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Home My WebLink About357 LA PERLE LN - Building PermitsAttributes Property Address Address 1 357 LA PERLE LN Address 2 COSTA MESA CA 92627 Parcel Information Assessor Parcel Number 42531174 Legal P BK 220 PG 32 PAR 1 Range Township Section Quarter Section Area Acres owner Owner Address 1 Owner Address 2 Vear Built Building Square Feet Building Count Stories Number Parking Spaces Number of Units garage Square Feet Front Footage Depth Footgae Bedrooms 5028.84027 0.27 Owner Information HOLMES JAIME C 357 LA PERLE LN COSTA MESA CA 92627 Property Specs 1954 984 1 3 Property Address Address 1 359 LA PERLE LN Address 2 COSTA MESA CA 92627 Parcel Information Assessor Parcel Number 42531173 Legal P BK 2Z0 PG 32 PAR 2 Range Township Section Quarter Section Area 6352.08497 Acres Owner Owner Address 1 Owner Address 2 Year Built Building Square Feet Building Count Stories Number Parking Spaces Number of Units garage Square Feet Front Footage Depth Footgae Bedrooms Owner Information FARLEY ERIN 270 E 25TH ST COSTA MESA CA 92627 Property Specs 1987 2153 1 Page 1 of 1 http://mesagi s2x/website/costamesa/parcel/popup.asp?opt=Attributes&HistoryID= {6B4B... 02/24/2003 ADPlleant ta fill in all spatts except t�ose wilhin neavy bortler Iines antl slgn all aporooriata aeelantions. CITY OF COSTA MESA CO1N�S,TRU TION PERMI PERMIT NO. � TRACT NO.� LOT NO. • UNIT NO. A P#�� Project Address 35� - �:G(� �erle • l.-a.,�n.e g �'' `{1 ZS � � 1 h5 : 23. � - -- - - S Main Building: ApplicanYS Mailing Addt2s5 SRnnF � TYPE OF CONSTRUCTION ' New � � aoo ALTERATION REPAIR E ❑ CONVERSION ❑ DEMOLISH � OTHER ' T Front Owner's Name ��M ��LM �S Phone ��DESCRIPTION OF WORK/USE OF BLDG. ' B Rear � Address iG� �A- peec-F � . . . . . . , a I C Right � Arch/Eng.' License No. TVPE OF PERMIT � GRA�ING FOUNDATION STRUCTURAL ' K ¢ Address � ❑ TENANT ❑ EIECTRICAL ❑ PWMBING ❑ MECHANICAL -. � � S'� �ef� aJ Convactor's Nam Phone'215 �l�G.(G(� � �oTHER � ' � Ping. Ref. # � PROJECT DESCRIPTION S.i. FT. oCCUParvcv Addresslmailing) 3�� R'�'�� p PlanningNotes: ��%m63 CONSTRUCTION TVPE V I�.I VALUATION $ ��{� �, City LicenSe No. , ZONE GRADING CU. VOS. ACRES LICENSED CONTRACTOR DECLARATION � ' I hereby aifi�m that I am licensetl untler provisions of.Chdrter 9�(comm¢ncing Rema�ks: � ' with section ]000) of Division 3 of the Bu5ine55 antl Professions Cotle, antl , my license is in tull fbrce ana effect. . � � ' icense Class G _Li nse No. 3� 3 0:�� F:eu �—B'� Signature � PIUMBING FEES ,JORKERS' COMPENSAT�ON DECLA TION ' Baf Sink ShOWeIS' , I hereby atfirm that I nave a certificate ot consent to self-insure or a certificate — ot Workers' compensation Insurance, or a certifietl copy chereoi (Section Backflow Preventer . Service Sink 3800, Lab. C.) ' ' - ' ' aoiicy No. Company Backflow Irrigation Sewer Cap eCertifietl copy is hereby furnishetl. � ' Certitietl copy is filetl with the city Builtling Division. Bathtubs Sewer Connection Date � Applicant � EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clarifiers SOldf COII¢Ct0�5 _ (7his section neetl not be completed it the permibis Tor one huntlretl ($100) or iesz). Dish�vasher Solar Piping I certify that in tne performance ot tne work tor which this perm�t is issuetl, I . shall not employ any person in any manner so as to�Ye5p(��e subjeyt to'the Drinking Fountains Solar Tank ' workerS CQmRensation Laws o/ Califorp'ry. q /_?�'\\_ �{V - — Oate lt—C A'8' ,�Si9nature %QftYH"-'�` '--hiR� „G Floor Drains Swimming Pool w/Spa ' NOTICE: It, after making this tleclaration, you zhoultl beco� the , — Workers' Compensation provisions of the Labor Cotle, you must (orthwith Floo� Sinks.� . . ._Urinal � �comply `wi[h such p�ovisions o� tltis pe�mit shall be tleemetl revoked. � CONSTRUCTION LEN�ING AGENCV ' , GaiServiCe Outleti ' WaterCloset - 1 hereby affirm that roere is a construction lentlin9 agency for the performance — ot tne work for which this pe�mit is issuetl ($ection 3097 Civ. CJ Interceptors � Water Heater � - LPnaer's Name: — Lentler's.Atld'ress � - Kitchen Sink ' . . '.Water Service � ! ,�; OWNER BUILDER DECLARATION � ' - � - � I hereby aftirm Lhai I dm ezempt from the Cont�aclor'S License Law for tM1e Ldv3t0li¢5, ��- � .AUtO-WeSh �. ,_ . following reason (Section 7037.5 Business antl Protessional Cotle: Any city or ' county which �equires a permit to consbuct, alter, improve, Gemolish or repai�- �,ny structure, ptio� to its issuance, also-requires [he applicant tor Such pe�mlt .o file a signetl 5[atement that he/she is licensetl pursuant to the p�ovisions ot the Contractor'S License Law (Chapter 9(commencinq witn Section ]000) of Division 3 ot Ihe Business antl Protessions Cotle) or that be/she is exempt therefwm and the basis Por the allegeG exemp[ion. Any violation ot Section ]031.5 by any applicant for a Oermit subje<ts [ha ap011cant to a civil �enalty ot not more [�an (ive huntlre0 tlollars (5500). ' i 1; as owner of tM1e property or my employees with wages as their sole � compensation, will do the work, antl the structure is not intentled or�offered ror sale� (Section 7044, Business antl Professional Cotle: The ConVactor's License Law tloes not apply to an owner ot a property who builtls O� improves thereon, antl who tloes such wo�k him5elf/herself onthrough his o� he� own employees, provitletl that such improvements are not intentletl or otieretl for sale. If, howevcr, the builtling or improvement is solG.witnin one year of com- pletion, the owner, wlll have ttie buraen ot proving he/she tlitl not builtl or im- prova Por Ihe purpose of sale). , ' ❑ I, as owner of the prooerty, am exclusively contractin9 with Ilcensetl con- tractors to consiruct the project (Section 7044, Business antl Professions Cotle: The Contractor's License Law tloes not apply to an owner ot property wno builtls or improv¢s'[hereon. antl who cont�act5 (o� such oroieGts with a rom� [ractor�sl licanse punuan[ m me ConVattor•s License Law). I am aware that proof o� [heir Worker's Compensatlon insurance shoultl be provitl¢tl to me.� �� 1 am exempt untler Section B. & P. C. for this reason Da[e I hereby certity-that�l information is correct. I antl state laws relating•t Sentatives Of�this city InSpection purp s. Signature Drivers' Li<ense or,55 � Owner have reai [O i state that the above antl countv ortlinances Date �'"2'�� Roof Orains � � � � . � � Reinspection Fee - ' $15 Isue Fee : Boiler DuiY- Under Ground . � Duct - Structurel Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO # Heating System & Ducting - ❑0-100,000 BTU 0100,000 Reinspection Fee � � $15 OB65�46,�rev. 5/88 White - Builtling; Canary - Applicant; Pink - Accounting: Goltlenrotl - Assessor Hood or Type I ❑� Canopy Type I I ❑ iefrigeratlon System � �0.700,000 BTU ❑100,000 B System Repair/Alteration � Fire Dampers � Registers ti —.� I —I` Accessor� � // ' ' 2� -Q� � � Parking R Automatic Washer Construction Pole Sub. Cooking'Unit Zone. L � uilding: Z O N I ' N - G R ./Provided . . E � ` M T S. ELECTRICAL , Transformer ❑ 16-50 KW ❑ SO+KW Dryere LJGas LJElectric Fan F�.A.U. ""� ' Fixtures' Device Boxes Outlets Switches Garbage Disposal Generator 00.5 KW 05-15 KW 9 Meter LJup to 100 amps Meter ❑over 100 amps Sub Panel Motors �0.1 HP �1 %� 8 . Inc.Soiar �9=15 HP �16-15+ Microwave •r. Pole Light . � Sign Standing Sections Trash Compacror ` Reinspection Fee �$15 � � Issue Fee $-�.DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By dJ FEES -Building Approved By FEES . . _ . .. I i . ._. $ 3 ► j • � SUMMARV OF FEES BUILDWGPERMIT $ �U=, SMIP �. $ C�7�tl PLAN CHECK ' $ T,O ��a • PERMIT , �� PLUMBING $ ISSUANCE - $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ �GRADING $ PLANCHECK 50% $' �MICROFILM $�_�_�__ ' MECHANICAL $ � - TOTAL FEE $ , _�� . PLAN CHECK 25% $ � ' � laue Fee $ 3 '", OS �Q011007—ODD11D09 TGT�._. ' 104,45 DATE: 08/p2/88 TI%E: 13:42 . . _... �. �. CONSTRUCTION AND PLANNINp � . JOL & SPA _ APPROVALS Permit#-- Date Inspector p�ppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole � _ �; 52. Pool & Equipment Location . .2. Soil Pipe-Undrgrnd. . r,��; ' 53. Steel Reinforcement � " „ 3: Electrical ConduittiUtility-Undrgrnd. 54. Forms . � -' 4. Electrical Conduit-Undrgrnd. _ . 55. Electrical Bonding ' i 5. Steel Reinforcement� � 56. Rough�Plumbing & Rressure Test •�� !�� 6. Electrical UFEFt��Grnd. - 57. APPROVAL TO COVER-GUNITE - � � � �. 7. F.00tings -� '� C` 58. Electrical Conduit-Undrgrnd. j�,' ;$. Foundation �� r• �'i � 59. Gas Pipe, � Undrgrnd., Test '�' r 9. Water Pipe-Undrg}nd. ', y 60. Backwash Lines, P-Trap, O Undrgrnd. �" 10. Structural Floor System 61�. APPROVAL TO DECK ' 11.- Property Sewer Line & House Cpnnection ?' ; 62. Backwash & ReceptorFinal � 12. Sewer Cap . �� 63. Heater & Vent-Final � �� 13.� Roof Drains ^ � � 64. Plumbing System - Final r. • 14. Rough Plumbing� � ! 65. Electrical-Final " , 15. Rough Electrical-Conduit . 66. Solar SYstem-Final . �16. Rough Electric Wiring 67. Fencing & Access Approval 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electricaf-T Bar Ceiling 69. POOLiSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace '" APPROVALS Permit # 1 21. Ducts, in Structure � 70. Underground Hydro � 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil � 23. Gas Pipe-Rough & Test - 72. Underground Flush 24. Roof Framing •�� ' ' � ' 73. Undergrnd.StorageTank.OGas ❑Oil �, � 25. Roof Sheathing i"� � 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 Metei-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric .. Notes: � 6 G�` 34. Final Heating & Air Conditioning � 35. Final Gas Pipe=Test • ' 36. Hood or Canopy ', . ,37. Final Factory_ F.ireplace ' 38. FinaI�PlLmbing . � � ' . � � .39. Water�Service-Final � � � 40. Gas Service-Final - , � ; 41. Solar pomestic-Final 42. Backflow Preventer ., � ' �; �., � 43. Backflow Irrigation' , . �� A 44. Landscape Irrigation System � ��. ' 45. Sound Attenuation � - � 46. Handicap Regulations � 47. FINAL STRUCTURE & BUILDING '� j' � � 48. Special Requirements Completed 49. Electric Release to Edison � � .' . � 50. Gas Release to Southem California Gas Co � ��, - „ 51. CERTIFICATE OF OCCUPANCY � -. : �i I No. Date � •� � _ C/ --__. . �_-- ADP��ant to flll in all spacez exeeDt �hose within �eavY bortler lines antl sign all appropriate Eecla�ations. � ? � .