REQUIREMENT
tel
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final :,,! 6.cFOODJCERTIFICATE ISSUED
33. Final Electric ' 'Notes: 0
34. Final Heating & Air Conditioning
• 35. Final Gas Pipe-Test /Q./Z_i4 (.W9
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing to-(2-4'l L,fp
39. Water Service-Final
40. Gas Service-Final '
41. Solar:Domestic-Final
42. Backflow Preventer
a
43. Backflow Irrigation
n rn
44. .Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations _
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed 1. r
49. Electric Release to Edison C
50. Gas Release to Southern California Gas Co ./ a fry`
51. 'CERTIFICATE OF OCCUPANCY - Q /
No. Date '}'•
,
Aeolic, . ..t those within heavy border fines and sign all appropriate declarations.
PERMIT NO. •CT NO. LOT NO. UNIT NO.
CITY OF COSTA ESA CONS ' UCTION PERMIT E 3 9 1 0 A.P.M• Zone
Project Address -•�- _ `_.tet rt..../_ $ Main Building: Accessory Building:
Applicant's% Ii • Add •ss - ,_•••_......., .. TYPE OF CONSTRUCTION NEW U ADD U ALTERATION II REPAIR E — Z
// I / / we
- - - - . — •EMOLISH ❑ OTHER . T Front o
Owners Na r: y. �"J' .a -• ' one► .��-/ DESCRIPTION OF WORK/U,- 5F :LOG. B Rear N
Address :. -�_ a, ___ _ er San A I
Arch/Eng. ��a`e License No. TYPE OF PERMITSs-� �U GRADING III FOUNDATION N STRUCTURAL I C Right G
Address
❑ TENANT U'ELECTRICAL ❑ PLUMBING ❑ MECHANICAL S Left
Contractor's Namre R
�/____ pla� ( __ ____/ ❑ OTHER Ping. Rei.# Parking Req./Provided E
PROJECT DESCRIPTION SQ. FT. OCCUPANCY 0
Address(mailing) 7 Planning Notes:
City License No. M
Z 91 exec. CONSTRUCTION TYPE • VALUATIONS T
ZONE GRADING CU.YDS. ACRES i
LICENSED CONTRACTOR DECLARATION S.
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: '
with section 7000) of Division 3 of the Business and Professions Code, and
my license is in fu orce and ifect. , ELECTRICAL FEES
Licen- Cla s Lice . r•-_ t •
Dat. i Signature //� ce • PLUMBING I FEES Automatic Washer Transformer 0 15-50 KW •
WORKERS' COMP'NSATION DECLARATION , „—, Bar Sink Showers Construction Pole Sub. 0 50+ KW
5ereby affirm that 1 nave a certificate of consent to • -insure •r a certificate -
Workers' Compensation Insurance, or a died copy thereof (SectionCooking Unit Meter ❑up to 100 amps
a800, lab. ) p r� t� Backflow Preventer Service Sink .
Policy No.�SQ �al Comp °Pi Backflow Irrigation Sewer Cap r Dishwasher Meter Dover 100 amps .
Certified copy is hereby furnished. Dryers ❑Gas ❑Elect it $
Certified
fled opy is`i tojth the city�:/r�i,:lvi i Bathtubs Sewer Connection Fan
Date d'- Applicant Motors❑0-1 HP ❑114-8
EXEMPTION FROM WO KERS'COMPENSATION DECL AT Clarifiers Solar Collectors ,
(This section need not be completed if the permit is for one h ndred (5100) or F.A.U. i -
less). Dishwasher Solar PipingInc.Solar 09-15 HP 016-15*
I certify that in the performance of the work for which this permit is Issued, IFixtures Microwaveshall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank
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Workers' Compensation Laws of California. Device Boxes
Date Signature Floor Drains Swimming Pool w/Spa Pole Light
NOTICE: If,after making this declaration, you should become subject to the Outlets
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Range
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches Sign
CD I hereby affirm that there is a construction lending agency for the performance -
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections
Lender's Name
Lender's Address Kitchen Sink Water Service . Generator 00.5 KW 05-15 KW ash Compactor
OWNER BUILDER DECLARATION - hI`. 1 ('`
I hereby affirm that 1 am exempt from the Contractor's License Law for the Lavatories Auto-Wash ' \.Is(14 LS ) 0
following reason (Section 7031.5 Business and Professional Code: Any city or
csi county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays
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 Roof Drains
the Contractor's License Law (Chapter 9 (commencing with Section 7000)of IC' M
•inion 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee J $15 Issue Fee 29-S--
