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289 LILAC LN - Building Permits
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 289 LILAC LN Suite: Vicinity: RESIDENCE AND ATTACHED GARAGE Parcel Number: 42615110 Applicant: WATKINS, EDWARD Address: 289 LILAC LN Zoning: ISSUED BY: Arch : Address: Phone: 714-966-8303 COSTA MESA, CA Zip: 92627 License: 393321 Phone: Eng: Address: Status: ISSUED Applied: 05/20/2002 Issued: 05/20/2002 Phone: Zip: License: License: SCOPE OF PERMIT REROOF: T/O 1 LAYER WOOD SHINGLE & 1 LAYER SHAKE, 1/2" COX PLYWOOD, 1 LAYER 30# FELT, APPLY ELK PRESTIQUE COMP SHINGLES. 25 SQUARES FEESUMMARY Plan Check: " Phone: 714-966-8303 Permit: COSTA MESA, CA" Zip: 92627 Owner: WATKINS, EDWARD E TR SMIP Com: Address 289 LILAC LN " Other: $0.00 " - Phone: ,' .. COSTA MESA, CA Zip: 92627 Contractor: AERO -THERM "CONSTRUCTION INC Address: 289 LILAC LN Arch : Address: Phone: 714-966-8303 COSTA MESA, CA Zip: 92627 License: 393321 Phone: Eng: Address: Status: ISSUED Applied: 05/20/2002 Issued: 05/20/2002 Phone: Zip: License: License: SCOPE OF PERMIT REROOF: T/O 1 LAYER WOOD SHINGLE & 1 LAYER SHAKE, 1/2" COX PLYWOOD, 1 LAYER 30# FELT, APPLY ELK PRESTIQUE COMP SHINGLES. 25 SQUARES FEESUMMARY Plan Check: $0.00 Permit: $125.25 SMIP Res: $0.55 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.80 Calc Valuation: $5,500.00 Claim Valuation: $5,500.00 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 " NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. , INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2646-46 (6/00) WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the / work for which this permit is issued. i❑' I have and will maintain workers' compensatlon Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. y My workers' comp.+sation Insurance carder and policy number are: carder:__ S t A 7 W 5 de /Z %itJS/i7/3� !NS(%?�we.W- I*A4 PolicyNu� m �ii— —D Z— Utl/f®eoa t0his section need not oe completed if the permit is valued of one hundred dollars ($100) Orissa.) ----� ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions....y/ j `Applicant'Signature:-� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL MINES UP TO ONE HUNDRED THOUSAND DOLT -ARE (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirn that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force end etfecCLic.q, Cla`�s�s #(�j—! <_—%. G-33 .—Z4 `Contractors S u } �Date:,C-70—/)'—� CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Cade: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Cade: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Cade requires, with some exceptions. that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons. or 200 cubic feetof compressed gas at stan. . .......................... ..................... .......................................... .................... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa,Flm Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 2GG cubic feet of compressed gas at standard temperature and pressure). ................................... .................. ................................... _................................................................................. _.__—_.__......_......._........_..___.......................................................... _.................... _................... _................. _................. _......... 3 Does or will theappplicant or present or future building Occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes 11NO (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ....................... ...................... .................................................... ..._.......................................... ...................................................................................................:............................................................ 1............................................I..........I............... 4 If an RMPP is presently required, has Section 25S34 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ... ............................ ........ _...._........... _......... _........... _............. __......................................... ...__..................................................................................... ................................... ................. ............................. ......................................................... 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication aEEermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes [9 NO (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). .........................._........_........_._.........._............—............_.