� � . � , CITY OF COSTA MESA �I�.�TRU�TION PERMIT PE IT.NO. TRACT NO. -LOT.N UNIT NO.; � � � ; f , t � � � . ;� � \`,,, Il1 , �� •3 , ; � s . �, � , ; � ; 6460 1-0/31 /8'6 p91 .94 c7L , .l?; ProjectAddress ��s� c `�x+�J��.- %-.GA�a-i .. � . � : � ' � � � � ' � � s l� ��'� �._ jt� \� TVPE OF_CONSTRUCTION NEW ADD ALTERATION REPAIR, ' � ' � ; Appiicant'sMailingAddresS . ' 1 ,`l� �❑ CONVERSION ❑ DEMOLISH ❑ OTHER � - �� ! -'Owner'sNeme'�\7\.M3f1eQ'��' �. . Phnnrd o�LSNSG(� � - - - _. . . f ' . .. - A.P.# a . '- �' � '_ .. . . Zone. ' ' �� DESCRIPTION OF WORK/USE OF BLDG. � � Address��U4'b'��C`lLL] ,��.IL -A-1• C.tn � ,�/,v�LE'F�4�/LY .eC.r��i�C-=CE ; E MainBuilding: I y AcceuoryBuilding: ;� � Z Arch/Eng��'k' � �'�-%�e� LicenseNo. T TVPEOFPERMIT � G�G� ❑�FOUNDATioN � 57RUCTuaAL T Front� ��'j� Sp.S � i ' � j ; , p Addr¢ss ��n �'Q-w�� L�L1�V' � � � � 1 • �� ❑ .TENANT i❑ E�ECTRICAL '❑ PLUMBING ❑� {�.�7 ECHANICAL B Reaf � ' � 9� t � � f 1 . , N ConVactor'c Nama ' �'l��'{� Phone � .❑ OTHER ' � "� �o.s 'N ' . %� ""r " _ ' ' _ " _ _ "' ' _ ' ' � � � ` PROJECTDESCRIPTION Sq.F7. occuvaNCV - C Right-� 9� � '- N � Addresslmailingl�� F,c��'G1YlV2 ei,� -�.•-� K � . ,, G t . � �CONSTRUCTIONTYPE � � ` 'VALUATION$ �I9, �_„� �G'"""_ g Left � � I , '. , i i R � City License Nori�� ' � "ZONE � ;GRADING CU.YDS. ACRES � �,f 4 � LICENSED CONTRACT00. OECLARATION' � � • ' '. - .„ � P�ng. R¢i. # � _ ' � Pd�ki�y Req./P�Ovid2d � I h¢t2by dfflfrtl thdt I dm lit¢n5etl U�tl¢� p�Ovi510n5 of CM1dlf¢� 9 commencin �� ' c Plannin NOi25: /� ' � 9 Remark5 �r' . � � ' �-EG.. '� �3. � . r . PF�. � � 2� �� 9 � _ � ' �— Y � �'IZ I 2 � M y with section 7000) of Division 3 of [he Business antl Prot¢s5ion5 Cotle, antl ' y� ; my license;is in full force antl eftect. �, � ,C: �S ` Q � L i � � t � ' � � - � � g License C1555 - � License No. ' '• � ' . � Date Si9nature � "�+�;f.�'" • ' ' PLUMBING . - ' ,FEES � � �1 REQUiREMENTS� � � � � , WORKERS' COMPENSATION DECLP.RATION � Bar Sink � Showers � - 1 '�ereby aHirm (hat I have a certificdte of consent to self-insure or a certi/icate. ' - ' ' ' ELECTRICAL• � , i„� ! � REES Workers' Compensation Insurance, o� a certifietl cOpy thereot (Section Backflow�Preyenter - �SerJiceSink � � ' � ' , ' � eoo: �ab: c.) , . _ _ ' 'L �� Aummatic Washer� . '; - , Transformer �� 15-50 KW '' , � � Policy No. � � - • Company � ' � � Backflow�lrri9ation- � .SewerCa� �� ; � . I �0�50+�KW' � r� eCertifietl copy is hereby (urni5hetl. • , � ' - P COOSt�uCtiOmPOIE Su6. � � - . - Certifietl copy is filetl with Ihe city Builtlmg Division. Bathtubs' ;Sewer,Connection� - - Cooking�Unit ' Mete� ❑up to 100 amps Da[e . • � APPlicant • ' .�.. ." , � ' �- . " '.. , . • . . , EXEMPTION FROM WORKERS' COMPENSATION DECLARATION � � CIa�i1i¢�5 . , S013f COII2C[O�5 � - � � Dishwasher � . � • -Meter� ❑oJer-100amps• ; . � � (TM1is sec[ion neetl not be mmpletetl if the permii is for one hundred ($100 or . . ' , ' ' , less). . . _ � . � . Dishevdsher � _ � i Solar Piping, , • Dryers ❑Gas ❑Elect�ic� � Sub-Panel � : . . - ' il . I certlfy that in the perto�mance ot the work for whith i5 pe�mk is lssuetl, 1 , � � � • - � �• '"�` I shall not emoloy any person in any ma � o as t b come subj .to the , Drinking fountains � �Solar Tank � Fan � Motors �0-1 HP �1 / 6, � Worke� �(*�pe $t-iO�n Laws ot Cali(orn � � � • � - � ,! ' ,� � Date _Sj�I��3J�5i9nature ' ' Ploor Drains ' Swimming Pool w/SPa� ` F.A.0 � ' Inc.Solar �9-15 HP �1615+ NOT�ICE If, att r making this tleUaration, You shoultl become-subject'to�the ' - - � -- � - - - _ - . _ _- ' _ Wo�kers' CompenSatiOn provisions•of th¢ Labor Cotle; you must Porthwith FIoO�$ink5 � � � � - - compy with sucb,provisions or tnis.permit shall be tleemetl revoketl. � tUrinal � F�iztures ' � � Microwave• J � � CONSTRUCTION LENDING AGENCV ! ' ' ' � � � GasService . ' Outlets ;� � �Water CI052t � � ' I� . T - a � ' � � ' ' 'i Device Boxes I � , Pale Li ht � ' ' ' ' ' ' I hereby atfirm that there is a consiruction lentlin9 agency tor.the performance 9 of the work tor wt}� thi p m is issue6-{Sectlon 309� Civ. C.) � Lentler's Name � 15�� autYw.�� Interceptors �Water Heater ' OuUets i Range " � Lenderts�Aatlress'�`Q�ti�Fk . Kitchen Smk �' Water Service - �Switches �� - � -- OWNE0. 8111LDER DECLARATION i - � Sign , , I hereby affitm that I am�exempt from the Contractor's LicenSe �Law fo� the �dvdt0li¢5 „� ' AutO-WdSh � � Garba e Dis osal � ' � g P � Standing Settions following reason,(Section ]031.5 Businessantl Professional CodedAny city or - i county which requires'a permit to consVuct, alter; improve, tlemolish or repair P-Tfap ' �. - Laundr Tfa 5 � � � � any structure, prlor,to its issuance, also �equires the applicant for such,pe�mit Y' � Generator �0-5 KW OS-15 KW ��Trash Com'pacmi � [o file a siqnetl statement that he/she is licensetl pursuant [o the provisions of Roof Drains ' � - � � ' � � the Contractor's Cicense Law (Chapter 9:(commencing witn Section ]000) of �`> r-' ' ' ' Division 3 oPthe Bu5ine55-antl Professions Cotl2) o� tbat he/she is exempt ' � � � • - - -- - theretrom antl the basis for the alle9etl exemption. Any violation o� Section , � . , ' � , , � � 7031.5.-by any applicant for a Oermit subjects fhe' applicant to a civil � ' + � � i �enaltyof,no[ more than tive huntlretl tlollars�($500�. � . � � ' � , , � , � LJ I, as owner of tM1e. property or my employees with wages as their sole Reinspection �Fee � $15 , �55ue Fee $�3 � rompensation,'will do the work, anG the structure is not intentled or oiferetl - ' � Reinspection Fee $15. Issue Fee . � '; $ 3 � for sale' (Section. �044', Business ana Professional Cotle: The Contractor's . � , MECHANICAL � FEES � - ' . ' Llcense'Law tloes not apply [o an owner of a property who builtls'or improves � - .� , . . 'thereon;.antl who�does such work himself/herseli or chrough his or her own � DEVELOPMENTSERVICESREQUIREMENTS: . em lo ees, provitletl tfiat such im rovements are not intenaetl or oHeretl for Boiler . � • � Hood.or T e I ❑ � _ � b sale Ii nowever, the buiming�or imp}ovement is soltl within one year oi com- - , Canopy Type II ❑ � � ZOning Approved By A �� Date I�� 3� ' g- , pletion, the owner will' have the burtlen of p�ovinq he/she tlitl not builtl o� Im- DuCt - UndE� G�OUOd � , � ' pr ve for the'purpose ot. sale�. . . ! ' - f ' ' Building Approved By � Date I as owner ot tlie property, am exclusively contractin9 with licensetl�con- Duct -Structural � Refrigeration System. � � - Appliration Issued By Date�� ra �onto construct the project (Section ]044, Business antl Professions Cotle: � � The Contractor's�.License Law tloes not apply to an owner oLoroperty;who Duct - Ventilating � , .� �0-100,000 BTU ❑100,000 BTU ,' � ' '. . � SUMMARY OF FEES " ' ' ° builtls or improves there6n,-antl who ron[ratts for such p�oject5 wrth a con- � � � � � . '- . � '�j1 �: l: tractor(sI ucense pursuznt to the Contractor's eicense Law). 1 am aware.that ' - ' . BUICDING PERMIT $- �8�. �e � SMIP . .$.' Q �f' root of their,worker•s Compensation insurance�shoultl be ExhaustSystem �� Multiple❑ �SVstem'Repair/Alteration� � � P provitledto-me: . . c _ ' •� ' � � - � � - - - - � PLAN,CHECK $= PERMiT . � • : i � , � I am exempt untler Section - e. & P. C.•ior this reason ' Firepl/Fact. BIt.�IC60 # - - Fire Dampeis I ' - � p�UMBING ' $ � �SSUANCE �-� $ [ _ , Date�. � Owner � ' � - � ' HeatingSysfem&Ducting� � Registers� . � � • � � , p[qNCHECK �25%' $,- ' � `;`ENERGV�P.C:� $.� � � �� I �ereby certity that I �ave reatl ihis a olication autl state that the,above� �❑6100,OOOBTU �100,OOOBT , � - '" � � ' ' GFlADING '$ � �� information is correct._I ree to'compty ith all ciry antl munty ortlinances ' �. ! ELECTRICAL ;$'. ., - . antl stat 9_t builtling const ction; antl hereby authorae reore- � - . - PLAN CHECK 50%. $ ' '� MICROFI LM _$�� Senlati 5 ot t'S u y t enten, upon he above-mentiOnetl pr pert fo� ' ,.t � i . ' � � -.. inspec8rn��ucQo s � � - ' MECHANICAL $ � TOTAL FEE $ � Si9oature . ' �ate . peinspec[ion Fee , '$15 -' � lesue Fee ' $ �3 � PLAN CHECK 25%- $ � � � ' � Drivers' License or 55 � , � � ��CMF 0865-46, rev. 30/84 Whit¢ - Builtling; Cana�y - Applicant; Pink - Accounting; Goltlenrotl - ASsesm� ' �^ \ ! . , .CONSTRUCTION AND PLANNING APPROVALS ��Permit # i _ T: .Temporary Electrical�Service or Pole 2. Soil Pipe-Undrgrnd. .'. � • ' 3. Electrical Conduit Utility-Undrgrnd. 4. Electrical Conduit-Undrgrnd. � 5. Steel Reinforcement 6.� Electrical UFER Grnd. 7. Footings . 6. Foundation � � '- 9. Water Pipe-Undrgrnd.' '' . . 70. Structural Floor System' 11. Property Sewer Line & Hause Connection 12. Sewer Cap - 13. Roof Drains 14. Rough Plumbing 15. Rough Electrical-Conduit . 16. Rough Electric Wiring 17. Rough Wiring�Sign - 18. Rough Electrical-T Bar Ceiling 19. Rough Heating & Air Conditioning 20. Rough Factory Fireplace 21. DuCts, in Structure 22. Ducts, Ventilating . 23. Gas Pipe-Rough & Test 24. Roof Framing. � 25. Roof Sheathing 26. T-Bar Ceilirig (Structural) & Monocoat 27. Frame�and Flashing � 28. Lathing & Siding � 29. Insulation 30. Drywall Nailing � 37. Plaster Brown Coat 32. Electrical�Power Meter-Final 33. Final Electric . ' 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. Solarpomestic-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 Date Date 0 G � , � POOL & SPA . � Inspector qppROVALS Permit# 52. Pool & Equipment Location 53. Steel Reinforcement . 