refrom and the basis for the alleged exemption. Any violation of Section
21.5 by any applicant for a permit subjects the applicant to a civil
eenalty of not more than five hundred dollars(5500)• DEVELOPMENT SERVICES REQUIREMENTS:
U I, as owner of the property or my employees with wages as their sole Reinspection Foe I $15 Issue Fee $ 3 Zoning Approved By
compensation, will do the work, and the structure is not intended or offered - Date
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date iI
License Law does not apply to an owner of a property who builds or Improves y_
thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 Application Issued By Date �`1 VI
employyees, provided that such improvements are not intended or offered for
sale. Ifs however, the building or Improvement is sold within one year of com- Canopy Type II 0SUMMARY OF FEES
plellon, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground
prove for the purpose of sale). - BUILDING PERMIT $ - SMIP $
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK
tractors to construct the project (Section 7044,Business and Professions Code: $ PERMIT
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU
builds or Improves thereon. and who contracts for such orolects with a con- PLUMBING $ ISSUANCE $
tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I PLAN CHECK 25% $ ENERGY P.C. $
proof o their Worker's Compensation insurance should be provided to me. ELECTRICAL $ r��I V GRADING $
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit.ICBO dk Fire Dampers - MICROFILM $
PLAN CHECK 50% $
Date Owner Heating System& Ducting Registers MECHANICAL $ CD
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL - - TOTAL FEE $ 22 `V
information is correct. I agree to comply with all city and county ordinances _ PLAN CHECK 25% $
and state laws lati • • building constructs•. nd hereby authorize repre-
—
sentatives o �]j o • er up•n - above-mentioned property for
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Inspection •s�'f. a'
-••� (�9
Signature ktz' ' i Date�Q�p�7-Y/
g Reinspection Fee $15 Issue Fee $ 3 DI 00036455-C0036453 TOT 22,7,
Drivers' License or SS
Pink -Accounting; Goldenrod - Assessor
r. , - , 1 /
1 • ,CONSTRUCTION AND PLANNING PO( SPA
APPROVALS Permit# Date 1 Inspector APPROVALS Permit # Date Inspector
' 1. Temporary Electrical Service or Pole r . 52. Pool & Equipment Location , -
2. Soil Pipe-Undrgrnd. cl .. 53. Steel Reinforcement f •
3.0:'Electrical Conduli Utility-Undrgrnd. 54. Forms
4.,Electrical-Conduij-Undrgrnd. • - r_. 55. Electrical Bonding
S.,Steel.Reinforcer nt4' 1 t 56. Rough Plumbing & Pressure Test r , r
6. Electrical UF ER Grid.: 57. APPROVAL TO COVER-GUNITE t
7 Footings 1`: r. l.^ 58. Electrical Conduit-Undrgrnd.
8"Foundation ' / 59. Gas Pipe, 0 Undrgrnd., Test w
� . -, t
'-t
9,Water Pipe-Undryrnd. /�i 4160. Backwash Lines, P-Trap, 0 Undrgrnd. --
1'0:',.Struc,tural FloolSystem , \ :. .it e 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection . - - - 62. Backwash & Receptor-Final
12. Sewer Cap . �, 63. Heater & Vent-Final
13. Roof• 1Drains '� - �
64. Plumbing System - Final
TARough Plumbing 65. Electrical-Final
1 15. ftugh Electrical-Conduit 66. Solar System-Final
16. Ro""ugh Electric WiringIf
67. Fencing & Access Approval
17. Rogh Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
II 19. Rodgh Heating & Air Conditioning FIRE DEPT. REQUIREMENT
S 20. Rojighh Factory Fireplace APPROVALS Permit#
( 21. Dcts, in Structure 70. Underground Hydro
))..,22. cts,1Ventilating 71. Product Piping 0 Gas 0 Oil
,2.i. Gas PiperRough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
'27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final , 8 FOOD CERTIFICATE ISSUED
33. Final Electric (jj� � ,-•may"otes:
34. Final Heating & Air Conditioning
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35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final tS'a,��
41. Solar Domestic-Final
if/ 7^,� ,
42: Backflow Preventer // ,/, "'S'e '
43. Backflow Irrigation ./ '/ '
.
44. Landscape Irrigation System �/ 7/
45. Sound Attenuation d iii
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 •