__.._.......................................................................................................................................................................................................... 6 Will an Dart of the lacili to be constructed under this permit be within 1000 feet from the outer boundaries of a school? y ty p ❑Yes ❑ No (If yes-, the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ............................................... .................................................................................................................................................................................... __.................................. ............ _...... _.......... __ ......... _........ _......... _.. 7 II a permit from the South Coast Air Quality Management District or other air pollution control distract or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑ No ...............__.........._............_........._.........__........iance_.....__�--atea......._......................trol..offi......................................_............................................_...__..............__......................................................................... 8 (If yes", affach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: 1 certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to Occupy or allow Occupancy of any building authorized by this permit until final inspection. Signai Of Legal Owner(s) Date 7�i�. ° �rr..� 9 a I S- 20-10_Z, AmIfOf AuThorized Applicant tDate� CODE P. INSPECTION TYPE DATE ISI! CODE INSPECTION TYPE SIF ImTrifitUs 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final /�—�''n' 208 Final Plumbing 200 Final Re -Roof (� (L�!/ 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy M PROJECT ADDRESS: ' 289 L.I LAC LN UNIT: - OWNER'S NAME: WATKINS .. ADDRESS: 289 'LILAC LN.. COSTA MESA' CA 92627 (714)966-8303 AflCH/ENGINEEfl: - 'REG.NO.P ' ADDRESS: + - ' UNIT: ' PERMIITEE:.PRECISION •:AIR SYSTEMS (714)241-8186 'ADDRESS: 1.235 E GLENWOODPL . s SANTA ANA I CA 92707 LICENSED CONTRACTOR DECLARATION: I he affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division Tot the Business and Professions Code, and my license is in full farce and effect.' CITY 1 0 3 75 0 5' STATE ul4 5 5 4 7s2 O CLASS: C..— ? 0 --y-- Date: �I _ .3 / Q• Signature: ,� DECthat WORAERS'COMPENSATIONLAMTIDN: Iherebya irm that) a certificate of consent to self -insure certificate of Workers' Compensation Insurance, or a cenifie0 copy thereof (Section 3800, Lab. C). POLICY NO.: EAP. DATE: l COMPANY: t t Certified copy is hereby furnished. ❑ Certified copy, is filed with the city BUIItlinA Division. Date: Applicant: EXEMPTION FROM WOFII(ERS' COMPENSATION DECLARATION: This section need not be completed it the pemul is for one hundred (5100) or less). I canny that in the performof the work for which rm Delt is issued, I shall not employ any person in any manner so as to become subject to the/y�orkers' Com/p)anceRsalion Laws of Cali + Date: / .3 NOTICE: If, atter majil this declaration, you sh become subject to the Worke Compensation provisions of the Labor Code, you must forthwith comply with such pr ions or this permit shall he de d revoked. i CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ! C). LENDER: ' ADDRESS: t. OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from'the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code:, Any city of county which requires a permit to construct. alter; improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500)." 'I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law' does not apply to an owner of a property who builds ogimproves thereon: and who does such work himself/herself or through +his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale).. - L as owner of the property, Co exclusively contracting with licensed contractors to construct) project builds Prov Business ❑, -+and Professions Cade: The Contractors' State License Law dens not pursuant to an owner of property ate kens er improves thereon and who contracts for such Compensation with a contractors)license rovident.tomhe Contractors' State License Law). am aware that proof o/ their Worker's Compensation insurance should be•provided to me. ' ❑ I am exempt under Section: B. 8 P. C. = I for this reason: I Date: Owner I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle ane) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District. Residential construction applications are exempt from these provisions. , i OatesApplicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state taws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned- propertyfor in ection p rposes. Date: Signature