54. Forms� � 55. Electrical Bonding 56. Rough Plumbing & Pressure Test . 57. APPROVAL TO COVER-GUNITE �� 58. Electrical Conduit-Und�grnd.� • 59. Gas Pipe, O Undrgrnd., Test ' 60. Backwash Lines, P-Trap, O Undrgrnd. � 61. APPROVAL TO DECK • 62. Backwash & Receptor-Final 63. Heater & Vent-Final . 64. Plumbing SYstem - Final 65. Electrical-Final � . . 66. Solar�System-Final ' ' ' 67. Fencing & Access Approval ' ' 68: APPROVED FOR PLASTERING � 69. POOL/SPASYSTEMSFINAL' FIRE DEPT. REQUIREMENT � APPROVALS Permit # 70. Underground Hydro 71. ProductPipingOGas ❑Oil° 72. Underground Flush 73. Undergrnd.StorageTank�OGas ❑Oil 74. Overhead Hydro .. 75. Dry Chemical 76. Dry Standpipe � 77. FIXED SYSTEM FINAL�' • 78. FIRE PREV. FINAL � ' HEALTH DEPT.REQUIREMENT 79. FINAL INSPECTION . � 80: FOOD CERTIFICATE ISSUED Notes: �ir....�..- �. �� -. - '- � Date � Inspector 0 9 � � � k::� CITY OF CUSTA MESA ��` � PARK FEES 6459 10/31 /86 1545.6P TL Fee Payment Receipt Q Q 10 �j Q '" '- "' = Project Address J57 Lii pG� L-� � ff N E A.P. Number �2 r7 — �� — � % - � Building Permit Number _(3 "�-<o I�J 3 Owner's Name �f Mailing Address _ FEE: Single Family ` 2-Bedrooms or Less 3-Bedrooms 4-Bedrooms 5-Bedrooms + Multiple Family '" - Bachelor or Studio 1-Bedroom + Planning Depa ent Ap ov ate ApplicanYs Signat % * City Ortlinance 72-44 / i Ortlina CMF 0174-30, rev.7/85 White—Planning; t�. � ning; � - I �CoST,4 KEs�� C�9 . Number of Units @ $ 861.76 = @ 1,205.67 = �_ @ 1,545.62 = ��02. @ 1,810.50 = @ 474.37 = @ 573.18 = @ 881.51 = @ 1,229.38 = Total Fee `*` �y�6�� c G ��c a !I INSULATOON CERTIFICATION This is to certify that, in conformance wilh thc current energy regulations ((alifomia Adminis- trative Code, Title 25, State of California'1 and approved plans, insulafion has been installed in the huilding laated at: COSTA MESA ORANGE c�n . c«�nn 357 LA PERLE Sh�et No. �1I Ar�lbbly SnM la1 NumMr ind Ms, DESCRIPTION OF INSTALLATION rtooFs CERTAINTEED 6'— Type ot Malerial FIBERf,LASS Manulacturer Thickness 4 R Value•' 19 EXTERIOR WALLsFIBERGLASS Type of Malerial CEILINGS BAT75: type o( Material BLO W N: rypP or $Q. FI. COVBICd Manufacturer CERTAINTEED Thickness_,3.'—�—A Value" 11 (Or LnE� N�m�l ' ManufacNrer_ (Or lnd� X�mq Thickness R Value*•� ManufacWrer Thlckness No.Bags� �or r,.e. n.m.1 WL/Bag Sq. Ft. Covered R Value'"_ FLOORS Type ol Ma[erial �. Manulacturer_ (O. inAe N�mq SLAB ON GRADE iype of Material Manulacturer_ �o� r,.a. n.m.i Width ol Insulation Inches F6UMDA7ION WALLS (if requfred) TyDe of Material Manulacturei_ ro. u.e. n.md REMARKS (N Ceneral Conhactor (Builder) license Sub�Contractor pnsulation Applicator) 11�'('(;II .[(I>U,C�11`1'I��Id Pmubtloo. M�wnry, Etc) _/_ (Sbb "SAME" II um� u G�n�nl ConM1stfvA ThicNness R Value•" ThicMness R Value"_ ihicknesa R Value•"� License Number_'182646 C-2' By E-•��bt�� riue vwner Date MAY 11, 1987 �•f,nnle��la Adminlibntlrr Cede, Eneryy Imulatlon Slondeid�, dedmui EMCFIR Irem Lc 10E7! d IA� N�aIIA and SabM �d� ef IM Sbb "Cemoltano. Uoon < mnle�ien ol �Fs innelle�ion ef Inmlai�en, e mrd e1 Celllernlo� . urlilyinp tMo1 IA� In�uloiion ba� been In�lelled Im m�lormnnve .i1M1 th� rwool.<mem� el �he�e repololien� �holl be aemoleied and e mt.d by "Ne vo1lA�ab el e�<r0anp er �Imllar c«liflmllen �hal a nwl� mm Ih. (nudol;en aoo�l<alar end by Ihe bull�e.. IM1I. !:vlolim <emollmn nreabd �eld, me1d, aoarlmenl heme, hom� e� elhw ndd�nllal ord �M1eil bn oa.�iM e� e aomolauem la�oilon wp61n �he A.dlin0.") d�.lilno b Anbllabb �hall b� I��d by mch e bvlldln0 d�porlm�nl ` — -- - unlu� �F� .irvvlrn al I�etl �a0�fin ih� minlmem m�ryY Imrlollen ("R Vofo. f. Ihs mw�vre el Ihe rn�M1lonro ol e maMrlal er-bulldlnp nanda.E� n1ob11�heA 0��enl le Ihl� thepl�r." mvennnr �a �A� ovuoue el hea�. �bn r��.ionr� roh� �R� el m u�hoe Imoleiiam �holl nol InAude ony valoe•b� relle��ire b<inp.) � . J _ _� �aTY OF COS7A nnE'SrA CONSpTRUCTION PERMIT ' Project Address �J-�7 �-�' / E�LF ��' : � Applicant's Mailing Address � � ' � � Owner'sName�"p�� GK- Phone � Address 1 ' ' � � ' � i � � , I Areh/Eng. � Licenu No. Address � � - � . � �/p�j� �' Contractor'sName�'��5�7� ��'L�G� /G PhonesG]_/ L:_� Address�mailing) -�• =�� City License No. a27�� LICENSED CONTRACTOR DECLARATION � � , � I hereby affiirti that I am licensetl untler provislons ot Charter 9(commencing with.section 7000) of Division 3 of the Business:antl Professions Code, antl � my license is in�full for e antl effect. '. O � LicenSe CIaSs -�� v' Licens �� '3� /'� Da[¢L,��b Signature WORKERS'COMPENSATION OECLA ATION � I hereby af�irm that I �ave a certifica[e of consent to self-Insure or a certificate of Workers' Compensation Insurance, or a certifietl copy,ihereof (Section 3800, Lab. C„)�3.n,/1/O �7 ' • / ''e��' ` Pfollicy No. ��' w � U �� Company _ v/� ��^`�1 % ' y,� C¢rtifietl copY i5 hereby furnishetl. . . fg Certifiea capy�i�fileG with the city By,il ''g Division'. � Date %�-��-d � qpplicant�il EXEMPTION FROM WORKERS' COMGE{ SATION DECLA�RATION ' \+ (This section neetl not Oe completetl if the permit is for one huntlretl (5100) or IeSS).. • � � . . . ' ; i I certify that in Ihe Oe�fo�mance of the work'tor which'tM1is pe�mit is issuetl; I shall not employ any pe�son •in any manner so as to become subject to the Workers' Compensatlon Laws ot Calitomia. \Date � ' Si9nature ' � � NO.TICE: If, after makin9.thi5 tleCla�ation,.yo,u.5houltl.become subject [o th¢. Q, Wo�ke�s' Compensation O�ovisions'of the L2bo� Cotle, you must forthwith V mmply wi[h wch�provisions or�this� pe�mit snall �b¢ tleem¢tl revoketl. \CONSTRUCTION LENDING�AGENCV t ' - 1 hereby affirm that thEre is a con5truction lentling agenciy tor the performdnc¢ of [he work for which this permit i5 iisuetl (Section 309] Clv. CJ L.ender's Name � � ,.Lentler_s Atltlress � OWNER BUILDER bECLARATION ' ' � � I hereby xifirm that 1 am exempt trom Ihe Contractor's License� Law for the followinq reason (Section �031.5 Business antl Professional Cotle: Any city or county which requir¢s a pe�mit to const�uct, alter, improve, demolish or r¢pair any structure, prlor to its issuance, also requires the applicant tor sucn permit [o file a sianetl sta[ement that he/she is licensetl ou�suant to ihe o�ovisions ot Applitant to fill in all spaces except those within heavy �ortler lines anE sign all appropriate tleclarations. PERMIT NO. � TRACT NO. - LOT NO. UNIT NO. � � � � � oZ`�P i � � � . � ' � � , ; i . � , ; � TYPE OFCONSTRUCTION f NEW ADD ALTERATION REPAIR • ❑ CONVERSION ❑ DENIOLISH ❑ OTHER � ' A,p, # . � DESCRIPTION OF WORK/USE OF BLDG� � � � 5/ LE� FiihQfL� ,� � � � - ' S Main Bmlding: TVPE OF PERMI� � FOUrvDATION STRUCTURAL T Front ❑ TENANT �� ELECTRICAL ❑ PLVMBING ❑ MECHANICAL B Reaf � O OTHER L : � ' � ' ' %� C Right� ' PROJECTDESCRIPTION �Sc�.FT. ! oCCVPaNcv K ' , � CONSTRUCTION TYPE � VALUATION $ S Left � ZONE ; GRADING CU. VDS. � ACRES p�ng. Ref. # ' aemark �: � ' � � .. � Planning Notes' � � . . '. ! ' ' i � , � ' ' " . � Bar Sink � � "' Backflow Preventer� . Backflow Irrigation - Clarifiers; Drinkin9 Fountains� Hoor Drains' � Floor Sinks ' ' Gas�Ser'vice� .OuM Interceptors' � � ' Kitchen Sink. - _ Lavatories i � Roof I s_ Showers' ' � . Service Sink . ' � � � ' Sewer Cap=- � Sewer Connection � . ; � Solar Coliecto�s - ' Solar Pipin9 . : � � Solar Tank � • ' Swimming Pool w/Spa ' , � ' Urinal ' Water Closet � Water Heater WaterService' � .- a--. � Auto-Wash ' � � � �' � �uiv�swn s�m me�eusmess��ana-rroressions-�.oae� or ma� neisne � exenpi - — .-- � -�. - - � - therefrom.antl'tM1e basisSor the alleged exemption. Any viola[ion of�5ection � , 1 7031.5.'by any applicant for a permi[ Subjects tbe applicant to a civil penalty of not more than'five huntlretl tlollars ($500). : � � � • ❑ I, as owner ot ,the) property or my employees with wages as thelr sole ReinspeC[ion Fee $15 -• compensation, �will do the wo�k, antl the st�ucture i5 not intentletl or ofteretl �'. for sale (Section 7044,.Business antl Professional Gotle: .The Contractor'S � ' . License Law tloei not appty to an owner� of a property who builtl5 or improves t � thereon, antl who'tloes such work himselt/herself or throu9h nis or her own ' employees, pwvitletl that Such improvements are not intentletl or ofteretl Por BOiI¢� sale. Jf, howev¢r,+the bulltling o� imp�overnent is soltl within one year of mm- ,pletion; the Owner will haw Ihe burtlen ot proving he/she tlitl not. builtl o� im- DuCt - UOd2� G�OUnd �rOvO for the pu�0ose of sale).' i I; as owner of the property, am exclusively mntracting with licensetlson- Duct -St�uctural � ' bactoRto cOnsVuct tbe projec[ (SecYion 7044, Business antl Protessions Cotle: ' The Contractor's License Law tloes not apply to:an owner o( property.who Duct - Ventilating � � bulltls o� imDroves tM1ereon, antl who conttacts fo� such prolect5 with a con- tractbr(s �ilcense pursuant to the Contrattor•s License Law). I am aware that' Exh2ust System� ❑ Multiple �. proof o�theinWorker'S Compensation insutance shoultl'be piovitletl to'me.� �� I�am ¢xempt untler�5eciion B. & P. C_for this reison -� � F.irepUFacL BIL ICBO # Dale � "' Owner ' - Heating System & Ducting` _' ; 1 hereby certliy that�i have reatl this applicption antl state that the above �a100,000BTU �100,OOOBTI • information is correcL4 agree to compty with all dty antl county ortlinances . — - antl'state laws relating'to builtling construction, antl,hereby authorize repre- � , . sentatives oL [his ity to'entgr. upon' the .above-mentionetl � property for '� - ' inspection Du�p95,e� ' / - ' � J � � � � Signature / ' li ' Date /y'/ �i . �, Drivers'�Li � � �� FeinspectionFee � $15 CMF 0865-46, rev. 10/84 N/hite - Builtling; Ganary -�Applicant; Pink - Accounting; Goltlenrotl - Assessor ; : Issue Fee, Hood or Type I ❑ � Canopy Typell ❑ ; Refrigeration System. ❑0-100,OOOBT�U ❑100,000 System Repair/AI[eration Fire Dampers ; ' ' . 'Registers• - - . ' ' .' � � � Issue Fee � . FEES $3 �' I ' _ $ 3 A a� 80''� 4 I 2/[ � ! � Accessory Buil� . i Parking Req./P . ', � ' IE�LECT-�RIC—AL , Washer: . � 1• �1 Transfnr Cooking Unit - ' r ; Dishwasher ' � _ Dryers �Gas ❑Elechic " Fan � F.A.U.� � � ' _ ' Fixtures Device Boxes � Outlets t _ . I/66 � ,�n �in Ty � 2on8 ! �' ling: i ' \ Z i + . � '.._ , N��J - : - ' �L1'SO+KW 1 , Meter, u'p to 100amps � . ' Meter ❑over,100amps � ' ,Sub Panel : � �"� Mo[ors OO-1 HP �1!'/:. 8 Inc.Sola� �9-15 HP �16� ' Microwave . . . , Pole Cight ' Swrtches -^ _ .--^ - ' - Sign , " ' ' '" ' Garbage Disposal - Standing Sections ' � Generator �0-5 KW ��5-15 KW � Trash Compactor , � Reinspection Fee s �DEVELOPMENT SER Zoning Approved 6y_ Buiiding Approved By Applicatian Issued By_ $15 Issue�Fee REQUIREMENTS � � 0 ' E Q M T 5 � FEES � $ ' ,'��SUMMARYOF FEES -- : . '� "' � � BUILDING PERMI7 $. -SMIP ' � � � $ _ PLAN CHECK $=� ' PERMIT. • , , , PLUMBING • � : $ ISSUANCE �'. $ " PLAN�CHECK 25%' $t ' ' ' - , ENERGV P.C. �$ _ � � ' �' ' ' � ELECTRICAL � � $' ��I• S�U � »GRADING � : $ • • - PLAN CHECK 50% $. J•� % O '�MICROFILM' S � � �� ' � . MECHANICAL $ ' � � 'g5Q_�_Q_ . _ c � TOTAL FEE �, , - PLAN�CHECK 25%� �$� � � , '� \ CONSTRUCTION AND PLANNING ,�PROVALS Permit # � 1. Temporary Electrical Service or Pole 2. Soil Pipe-Undrgrnd. 3. Electrical Conduit Utility-Undrgrnd. 4. Electrical Conduit-Undrgrnd. � 5. Steel Reinforcement 6. Electrical UFER Grnd. 7. Footings 8. FouncJation . 9. Water Pipe-Undrgrnd�. . 10. Structurel Floor System 11. Property Sewer Line & House Connection 12. Sewer Cap 13. Roof Drains � 14. Rough Plumbing 15. Rough Electrical-Conduit 16. Rough Electric Wiri�g _ . - 17. Rough Wiring Sign� 18. Rough Elec[�ical-T Bar Ceiling 19. Rough Heating & Air Conditioning � 20. Rough Factory Fireplace 21. Ducts, in Structure . 22. Ducts, Ventilating 23. Gas Pipe-Rough & Test� 24. Roof Framing � 25. Roof Sheathing � 26. T-Bar Ceiling (Structural) & Monocoat 27. Freme•and Flashing ' 28. Lathing & Siding 29. Insulation 30. Drywall Nailing 31. Plaster Brown Coat ' 32. Electriral Power MeterFinal - � 33. Final.Elect�ic ' i 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 pomestic-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 _ ;;,, �f `. . � ' POOL & SPA� .� Date Inspector AppROVALS Permit # 52. Pool & Equipment Location 53. Steel Reinforcement 54. Forms ' ' - � . 55. Electrical Bonding . 56. Rough Plumbing & Pressure Test ' 57. APPROVALTOCOVER-GUNITE 58. Electrical Conduit-Undrg'rnd. �59. Gas Pipe, O Undrgrnd., Test 60. Backwash Lines, P-Trap, � Undrgrnd.� 61. APPROVAL TO DECK 62. Backwash & Receptor-Final 63. Heater & Vent-Final 64. Plumbing System - Final � 65. Elecirical-Final 66. Solar System-Final � 67. Fencing & Access Approval .. 68. APPROVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL . FIRE'DEPT. REQUIREMENT APPROVALS Permit# 70. Underground Hydro 71. Product Piping �Gas ❑Oil 72. Underground Flush 73. Undergrnd. Storage Tank O Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical � 76. -Dry Standpipe . 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL � HEALTH DEPT. REQUIREMENT 79. FINAIINSPECTION ' , 80. FOOD CERTIFICATE ISSUED Notes: «• i a . r . �• • i _ _ � - ' Appiicant to fill in all svaces except inose within neavy Eortler Ilnes ana sign all appropriate aeclarations. PERMI NO. � �TRACT NO. . LOT NO. UNIT NO. � ?�-CITYOFCOSTAMESA TRUCTION:P RMIT q � � • � � � � ' ' � � . + �a , � �`� ' Q �. �� . Zi03�0 / . . � . . ; � � ProjecyAddress��%y� li� ^ ' , � ' • - r • q �. Ii ii� n� � ApplicanYs Mailin Add� ss • E�.tl/�.�� ,�/L � TVPE OF CONSTRUCTION � niEW /aDo ALTERATION REPAI R ' � ' TL Owner'SName��36i��S�, � �PhoneG`�(e�°'S�i� . � ❑ CONVERSION, ❑ DEMOLISH ❑ OTHER _ � q,p,#. ,_ .'.. _ � _ _,� ._' _� __ Zone � " _ ' �y� � �^ • DESCRIPTION OF, WORK/USE OF BLDG.' Address �4�� CCL1�-LpA�w/b l Q US.' �-�� ' . ; ' � ' 4 S Main Building: � � : Accessory Buildingi � � ' Arch/Eng. ��` ^ ti.- � icense No. � 1 TVPE OF PERMIT � GRADING FOVNDATION STRUCTURAL � T Front� � - � ' � , 0 Add�ess � � � ❑ TENANT ❑ ELECTRIGAL ❑ PLUMBING � MECHANICAL � � B Rear � ' • ' � � � ' N Contfactor'SName � � 7 � . Phone �2-� ' � OTHER_ ' � 'C Ri9ht.` " � �' .. _ � . . ' . � " ' "N 2 �� PROJECT DESCFIPTION .Sq.FT. ; ' OccuaaNCv K . � G Add�ess�mailing) �CONSTRVCTION'TVPE VAWATIONS ' g Left . ' CiLy�LiCenSe No. ' { 20NE � - GRADING CU. VDS. ' ACRES� � R LICENSED CONTRACTOR DECL RA i � � Ping. Ref. # ' � � � ' Parking Req./Provided E I here5y aifirm tnat 1 am licensca unaer pro sions ot Charter 9(commencing Remarksi it . � Planning NoteY. i- . ' 1 M with section ]000) of Division 3 of the Buiiness antl Protessions Cotle, and '� L ' ' my license is in f W I force antl eflect. � ' � � . - . _ ' , ' � �, . ' . , - , � ' , , S License Class License No. , � i _ �. f Date Signathre � � ' 'PLUMBING ' -FEES � � ' � WORKERS' COMPENSATION DECLARATION � ' ' 8af Sink � ' ' � ShoWers ' " �`� I hereby affirm'that I have a certiticate o� wnsent to selt-insure or a certificate '' "� � . ,. ELECTRICAL �� y FEES of Workers' Compensation Insurance, or a certlfietl copy.thereof (Section _ • �-� .� �' ' 3800, Lab. C.) , Backflow Preventer � . , Serv'ice Sink i Automa[ic'Washer � � Transformer ❑ 15-50 KW ' • Policy No. Company � Backflow Irrigation r . ' � Sewer Ca � - ' ' ' 1 � ' � � ❑ 50+ KW � : eCertifietl copy is hereby furnishetl. � �- , P ConSttuction�Pole $ub. i •, , f -' Certi(ied copy is filea with the city Builtlin9 Division. Bathtubs � �� Sewer Connection - �- Cooking Unit . Meter ❑up to 100 amps ! �_ � � Oate� ° Applicant � �- � - ' EXEMGTIONfROMWORKERS'COMPENSATIONDECLARATION � .Cla�ifiC�S�- �� SOIa�COIICCtO�s ' � � Di5hwa5h¢�_ . . '� . ,M2tE�,OOv2/,10O2mp5 . -� � (Thi55ection neetl not be completetl if�the permit is for One huntlretl ($300) or ' � tess): � . Dishwash'er' - Solar Piping - � • Oryers'�Gas ❑Electric Sub�Panel � � � � ^ t - 1 certity t�at in tbe pe�fo�mance ot the wo�k fOr wh' thi5 pe�mit is' uetl, I . _ _� � � - shau not employ any person in any so as become subje he Drinking�Fountains . . Solar Tank i ' Fan ' ' . Motors DO-1 HP 01 % B ' Work rs' �ompensa[ion Laws o! Calif ni � - � � ' . _ . ' Date �S� �Q "L'�, Signature Floor Drains � Swimming Pool w/Spa . , ' ` T', p,q;�j,'-� - ' --- - Ine Solar �9-15 HP �16 15+ NOTICE: If, a/ter. makinq. [his tlecla�atiOn,.you shoultl.b come subje2 o th . ' -- ' � _ ___ Workers' Compensation provisions of the Labor Cotle, you must fort iM FIOOf Si�kS � U�indl Fixtu�¢5 " comply wi[h such' provi5ion5 or (his pe�mit iM1all : be tleemetl revoketl. � � � � � Mic�OWdv¢� ' ' �. CONSTRUCTION LENDING AGENCV � � � GaSService• � 'OUtlets � � + ' � , :D � ' Water Closet Device Boxes . Pole Li ht . � u � I hereby affitmithat there'is a construc[ion lentling agency to� the pe�fo�mance � ' 9 ; � of the wO�k for �which this permit is i55uetl (Section 309] Civ. C.) Int¢�C2pt0�5 Wdt2� H¢dte� � Outlets � ' �- Lentler's'Name � - � � Range i � i i � i r • . -* s . . , . i . • Lenaer'sAtltlress . ' _.. Kitchen Smk ! ' � _ . WaterService . .. . ' . . . --.- . :.. �Switches- � �� -' � -- ' � � - -- .+- � - -- - . OWNER BUILDEH �ECLARATION - � . , Sign � I hereby affirm that I am exempt from the ContractOr's License Law for the , LdvdtO�ieSy � AutO-WdSh � � � Gai6age DiSposal Standing Sections � i ' ' following reason (Section ]031.5 Business antl Protessional Cotlei Any city or � � ' 1 . . i � county whfch requires a permit ro construct,'alter, imorove; tlemolish or repair i P-7rap ,,�.�i . Laundry,TraYs ' Generator �0-5 KW �5-15 KW � Trash Com actor ' � � any Struchre, prior to its issuance, also requires the applicant to� sucli permit - P to file a signetl slatement that he/she is licensetl pu�suant to the provisionspt � "' ' . " � i , the Contractor;s License Law (Chapter 9(commencinq with Sectlon �000) of i Roof Drains � . . . � �DiviSion �3- of the �Business antl-P�otessioni �Cotle) or ¢hat�ne/she is �exempb - � � � therefrom antl [he basis�fo� the alle9etl exemption. Any violation o( SectiOn ^ � , , � � � � ` � ' ' , ' � �,..,�^ �� ]031.5 by any applicant tor a pe�mit subjects the applicant t0 a civil ' ��enalty of no[ more than �ive huntlretl tlollars ($500). . � 1; as owner ot �the' property or my employees with wages as their sole � Aeinspection Fae $15 �� Issue Fee . $� 3 � � , � � ! mmoensation,�will tlo the work, antl the structure is not intentletl oroHeretl Reinspection Fee' $15 ' Issue Fee ' � "�$ 3 : for'sale (Section, 7044, Business antl P�ofessional Cotle: The'Contractor's � : ' . � MECHANICAL � -FEES : � - � - �, Li[ense• Law tloe5 not'apply to 3n owner ot a'property wM10 builtls or improves ' - � - thereon,.antl who tloes sucn�work himself/herself or througn his or her own - � � . DEVELOPMENTSERVICES REQUIREMENTS: ' �,, i �� _ emploYees, provitletl tM1at such improvements are not intentletl or offeretl to� , BOiI¢� I � j HOOd Of Typ¢ I ❑ , � _� . ' . r� , sale: It, however; the builtling or imorovement is soltl within one year ot com- - "- Canopy Type I I ❑ � 2oning Approved By '� nate —/-{�'/-' _pletlon, the�owner will nave the burtlen of proving he/she tlid not builtl or im- Duct - Under Ground � ' � - • Building Approved By • � Date�'7—f-`�3=— ' prove for the purposepf sale). . , • ' ' �� ' , � � . .C�pY.'� as owner�of �the pro0erty, am exclusively mntroctinq with licensetl-com � Duct - SVucturel _ • Refrigeration Sys[em � ' Appliration luued By � D t 'tvaci�o�5 t6 const�uct the project (Section ]044, BuSinesS antl Professionz Cotle: ' . The Contractor's License Law tloer not apply.m an owner oi property who DucT- Ven{ilating • � ❑0-700,000 BTU ❑100,000 BTU '- S '� SUMMARV OF'FEES ..; �� - - ' builtls�or improves tbe�eon, antl who'cont�acts to� suGh projects with a con- � � � - _ � . � , tracCor(s) ucense pursuant to the Contrzctor's License�Law). I am aware that r Extiaust SYstem ❑�Multiple ❑'� � System Repair/Alteration � � BUILDING PEFMIT $ - Y'SMIP '•� '.�$, - proof of their Worker's Compensation insutance shoultl be provitled to me: . . _ , ' ` ; , ' . . . ; - _ _ ' PLAN CHECK $- . �-PERMIT s I ❑,I am exempt untler Section 'e. &; C. for this reason . T FirepVFact. Blt. ICBO # Fire Dampers � ' ISSUANCE $. - PLUMBING �$ i, Date; �� - �owner ' Heating System,& Ductin9' • � Registers PLAN CHECK ��25% S ENERGV P C ,$ I � � �� CMF �icense or 55 � , (� 6,rev.10/84 White i antl state tnat the above �P700,000 BTU 0100,000BT _ � ' - � '�/� J p � � �� ' � cityantl�countyortlinances - ' - " ' ` " , ELECTRICAL ' $ � �:GRADING .:'$_ ' mtl�hereby autnonze repre- _ - ., ' ' --d � - re-mentionetl-properry;tor _ ' -� ' - . � PLAN,CHECK, 50% $: � - MICROFILM. �$' - -� . � � .. . _ , � ..r i _�. . .. _ oaie(/-bt/-S�l. . , _ , MECHANICAL � . $ �TOTAL FEE �$ , � � � ' Reinspec[ion Fee .$15� � - .. � Issue Fee - , $ 3 , - PLAN CHECK 25%� $ ' ' G'� � , � _ Canary - Applicant; Pink - Accounting; Goltlen�otl - ASsesso� — / ' CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit # Date Inspector qppROVALS ' 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. Elect�ical Conduit-llndrgrnd. , 55. Electrical Bonding 5. Steel'Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings � �' � 58. Electrical Conduit-Undrgrnd. ' . 8. Foundation, ' - ' � 59. Gas Pipe, �� Undrgrnd., Test 9. Water Pipe-Undrgind. .� 60. Backwash Lines, P-Trap, O Undrgrnd. 70. 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 t7. Rough Wiring Sign �' - ' '' 68. APPROVED FOR PLASTERING 18. Rough Elecirical-T Bar Ceiling �� .� 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning � . FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro � 22. Ducts, Ventilating ' � 71. Product Piping �Gas ❑Oil 23. Gas Pipe�Rough & Test- ' ' 72. Underground Flush 24. Roof Framing �73. Undergrnd. Storage Tank 0 Gas ❑ Oil 25. Roof Sheathing • 74. Overhead Hydro � � 26. T-Bar Ceiling (Strucwral) & 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 . . 38. Final�Plumbing � . - 39. Water Service-Final ' � 40. Gas Service-Final • 41. Solar pomestic-Final 42. Backflow Preventer , � ' �•43. Backflow Irrigation - � , . � . '�� • �44. •�Laniiscape Irrigation System ' � .� 45. Sound Attenuation , _ � . �, • .46. Handicap Regulations . " � � 47: FINAL STRUCTURE & BUILDING � ' � 48.�SpecialRequiremenfsCompleted � � ' � 49. Electric Release to Edison -. �,x� ' 50. Gas Release to Southem Catifornia Gas Co - � .• �57. CERTIFICATE OF OCCUPANCY • No. � � Date . � CITY OF COSTA MESA BUILDING DIVISION OWNER-BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of, an owner-builder verification. Attention Property Owner: An 'owner-builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. ❑ Yes � No 2. I(have/have not) %��-- signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone ( 1 Contractor's Lic. No. 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name Address Phone ( 1 Contractor'S Lic. City 5 I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone � Type of Work I hereby affirm that I have State of h and Sa perso I knowledqe, in c i ianC ived a copy of i Code and have h this State law. ition set forth in Section 19830 of the the above information to the best of my Date: � � � 1� � � Name: � 1-+\ 1 \ �'�V � .V., `�. � � � (Printed or Typed) � C.D.L. #or S.S. # `�� — � � cmF ioaz-as 7545273 � ' AOPlicant �o fill in all ipates exceDt those within heavY EorEer lines an0 sign all appro0riate tleclarations. �� CITYOFCOSTA�MESA �CONSTRUCTION,�PERMIT ' PERf�p�TNO � D� � �TRACTNO. , � LOTNO: UNITNO'. � � � V� i ' Project Address 357� LA� Ff'�2L..� II�iVE � `Applicant's Mailing Address 144•� °J" P. ' GUP4 c�,^.� AT� - TVPE OF CONSTRUCTION ' NEw �ADD � ' • ❑ CONVERSION ❑ DEMO ISH ❑ OT i2 Owner's Name� j�� RT� ' � Phone64Z-S4H8 ' DES O WORK'N F BLDG.�� Address 2446 r.��nE?V AVE.. � STE: A-1,' COSTA N�'SA , • ��L`� �& ON IJ REPAIR Arcti/Eng� � License No. TVPE OF PERMIT GRADIN FOUNOATiO�rv�/LJ STRVGTURaL AddrEsS - . ' ' - � . ❑ TENANT � 0 �EIECTRICAL ❑ PLVMBING VJ MECHANIGAL Contrector's Name �� T,Fc S LRS, TN _ Phone 630-1°�13 � ❑ OTHER ' - � • Address (mailing) -"Ji� �^'� GU^4 Si. P�WZ". 92806 PROJECT DESCRIPTION SQ. FT. OGCUPANCV— . � � � CONSTRUCTIONTYPE � ' VALUATION$ � � City License No. � _ � _ i ZONE � GRADING CU. VDS. � ACRES— � LICENSEO CONT RATION , ' ` I hereby affi�m that 1 am licensetl untler provislons o( Chart¢� ommencinq Remarks: „ �w with section ]000) of Divislon 3 ot the ne an rofe s' ns Cotle, a � � � my license is in fulj,(p/�ceDncLCjfect. 32 , - � � ' � � • � C:LV n ('4 3 � License Class ' Li en o ' � Date ��9�� Signature ' . PLUMBING � �D `��ORKERS' COMPENSATION DECLA AT ON '� I h¢reby affirm that I have a c2rtifiGa[¢ OSCOi LO SCIf-IOSIIIC Of d C2fLIiICdLf Bdf S�III( �� . SIIOWClS of Workers' Compensation Insurance, or a'certifietl copy thereof ($ection gackflow Preventer ! Service Sink ' PB�OOY Na�e.�vL L62��1� � Co ny '� / � Backfl0w Irrigation � Sewei•Cap •' ::Y �Certifietl copy is hereby furnishetl. , _ Certifi�tl�qy�is�filetl with th¢ Ci[ Buy� isi Bathtubs . ' Sewer Connection � � Oate i 7i a APPlica - - . EXEMPTION FROM WORKERS' MPEN A ION DE�CLARATION Clarifiers � ' Solar Coliectors � (This section neetl mt be mmpletEtl i� the p r it i5 for one huntlretl ($300) or _ Iesz). Dishwasher!' . Solar Piping ' , 1 certify that in tM1e PerfOrmance�Of th¢ work /or which this perm�t is issuetl, I � - shall not employ any person'in any manner so as to become subject to ihe Drinking'�Fountains Solar Tank � Wotke�s' Compensation Laws of Califotnia. ' _ Date Signature - Floor Drains �� Swimming Pool w/$pa NOT�ICE: If,aiter making this tleclaration„you shoultl become subject to the ,. Workers' COmpensa[ion provisions of the Labor Cotle, you must forthwith FIOOrSinkS ' ' Urinal , compty with such provisions or [Itiz permii Shall be tle¢metl revoketl. CONSTRUCTION LENDING AGENCY GasS¢rviC¢ OUtl¢LS WdLefC105¢t 1 hereCy affirm that there'is a construction lentlinq agency far the perfarmance of the work �p i ptN� is issuetl (Section 3097 Giv. C.) Interce ton Wa[er Heater ' Lender's Name��n �-- :V1�4NY�T ' P �enCer's AGtlress - � Kitchen Sink Water Service OWNER BUILDER �ECLARATION . I heteby afti/m that I am ezempt from the Conlractor's LicenSe Law�fo! the �L2vdtOti¢5 ' AutO-WdSh following reason (Section 7031.5 Businass antl Professional Cotle: Any city or county which requires a permit to construct, alter, improve, Gemollsh or repair P=Trap Laundry Trays any structure, prlor to its issuance, also requlres tne applicant for such permit to file a signetl statement that he/she is licenzetl pursuant to the provisions ot ,ROOi D�ainS � � � � the Contractor's License Law (Chapter 9(commencing with Section �000) of ' �Division 3 of the�Business antl Professions Cotle)-or;that he/she-is exempt -- - - -- - therefvom and' Ihe basis,fo� the allegetl exemption. Any violatiOn of Section ' � 7031.5 by any applicant for a.permit subject5 [he applicant to a civil enalty of not more than �ive huntlretl tlollars ($500). � , , �� I, a5 owne� of tM1e property or my employees wi[h wages as [heir sole Rei�spactlOn F¢e $15 . ISSUe F@e � compensation, will tlo the work, antl the structure is not intentletl or offeretl for"sale (Section 7044, Business antl Professional Cotle: The �Contractor's ' � MECHANICAL ' � Licenu� Law tloes not appty to an owner of a property who builds or improves � thereOn, antl who tloes suclt wo�k M1imself/herself or through hi5 or her own • employee5, prOvitletl that such improvements are nOt intentletl ol offeleC for BOil2f , HOOd o� Typ21 '�❑ � sale.'If; however,"the builtling or improvement is sold within one year of com- � Canopy Type II ❑ � _ pletion, the owner will M1ave the burtlen O� proving h2/she tl�d not builtl ol ;m- DuCt - UOd¢I iilOUnd _ I : prove for the purpose of sale). � ❑-1, as owner of the�property, am exclusively contractin9 with licensetl con- Duct - StruMural . Refrigefation Syst¢m � Vactors to construct the O�oject (SCCtIOO �044. BI151I1Q55 dlIC.PIO�C5510lIS COdE: The Contractor's�License Law r1oe5'not apply to an owner of.property who � DUct - V¢ntildting � ❑0-100000 BTU �100; builtls or lmproves thereon, antl who contracts for such projents with a con- - + t�actor(5) btense pursuant to the Contracto�'S License'Law). I�am aware that ' - proof of their WorkerJs Compensation insurance shoultl'be provitletl to me. Exhaust SySt¢m �� Multiple ❑ Syst¢m Repair/Altera[iOn ❑�I am exempt untler�5ection -, _ , B. & P.,G for this reason . FirepUFact. Blt. ICBO # I Fire Dampers Date + - owner ' - � - Heating System & Ducting � Registers � � I nereby certiry.mat I have reatl inis a•lication antl state that the above / �0-t00,0006TU �t00,0006T ' information is wrr � I ee to com ith,all city antl county ortlinance5 _ - ' antl state laws r ti q o u ng co s ction, a tl hereby authori e r re-! .. � •;,- . sentatives of is. t o n r u ab e-mentionetl:,pro�t f�� . .� � � inspection pu os -/ O ' - � Signature O ; , _ - , . . . - Reinspeaion'Fee $15 Issue Fee � � "Drivers' License � - - ►� CMF OB65-46, rev. 10/04 N/bite - 6uiltlin9; Canary - qpplicant; Pink - Accounting; Goltlenrop - Assessor � � sTuf ° � ` � . A.P:# _ .. . � . � � _ _ S^ Main Building: ' E , T Front ! B Rear : ' ` � ' A C Right; ' -. � K Ceft S Ping. Ref. # ' Planning Notes: , , ,. �� Automatic'Washer � Construction Pole Sub._ Cooking, Unit DisFiwasher � � .. . Dryers ❑Gas ❑Electri Fan F.A'.U. Fixtures � Device Boxes Outlets , Switches- .� -- Garbage Disposal Generaror �0-5 KW �5 '0885 I/26i87 ' � Accessory Building: i 0 21.J5 TL 1 ' � iing Req./Provided ' + � I��.��N�t�� - ECECTRICAL � , �, � =: : F • � Transformer� 1&SOKW "� � . � "� SO+KW' , S' . " . Metef �up ro 100 amp5 � � Meter ❑over 100amps � ' � Sub,Panel � - • - � Motors OO-7 HP O1 %- S �� . � InaSolai �9�75 HP �16-75+ Microwave� Pole light. Range ' S�gn _ _ • Standing Sections i KW I Tresh Compactor � $,3 . . _ , � - . Reinspection Fee � $15 luue Fea FEES• DEVELOPMENT SERVICES REQUIREMENTS: 2oning Approved By , � � � Building Approved By � Application luued By � � Ss�� Z ' O N 1 ' N � G R � E t Q M T S f, i' ES rn l • �� , . $ 3 � . Date ' � = Date�(� + ' ' .."_ I /.7 1 _ . � ' � ; �,� SUMMARV OF FEES �� ' - � _ � ' ' ' � BUILDING PEFMIT $ ' SMIP � $- � - PLAN,CHECK � $ � �.PERMIT ' t 7y�. �.� (�//J.)� ' ' ' ' ISSUANCE _= i$c_`!—�-.=/— PLUMBING . $� � , PLAN CHECK 25%: $ ENERGY P.C.� ,$'� � ELECTRICAL ° ' ' $ ' GRADING �$ PLANCHECK�.50% $ , '' ' MICROFILM' �S� � y� '� , MECHANICAL� $ �� TOTAL FEE '$ � � ` � ' PLAN CHECK 25% $ �_ " ' y 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 ConduiDUndrgrnd. 55. Electrical Bonding �� 5. Steel Reinforcement � 56. Rough Plumbing & Pressure.Test �_ 6. Electrical UFER Grnd. 57. APPROVAL TO COVER;G'i1NITE• , ��* 7. Footings � ' � 58. Electrical Conduit-Undrg�nd. � , � 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9�VJater Pi e-Undr rnd. - � J P 9 � 60. Backwash Lines, P-Trap, �,Undrgrnd. 10. Structural Floor System � 61. APPROVAL TO DECK � 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Firia � � 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 � 76. 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 //�7 � FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # "�� 21. Ducts, in Structure 70. Underground Hydro ' 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil � 23. Gas Pipe-Rough & Test 72. Underground Flush � ' • 24: Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil � 25. Roof Sheathing � 74. Overhead Hydro . i 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 /1 yT - 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 pomestic-Final � � 42. Backtlow Preventer � ' 43. Backflow Irrigation � , '44. .Landscape Irrigation System � � _ 45. Sound Attenuation . �46. Handicap Regulations - - � 47. FINALSTRUCTURE&BUILDING � 48. Special Requirements Completed 49. Elearic Release to Edison � 50. Gas Release to Southern California Gas Co �� r- 51. CERTIFICATE OF OCCUPANCY � No. ' Date :. ' . . � , 4a . {� � I � • ADPlicant to till in all soaces exeept those within neavy Oortler lines ana sisn all apProoriate aeclarations. �— PERMIT NO. � TRACT NO. , ' LOT NO. . UNIT NO. CI7Y oF COS7a MESA CON TRU/C�TI'ON PERMIT �„� 2 g, Z�8. � ' Project Atldress �S� r�� ' ' . ��'L Cj.Q�T/ TYPEOFCONSTRUCTION NEW AD� A�TERATION REPAIR Applicant'S Mailing Address � /� 0 � 0 CONVERSION ❑ DEMOLISH � OTHER . q_p. # , � Owner's Name� �A��- ��'-%�--�C Phone ' �� ' DESCRIPTION OF WORK/USE OF BLDG �1N$�1 II_,_TRa�tIE-" Fci� ZN. -- Address Z i . � ) S Main Building: ; ___��L�s.� �'�J S�M �S!-� ; , Arch/Eng. E�,��\`` icenSeNo. � TVPEOFPERMIT GRAOING FOUNDATIO�jN STRVCTURAL � T Front, Address �/n SFil.�TA1�• l � ' '❑ TENANT, � ELECTRICAL ❑ PLUMBING ial MECHANICAL � 6 Rear ContraCtor'S Nam � � Phone � �THER � . ' A � 2 PROJECT DESCRIPTION 5a. Fr. • oCGUParvCV �� . C Right Address (mailingl � �%'� �%'�1/.O . . ' K Left � ' q � —1 CONSTRUCTION TVPE VALUATION $ � $ City�LiC¢052 NO. ' : ZONE GRADING CU. VDS. ACRES � � Ping. Ref. # LICENSED CONTRACTOR DECLAHATION I hereby affirm Ihat I am licensetl �untler provisions ot Charte� 9(commencin9 Remarks: , � , � Planning Noter � with section 7000) of Divislon 3 of the Business antl Professions Cotle, antl � - my license is in f II force antl effecL � i ] ' License pass 3 ' License No. -7SZ�i � ' Dale �'2�/-£'� Si9nature WORKERS' COMPENSATION DECLARATION ' ' I hereby affirm tnat I have a certi/icate of mnsent to selt-insure or a certiticate of Workers' Compensation Insurance, or a certitietl copy�.t�hae�eot (Section 3800, Lab. C,.) �_�, �p lj.�� J� � J� C2UMB��/11 PolicY No. �S�YIr�� 7L,L mPanY � �ertified copy is hereby furnishetl. i , ertifietl copy i5 filetl�with'the city Builtling Division. Date APplicant . EXEMPTION FROM WORKERS' COMPENSATION OECLARATION ' (Thissection n¢etl not be mmplete0 it the permit is fo� One huntlretl ($300) or less). I certify that in th¢ performance ot the'wovk for whlci� this perm�t is i55uetl I shall not employ any person-in any manne( so a�a become subject to the . �Workgxy�Gp�enygtlpn Laws of Cali(o��. 1�� C. Dale -� L. �tL/ Si9nature �� 1!i�i NOTICE: If, afte�,making thi5 tleUaration, you Shou tl.�come. subjecLto.the � Wo�kers' Comp¢nsa[ion provisions of the Labor Cotle, y0u must forthwith comply wilh sucM1 Orovisions or this pe�mit SM1all be tleemetl �evoketl. CONSTRUCTION LENDING AGENCV I nereby affirm that there is a construction lentling agency for the performance of tM1e work tor which this permit is issuetl (Section 309� Civ. C.) , Lentler'S Name Lentler's AOtlress.. , OWNER BUILDER dECLARATION ' I heieby 5tfirm that I am exempt from the �Contractor's License Law for the � foll6winq reason (Section 703L5 Businessantl Professional Cotle: Any city.or � couniy which requires aipermit to construct, alter, imorove, tlemolish or repalr any structure, prior to its issuance, also reqWres the applicant for such permrt , to fiie a signetl sWtement that he/she is licenutl pursuant to the provisions of Ihe Gontractor's LiGense Law (Chapter 9(commencin9 with Section ]000) of ' Divislon 3 ot the Business antl Profe55ionsCotle) o�'that he/she is'exempt-- thereirom and the�basis �or Ihe alleqetl exemption. Any violation of Section . 7031.5 by any applicant tor a permit subjects tM1e applicant to• a civil �enalty ot not mor2 than five huntlred tlollar5 ($500). 1, as owner of�the property or my�employees with wage5 as thai� sole compensation, will tlo the work, antl the structu�e is not intentled o� offeretl for�sale (Section 7044,. Business antl Professional Cotle: The ConVactor's ' License Law tloes not apply to an owner of a property who builtls or improves thxreon, antl who tloes such work himself/tle�self or through his oi her own employees, provitletl thai such improvements are not intentletl or offeretl for sdl¢. Il, however, the builtling or improvement is soltl within one year of com- pletion the.owne� will have the burtlen ot provin9 he/she tlitl not builtl or im- prOve for the purpose of sale). � ' ❑ I, as owner of the properTy, am exclusively contracting with licensea cori- Iractors to construct tne project (Section 7044, Business antl Professions Cotle: The Contractor's License Law tloes not apply to an owner of property who builtls'or improves thereon, antl who conVac[s.for such projects with a con- tractor(s) iicense pursuant to tne Contractor's �icense Law). I am aware that BarSink. - B flow Preventer " . ' Backflo rrigation - Bathtubs "'.� �- " . Clarifiers - � Dishwasher ; - Drinkin9�Fountains RoorDrains ' � ' ' Flaor Sinks 6as Service OuUets � Interceptors ' Kitchen Sink � .y . �t:avatories � ) ' . P.'-Trep "Roof Dreins � Reinspection Fee � $15 ' Boiler , " Duct - Under Ground Duct- Structural Duct - Ventilatin9 E h t S t m�� Mul[i le ❑ proof of their Worker'S Compensation insuran<e shoultl be provitletl [o me. ' x 3U5 y5 2 p__ ❑ I'am exempt untler_Sec[ion B. & P. C. for this reason Firepl/Fact. Blt. ICBO # Date Owner � Heating System & Ducting . I he�eby cer[ify Iha[ I have reatl tnis application 9ntl state that the above ❑0.100,000 BTU �100,OOOBT information is correct. I aqree to compty with all city antl munty ortlinances. antl sta[e laws relaling [o buil i g Wns[ruction, antl hereby authorize rep�e-� sentatives of. this y to en r'upon the' above-mentionetl property for , . -' � insoectlon purpose . � � Signature � Daie. ,. peinspeMion Fee � $15 '; Drivers"License or 5 '� � � , � � - AF 0865-46, rev. 30/84 White - Builtling: Canary - Applicant; Pink - Accountin9: Goltlenrotl - Assessor , � -FEES• $howers - ' ' � Service Sink - ' - ; SewerCap�, � � � � � �' � Sewer Connection . Solar Collectors • • . Swimming Pool w/Spa � - inal Wat Closet � � Water He r J�� ' Water Service . : � Auto-Wash , '� � Issue Fee Hood or ' Type I f7J 'Canopy Type I I ❑ Refrigeration System ❑0-700,OOOBTU ❑1( System.R epair/Alterati� Fire Dampers - Registers . Issue Fae $ 3 FEE: BTU . � �$ 3, . ' ti-� .. /:,.`, •�. ` Y ' Accessory _. . _. , _ .. . 1 ' . Parking Re �. � Automatic Washer' . Co uctionPoleSu Cooking nit - Dishwasher Dryers ❑Gas li Fan F.A.U. . Fixtuies Device Boxes Outlets $witches Garbage Disposal i Gene�ator �0-5 KW � � •. � .�ECECTRICAL • Transfo 5KW�., � �j-:' . 4 .. � �2 : '; � i� Zone � n9 _ _' ` r Z • O • N I _ _ r` , N i � i . G 0 A � � ien � 15-50 KW O SO+KW ' up to 100 amps over 100.amps Sub Panel Morors �0-1 HP Inc.Solar �9-75 Microwave �Pole Lig�ht R�ae • Standing R ' E Q M T S � FEES '; � i " � ' Reinipection Fee $15 Issue�Fee � $ �3 � DEVELOPMENTSERVICESREQUIREMENTS: �. � Zoning Approved By � Date Building Approved By Date�%$'j Appliwtion Issuad By � DatA _LL: �!�__ ' SUMMARV OF FEES � BUILDINGPERMIT $ SMIP ' $ - — . PLAN CHECK ' $ - PERMIT — ' PLUMBING $, �- �SSUANCE � $ ' � PLANCHECK, 25% $ ENERGVP.C. �$. ' - � � ELECTRICAL - .` ,$. GRADING - $ �� PLAN CHECK 50% $ � � � MICROFILM $ — MECHANICAL � §- � •�II � TOTALFEE $ I-�. %S� "' PLAN CHECK 25% $ � � %.S— . � " CONSTRUCTION AND'PLANNING � POOL & SPA ' � � r• � � Date Inspector • Date Inspector APPROVALS Permit�# _ APPROVALS Permit # , 1. Temporary Electrical Secvice or Pole 52. Pool &,Equipment Location. . � 2. Soil Pipe-Undrgrnd.� ` 53. Steel Reinforcement � 3. Electrical Conduit Utility-Undrgrnd. � 54. Forms � 4. Electrical ConduiDUndrgmd. � � �55. Electrical Bonding , 5. Steel'Reinforcement , . , 56. Rough Plumbing & Pressure Test � , 6. Electrical UFER Grnd. -' ' 57. APPROVALTO COVER-GUNITE . ,7.,Footings ' � � � 58. Etectrical Conduit-Undrgmd. �/ 8.� Foundation �' - - �� 59. Gas.Pipe, O Undrgrnd., Test � 9.� Water Pipe�Undrgmd.� �. . 60:� Backwash Lines, P-Trap, O Undrgrnd. ' 70. Structural Floor System � 61. APPROVAL TO DECK : ,11. Property Sewer Line & House Connection 62.� Backwash &� Receptor-Final � 12. Sewer Cap � � 63. Heater & Vent-Final � � 1�3. Roof Drains � ' � . 64. Plumbing SYstem � Final - , 14. Rou9h Plumbing .� .� 65. Electrical-Final 15. Rough Electrical-Conduit . � � � �66. Solar System-Final . 16. Rough Electric Wiring - �� 67. Fencing &�Access Approval 17. Rougli 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 � � �� - �- �e� �is 77, Product Piping �Gas OOiI ' i� . 23. Gas;Pipe-Rough & Test . • 72. Underground Flush � ' 24. Roof��Framing . " �, '- 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof�Sheathing " � - 7q. Overhead Hydro � , �'� .' 26. T-Ba�Ceiling (Structural) & Monocoat , ' 75. Dry Chemical S 27. Frame and Flashing � • � 76. Dry Standpipe �� 28. Lathing & Siding � ' 77. FIXED SYSTEM FINAL , ' 29. Insulation ' 78. FIRE PREV. FINAL ;i• 30. Drywall Nailing . ' .� � HEALTH DEPT.'REQUIREMENT 31. Plaster Brown Coat , 79. FINAL INSPECTION �, .�? 32. Electrical Power Meter-Final �. 80. FOOD CERTIFICATE ISSUED " V 33. Final Electric - Notes:�� , � � � � 34. Final Heating & Air Conditioning � � . � � , R �� 35. Final Gas Pipe-Test - � � � � '=� -' 36. Hood or Canopy � , , �, ,:, . '� 37. Final Factory Fireplace ' � � .. .t . 38. Final Plumbing ' y� '�q � _ 39. Water Service-Final � • • � . .. 40. Gas Service-Final . . � � `'" ` i. . i •i 41. Solar pomestioFinal ,' � - - 7, -� � �, � 1� 42. Backflow Preventer !1! .. ; . ,�.r r .�' . ,. � 43. Backflow Irrigation , � . ' " -, � " w .f.. � / 44. Landscape Irrigation System � , � . - t� . ' �� ts; i � � 45. Sound Attenuation � � . ' ' '� � ��. �« -• ' '-. �• I 46. Handicap Regulations . �" iy,� _'� �' '47:'FINALSTRUCTURE & BUILDING - � . �'� . • � �,�.� ' � .i 48. Special Requirements Completed !� � ' � � '�� , 49. Electric Release to Edison - ;� <- � _ 50. Gas Release to Souther'n California Gas Co � _ ' � . 51. CERTIFICATE OF OCCUPANCY � - 't ' - - \\ . . Date . _ � . . ' . /1 . 1 � - �_ ADO��ant to (ill in all ipaces except those \l -.. .. ._ -. .. . _ CITYOF.COSTAMESA CON/STRUC/�TIONPERMIT '""-' PER^^iT"o. 7 ' Project Address �� 7 L� r E� � C. ; , " 6� F.t,oE,e v,R=1 • Applicant'sMailing ddress �� i • Owner's Name - E�� ' K PAu � Phone 6 S�L -S �%Q Address %� � �6 EC�O Ci2. , v, � }f - / � • • i Arch/Eng. ' License No. - i Address Contrector's Name C��ST aU/CO/NC7 Sf �' Phone �i ssrr Addresslmailingl a7�aZ �m,N� . e�tFtsr'�zft�,r �7iZ2 City License No. �3g71 Z LICENSED CONTRACTOR DECLARATION � ' � I nereny affirm tbat I am licensetl untler provisions ot Charter 9(commencin9 withJsectio ]000)� ot Division 3 bt Lne Businoss antl Protezsions Cotle, antl myp�n.e �� fullfo�an�e�ect/��'��L e a,/ �!/ ,—� yq <S� D5 519 L T �/ � O (�' ..1K VJORKERS'COMPENSATION DECLARATION I hereby altirm'that I have a certlficate ot consent to self-insure or a certificate ot Worker5' Compen5ation InSurance, o� a'certifietl copy thereot (SeG[ion 3800, Lab. Cj�Q�/J� G N� Policy No. /nU 7 �� Company �� Ceriifiea cap� is hereby fumishetl. ' � Cerki 'etl w is'filed wiN Ihe city Builtlin o � Da[e APplicant ' ' �' EXE TIO FRO WORKERS'COMPENSATION DECLAR ION. (TM1is section neetl not be completetl if the permit is tor one hun r¢tl ($100) or less). I certify tM1at in Ihe performante o/ the wo�k to� which this pe�m�t is issuetl, I I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. , , Date Signa[ure ' NOTICE: If, atte� making this tleclaratiOn, y0u should become.subject to the Wo�ke�s' Compensation p�ovls�ons of the Ldbor Cotle, you must forthwitM1 comply with such pwvisions or this permlt sha11 , be tleemed revoketl. CONSTRUCTION LENDING AGENCV ' � '✓;1�. 1 hereby affirm4ha[ there is a conztruction lentling agency for the perrormance of [he work � for y(h i h Sp� p¢rmj is �is5ued (5,¢ct�pn 3097 Ci� KCJ Lentler's Name [y�NK '7h NG1Ll1fOiZT : . Lentler'SAGtlress C�K�C � ST �W� •��'' , OWNERBUILDENpECLARATION � %GO-� Oae �� I hereby atfirm that I am exemp[ irom,the Contrac[or's License Law for the following reason (Section 7031.5 Business antl Professional Cotle: Any;city or county which requires a permit to construct; alter, improve, tlemolish or�repalr � any sVucture, prior to itz issuance, also requires the applicant for such permit to file a signetl statement that he/she is licensetl pursuant to tlte O�ovi5ion5 ot the Contractor's Licenre I.aw (Cnapter 9(commencing with Section ]000) of Division 3 of the Business antl Professions Cotle)�or that he/she is'ezempt therefrom antl the basis'fOr the allegetl exemption. Any violation of Section ]031.5 by any applicant (or a permit subjects the applicant to. a civil �enalty ot not more than tive huntlretl tlollars ($500). 1, as owne� of !tM1e' property Or my employee5 with wages as their sole compensation, will do [he work, antl the sVucture is not intentletl or ofteretl tor sale (Section 7044, Business antl Professional Code: The Contractor's LicenSe Law tloes no[ apply to an owner of a prope�ty who builtl5 Or impwves ther¢on, antl who tloes such�work himself/herself oi tn�ou9h his o� M1er own employees, p�ovitletl that such improvemenl5 a�e not infentletl o� offeretl for sale:'If;.noweveq the builtling or improvement is solC within one year ot com- . pletion, the owne� wilPhave the burtlen of proving he/she tlitl no[ builtl or irn- p�ove tor the purpose of sale). � � ❑ 1, as owner of Ihe property, am exclusively con[rac[ing with licensetl mn- tractors to construct the oroject (Section �044, Business antl Professions Cotle: The Contrac[or's License law does not appty Io an owner of pwperty wbo builtls or improves thereon; antl who contracts for sucn projects with a con- tracfor(s) I¢ense,pursuant to�Yhe ConVactor•s License,Law). I am aware that pwof of iheir Worker'S��Compensation insurance shoultl be provitletl to me. ❑-I am enempt untler_Section B. &�P. C.�for this reason heavY Oortle� iines anE.sign all�approD�iate tleclarations. JO. LOT NO. .UNIT NO. , Z— : � TYPE OF CONSTRUCTION LI NEW U ADD LJ ALTERATION LJ REPAII � � CONVERSION, � DEMOLISH O OTHER ; DESCRIPTION OF WORK/USE OF BLDG.; � ' � � TVPEOFPERMIT GRAOING FOUNDATION ST,RUCTURAL 1 ' O TENHNT ❑ ELECTRICAL ❑ PLUMBING � MECHANICAL � O OTHER PqOJECT DESCRIPTION 54. F7. � oCCUaaNCY CONSTRUCTION TYPE ' VALUATION $ ZONE � GRADING CU. VDS. ACRES Remarks: ! � / i Sink kflow Preventer - kflow Irrigation �mbs .� Floor Drains - ' FloorSinks I 3as Service Outlets Interceptors Kitchen Sink _ _ . Lavatories P—Trap Roof Drains i ' � Reinspection Fee� $15 Duct - Under Ground ' Duct - Structuial Duct - Ventilating ExhaustSystem�❑ Multiple❑ FirepUFact. BIL ICBO �¢23� ' Date � Owner � ' Heating System & Ducting' � . I hereby cer[ify that I have reatl thls application antl State that the above � 04100,000 BTU �100,OOOBT intormation is correct.' I agree to comply with all city and county ortlinances - - antl sta[e laws relating to b� ing cOn uction, antl he�eby authorize /epre- ' � sentatives of [his ter up [ e ove-mentionetl pr erty. or - - inspecHon purposes � ZQ " � ' � Signature Date peinspection Fee $15 ' Drivers' Li[enze or 55 � CMF�0865-46, rev. 30/84 White - Builtling; - Acmuntin9; Goltlenwtl - Assessor �I IMBING ; � Showers� . Service Sink � Sewer Cap Sewer Connection � � SolarCollecrors. � ' Solar Piping � � Solar Tank � Swimming Pool w/Spa Urinal Water Closet �, � Water Heater Water Service� - � - A um-W ash Laundry Trays Issue Fae Hood or Typel ❑ Canopy . Typell ❑ Refrigeration System ❑0-100,000 eTU ❑ 100,000 BT System Repair/Alteration Fire Dampers � _ Registers ' .. Issue Fee J FEES � $ 3 A.P: # ' S Main Building: E T Front B Rear � A C RighY ' g Left � Ping. Ref. # Planning Notes: ' E Automatic Washer ' Construction Pole Sub:. � � Cooking Unit � � � . � Dishwasher � � � _ . Dryers ❑Gas ,DElectric Fan F.A.U. Fixtures � � . � Device Boxes � Outlets Switches - Garbage Dispoul � Generetor �0.5 KW �5�15 KW I Reinspection Fee — DEVELOPMENTSER Zoning Approved By_ Buiiding Approved By Application Issued 8y_ N . ...__ i 113:p�t ZOne � '�']��T� �ry Building: Parking Req./Provided � x ICAL ;.'. �-, '. Transformer[LJ 15-50KW;; : ❑50+KW Merer �up to 100amps , Meter, �over'100amps Sub�Panel � � Motors �01 HP �1 %- 8 . InaSolar �9-15 HP-O�16-15 Microwave Pole Light, . � Range Sign ' - " ' -" Standing Sections . Trash Compactor � $15 luue Fee ' � " :SREQUIREMENTS:. , , � . Z = O N I � N G R E Q M T S , � SUMMARY OF FEES - � ' � � � BUILDING PERMIT $ SMIP � , $ - � PLAN�CHECK $ --PERMIT, - � -..' PWMBING, :. . $ ISSUANCE � $: _- PLANCHECK 25% $, �_ ENERGV P.C. $' - � ELECTRICAL � - $ � � GRADING - $ � . PLAN.CHECK , 50% $_ � � � MICROFJ�M�, ,$ � ?�, `� �� MECHANICAL ' $ � � • � � � TOTAL FEE $ � ✓ `..Ob PLAN CHECK 25% $ . ��- . ' � , � CONSTRUCTION AND PLANNING , POOL & SPA: APPROVALS . Permit # Date Inspector qppROVALS Permit # ! Date Inspector i. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgmd. . � , 54. Forms � � � 4. Electrical Conduit-Undrgmd. 55. Electrical Bonding , 5�. Steel Reinforcement 56. Rough Plumbing'& Pressure Test 6 Electrical UFER Grnd.' 57. APPROVAL TO COVER-GUNITE 7. Footings ' 58. Electrical Conduit-Undrgrnd. � 8. Foundation . - 59. Gas Pipe, O Undrgrnd., Test -' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O 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 Dtains 64. Plumbing System - Final . 14. Rough Plumbing , 65. Electrical-Final 15. Rough Electrical-Conduii 66. Solar System-Final � 16. Rough Electric Wiring - 67. Fencing & Access Approval '17. Rough Wiring Sign • 68. APPROVED FOR PLASTERING ' 18. Rough Electriral-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 � 77. Product Piping �Gas ❑Oil ' 23. Gas Pipe-Rough & Test 72. Underground Flush . � 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑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 `, �'_ . , . . . .- �38. Final Plumbing � - � � � . . � � ' � . 39. Water Service-Final � � � � � 40. Gas Service-Final , � . � 41. Solar pomestio-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 Cn . � 51. CERTIFICATE OF OCCUPANCY ' No. Date ' � - • - > . ADPlicant to fill in all spatts exeeo� ihose within neavY Dortler lines anE sign all approoriate tleclaretionz. �i � " "' _ ' _ .. '" "_ '. "_�_ � � � � � , PERMIT ' � TRACT NO. � LOT NO; �UNIT NO. � � � ' ' ' qTY,OFCOSTAMESA �CONSTRUCTI NP RMIT � . . , � 'Pjo�eocq`¢d�ess � �S7 ��'+ : ��✓'� �� , : � ' � , ' �Y'7�95 II/2�a/86 4�:_I3 �Tl Applicant'SM2ilingAddre55 � � MC�1-//��I � � � TYPE•OF•C�NSTRUCTION , NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑'DEMOLISH ❑ OTHE� � � � q,p.# . � � , ' Za�e � OWier's Name �rij/.'k ' �iU/ Phone DESCRIPTION OF WOflK)USE OF BLDG. �`f� � -� � - - - , � Address � ; ' " ' S Main Building: � � Accessory Building: ' � ' Arch/Eng: � License No. � � TVPE OF PERMIT GRADING C]�UrvDATiOrv � T � ' O ' � � STRVCTURAL � Front, Address � ' � , ❑ TENANT ❑ ELECTRICAL"LgPLUMBING ❑ MECHANICAL ' B Real � � - � � N }� / ❑ OTHER �%� � Contractor's Name U S � �� • ✓� Phone N-Y�T 3' � � . � C Right, � - " � - � � ' I � G pp..��, •.�/ �o� � � , PROJEC7 DESCRIPTION �Sc?. FT. � oCCUaANCv � � Addresslmailingl�� r�/'/ . iCONSTRUCTION,TVPE � VALUATIOM$ ' I S �eft � ' � � , � � R City.License No. 20NE GRADING CU.YDS. ACRES Ping. Ref. # , 1 Palking Req./Provided ' E LICENSED CONTRACTOR DECLARATION - � ' 1 1 hereby aftirm lhat I am licensetl untler D/ovislons ot Charter 9(commencing Remarks: _� ' 33 ' � -� _ Planning Notes: � . ' ' �� M� wttb section ]000) ot Olvision 3 ot the Business antl Professions Cotle, antl mY license is in full for�p a�tl %f ct. . ' - . , � . � • _ ,-� � � ' ' � . , -' . . . . T License Cla s � ` �✓ 'E nse o �� ' -- . , � S oate'� 2- Signature � ' � ' � � PLUMBING ' � i � ' �.'PEES � � ' � ' ' � �WORKE 5' CO PENSATION OECLARATION � � . _ - � � „ - _ � �' � I hereby affirm thaY1 have a certificate of consent to selt-insure oi a certiticzte gar Sink Showers, � i-. • i' ELECTRICAL ,. FEES � 1 '� of Workers' Compen5ation InSurance, or a ce�titietl coOY thereof (Section � - - � • ; . 3800, �ati. C � � � , Backflow Preventer Service Smk _ � � - , , � � Automatic Wesher ' � _ ' Transformer �� 15-50 KW ., � t_ 1 Policy . l3 Gompany ��- ' � I Backflow Irrigation �� I , Sewer Cap _ � ' _ . � ' Construction PoleSub. - � • �� 50+ KW t + l � �]� hfietl mpy is h reby furmshetl. ,� Ly'Certi i d p's wim the city e i ng D' i Bathtu6s �:. 1 _ � ' Sewer Connection � Cooking Unit � Meter ❑up to 700 amps ' Date Applicant - . .. - ' E%EMPT N M WORKERS' CO ENSFTIO DECIARATION Cld�ifi¢�5 -• .. � � SOIa� COII¢Cto�S � - DiShwdshe� :_ � M2L2� ❑Ov2f 100 dmp5 (This sect�on nee nO[ be mmpletetl if tbe pe�mit is fo� one huntlr¢tl (E300) or � - Iess)J . , Dishwasher'' ' ' . ; Solar Pipiu9 � -� . � �� Dryers .�Gas �DElectric - . Suh Panel � ' - . I certify that in the pe�formance of the wo�k to� whicit this pevmk is issuetl, I �. �. , - � shall not emptoy any person in any manner so as to become subject to the - Drinkin9'Fountains � �� Solar Tank �•� Fan . ' � Momrs DO-1 �HP O1'f.- 8 Workers' Compensation Laws of Califomia. � � ' � ' ' ' . • . , . „ ` � Date� � Si9nature - � - Floor�Drains � j. Swimming Pool w/Spa � � I � � � F.A:U."' � � � ' NOTICE: If, after making this tleclaration, you should become subject to the . _ _ InG. Solar �9-15 HP �i6-15+, , �Wo�ke�s' Compensation provisions of the Labor-Cotle, you mu5t forthwith� FIo0�5inks U�ipol � . � FixLu�ES ' � compty with suth� provisions or; tM1iS Oe�mit shall.be tleemetl,revoketl. ' ' ,_, Mic�Ow3v¢� CONSTRUCTION LENDING AGENCV � '�•j: ; � ��GasService '�Outlets . �WaterClOset � � �� 1 herety affirm that there is a wnstruction lentling agency fo��the pe�fo�mance /� � � Device Boxes POIB Light � �% of the wo�k � for which this permit is issuetl (Section 309];,Civ. CJ , Intercepmrs • Water Heater ' � Outlets �. ��- tentler's Name Range �enders Atltlress � � _ Kitchen Sink _ �„_ � Water Servicet . __ Switches -. - Sign -- � - - OWNER BUILOEH DECLARATION �' - � - , . ' ' I hereby affirm [hat 1 am exempt from the Contractor'S License Caw for tbe � Lavatories , Auto-Wash ' tollowing,reason (Section 7031.5 Business antl Professional Catle:,Any cityior � Garbage Disposal Standin9 Sections . munty whicn requires a permit to consiruct; alter, improve, tlemolish or repair t� , p-Trap ' � i I Laundry Trays Generator �0-5 KW �5�15 KW Trash Com actor I any structure, p�io� to its issuance; also requi�es the applicant tor;5uch permit � � P � to tile a signetl statement that he/she is licensetl pursudnt [o Ihe provisions ot � ' , � 1 � ` . the Contractor's License Law (Chapter 9(mmmencinq witb Sectlon:7000) of � Roof Drains � � � /� , , Division 3 of [he Business antl-Profe55ion5 ;Cotle) or that he/she �is exempt - . _ , ._ _ _ _ . __ . _ . . . + � � ' therefram antl lne basis•for the all¢9¢tl exemption. Any violation of Section , • � ' � , � � ' ]031.5•by any applicant for a permit subjects the applicant to a civil ' penaity ot not more than tive hundred tlollars (5500). � ' � ' , • 3 � . ' �❑ I, as' owner of �the property or my employees with wages as their sole Reinsp¢C[ion Fee. $15 , ISsue Fee $ ' ' wmpensation,�will tlo tne work, antl the structure is not intentletl orbiferetl - ' Reinspection Fee $15 Issue Fee . ' � '$ 3 � foi'sale' (Section 7044,� eusiness anG Professional Cotle: The .Contractor's - � MECHANICAL, . � � � FEES � - I1 . i License Law tloes no[ apply to an owner of a property who builds or improves � , . - thereon, antl wno tloes such�work nimselt/herseN or mraugh his or her own DEVELOPMENT SERVICES REQUIREMENTS: ' ' ertiployee5, provitletl that such improvements are not intentletl or o((e�etl for BOiIE� ', HOod O� Type I ❑ .,Sal¢.Jf, however,-the builtling or improvement is Soltl within one year of mm- CBnopy Type II ❑ � . ZOOing ApproV¢d By DatO , � pietion, tbe owner will have the bu�Gen Of provinq he/she tlltl not build or im- . Duct - Under (�i�OUnd . . _ BUilding App�Ov¢d By � � Date '� - rove for the purpose of sale). - ' I ��-1, az owner ot the property, am extlusively cont�acting wlth IicenSetl�con- , DUct - Structu�dl ' Ref�iy2f3tiOn Sys[em ,AppliUtiOn ISsued By Det 4� 1'�% �� lractors to construct Ihe project (Se[tiOn 7044, Business antl Pwfessions Cotle: - � ` , The ConVactor's'License Law tloes-not aoPly to an owner ot property who Duct - Ventilating ' � ❑0.100,000 BTU ❑100,000 BTU - . SUMMARV OF FEES ' -' ' ' builtls or'impraves thereon', antl who contract5 for su[h projects with a con- ' � � „ tractor(s) imense pursuant ro ihe Contractor's Licen'se'Law). I am aware that; ' BUILDING PERMIT $ ' SMIP ' $� proof of their Worker's Compensation insurance shoultl:be orovitletl to me. Exhaust System' 0•MWtiple ❑ System.Repair/Alteration , . . _-, ' -� ' PLAN CHECK $. PERMIT � ❑� am exempt untler Section ' ,8..&'P. C: for mis reason ; Firepl/Fact. BIt. ICBO � j Fire Dampers ,-' ' � PLUMBING $�_ ISSUANCE �$` _ � �ate' - - Owner " ' ' � � � ' HeatingSystem&Ducting� � -` Registers� � pLAN'CHECK 25% $ ' ENERGV'P.C. $ I heretiy certif t 1 have ea this appimatmn tl state �that �tne above " DO-100,000 BTU �t00,0006T - ' ' _ � GRADING $. information �is orrec . I agr t comply with a and county ortlinances � � ' '' • ELECTRICAL $_ � antl'state law r lati 9-to u g consV t' tl hereby authorize repre-. ' � PLAN CHECK' 50% $. MICROFILM $ � sentatives of is ci y e pOn e-mentionetl ro� erty f r - ' ., - . � . ' P � i . � ' inspection p ses. ' � �� 2 G/ � � � � � - u MECHANICAL $ ' TOTAL FEE $ T l�J117 Signature � Date •.b . _ . , . �- � . , Reini ction Fee $15 • Issue Fee " . -� '3` � PLAN CHECK 25% � D�ivers License or S Pe. '$ $ 5 # CMF 0865-46; re'v: 30/B4 Whi e- Builtlinq; CSnary - Applicanq Pink - Acmunting; Goltlenrotl - Assessor � � � � ,/ CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit # Date Inspector qppROVALS 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 & Pretsure Test 6. Electrical UFER Grnd. . . 57. APPROVAL TO COVER-GUNITE, 7. Footings 58. Electrical Conduit-Undrgrnd. • � 8. Foundation _ 59. Gas Pipe, O Undrgrnd., Test '" 9. Water Pipe-Undrgrnd. ��Z�� gp. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection . N L✓ 62. Backwash & Receptor-Final 12. Sewer Cap � 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing .. y/� �� 65. Electrical-Final � � 15. Rough Electr.ical-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 O Gas ❑ Oil 23. Gas Pipe-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. 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. F.INAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' � � Notes: - � 34. Final Heating & Air Conditioning � � - 35. Final Gas Pipe-Test . Q y� � � 36. Hood or Canopy 37. Final Factory Fireplace _ � 38. Final Plumbing fs� � 39. Water Service-Final � � � '�� . 40. Gas Service-Final � 41. Solar pomesticFinal " - �42. Backflow Preventer -� � � 43. Backflow Irrigation � - 44. .Landscape Irrigation System - ' ' � , 45. Sounii Attenuation � �'46. Handicap Regulatio�s , 47. FINAL STRUCTURE & BUILDING ' • 48. .Special Requirements Completed ' - � 49. �Electrie Release to. Edison � 50. Gas Release to Southern California Gas Co ' t 51. CERTIFICATE OF OCCUPANCY . - .'-� No. Date ' � • .�. . . . .>_..;:., . . ,r... � .,.. ' , .. . .. _ ., i . .._ .. � ..