Driver's License or Social Security x; 164146 White—Buildino: Green -Code Enforcement: Canary -Applicant: Pink-Revenua. Goldenrod—Anel CITY OF COSTA MESA BUILDING PERMIT "PERM NO: M. 045907•- PERMIT"NO: M 045907 PLAN 'CHECK NO:. N , GOVT: N SUPP:•N CONSTRUCTION'TYPE: 5-N PERMIViYPE:,MEC PURPOSE: OTH JOB DESCRIPTION FAU & AC CHANGE•OUTS S;Q FT: CLAIM ,VALUE: CALL -'VALUE:, -GROUP 'tOCC- R-3 COMMENTS: NO "B" PERMIT.1.0 REFERENCE:,I - ######iE############-###iE iE?E iE if iE fF##iE###iF iE##M##iE##1E######%,iE1E iE if iE###df#'#iE#iE#iE#iF #3E it'iF'iE iE## + t' " Z 0 N I' N d: R E Q•U I4R E M E N T•S ' SET -BACKS ;. ---- --------- MAIN BUILDING -----_----'- --''-=-'--- ACCESSORY BUILDING -' FRNT: FT ,IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: ; FT 'IN- RGHT: FT IN` LEFT: FT IN RGHT: FT : IDI PARKING REQ• PROV: PARCEL: 42615110 ZNE: :REF NO:' PLANNING. N((SSTES> > _ *ie#** D E V E I, O P M E N T, S E R%,V I ;C E S 'it E Q U I• R E M E N T S'` ZONING• APPROVED BY, _ DATE: BUILDING APPROVED 13Y .c -- DATE APPLICATION ISSUED BY: 7 i DATE: LEGALIZATION:N F E E'•'.S-U M -M.A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC tFIRE+ SMIP/RES GRADING PERMIT - r 18.00 25$ SMIP/NON-RES. PLAN ISSUE FEE 15.00 BUILDING -DIV'->" PERMIT :ISSUE.' PLAN -CHECK 'TOTAL PAID :DUE TOTALS ---'> 18.00 15.00, 0.00 33.00! 33.00 .00 REVENUE'DIVISION TOTALS--->, COLLECTED: 33.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/TOT GRADING PLAN. -CHECK 33:00 INDIVIDUAL. F E E, 'B Y. E A K ,D O W N TYPE QTY D E S C R I P T ItO N UNIT: COSI' TOTAL COST MEC 1 + INST'ALT, FORC!A]:R F U R N <= 100 K BTU/H 9.00. � 9.00 MEC' 1 REFRIGERATION SYSTEM <= 100-K RTU/H 9.00 9.00 - END OF' FEES 0100053093-00053093 TOT DATE: 01/31/90 'TIME: 16:24 t ; 33.00 CONSTRUCTION AND PLANNING - APPROVALS Permit'q# - Date Inspector _ FOS _ e SPA -' .�� # APPROVALS. Permit Date - Inspector .1. Temporary Electrical Service or Pole :i - �' , - 52. Pool &,Equipment Location 4., Soil Pipe-Undrgrnd. • - 53. -Steel Reinforcement % ' �'W: Electrical Conduit'Utility-Undrgrnd. _ 54. Forms n ":4._Eledrical Conduit-Undrgrnd •. / � 55. Electrical Bonding Q-' - 5?Steel Reinforcement 56. Rough Plumbing & Pressure•Test 6._ Electrical LIFER Grnd.' z� - 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, ❑ 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. %of Drains ..- _ 64. Plumbing System - Final .- _4 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical-Conduit:l-- 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 _ APPROVALS="g`--Permit # 20 -Rough Factory F replace 21: Ducts, in Structure = i, ` w _'70. Underground Hydro 22 Ducts, Ventilating - ro L <' - . ;; ti71. Product;Piping O Gas OOiI 23. Gas -Pipe -Rough & Test 72• Underground Flush' " - 24. Roof FFaming-.73.1 Undergrrid. Storage -Tank O Gas ❑Oil 25. Roof Sheathing 7,1 .• _ - 74'Overhead Hydro_ 26 T -Bar Ceiling (Structural) &"MOAOcoat 75: Dry Chemical _ - _ 27�-Frame and Flashing - - - " 76. Dry Standpipe 14 28. Lathing& Siding "' _ - 1 `' 77., FIXED SYSTEM.FINAL _ 29. Insulation- - �- - - -..'(;_ 7& FIRE PREV. FINAL 30. Drywall Nailing _.; _, r :HEALTH DEPT'. REQUIREMENT " 31. Plaster Brown Coat' "79. FINAL INSPECTION 32i. Electrical Power`' -Meter -Final', '80 .FOOD CERTIFICATE ISSUED_. - 331 Final Electric -_ f' _ �' `� !' ia, " Notes:- ~34- Firia'I Heating &-Aif gonditioning• - ` 35. Final Gas PipewTest a - J j: , - - _ - 36...H66d or Canopy -_37' Final Factory Fireplace. ,- •-- ;. _ � _ - s Y 38. Final Plumbing 39. Water Service -Final,- ' 40. Gas Service -Final �.l_ '- !;41. Solar Domestic -Final - 42. Backflow Preventer - -• - - :.r.. 43. Backflow Irrigation -44. Landscape IFrigation System, - - - - - -. T a - 45: Sound Attenuation - '. r - - -• r n ' 46: -Handicap Regulations r �' " - - - ` _47: FINAL STRUCTURE & BUILDING ' - ' -- _ •� 48. FINAL PLANNING 49.. Electric Release to,Edison �R 50. Gas Release to Southern California Gas Co' i - - 51. CERTIFICATE OF OCCUPANCY No. Date , Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA ��STR UrCTION PERMIT PERMIT NO. _ _ __ _ TRACT NO. LOT NO. UNIT NO. Project Address / A 14 IF p w �pplican4t;Mailin/g�Address �� r Prva dt-� IV Owner's tf me (/�} W4y � / Phone Arch/Eng. 6 License No. Address Contractor's Nam Phone "I-ZAV-00 Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No. Date Signature " 1RKERS' COMPENSATION DECLARATION reby affirm that I have a certificate of consent to self -insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section o600, Lab. C.) Policy No. Company BCertified copy is hereby furnished. Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed If the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit isissued, shall not employ any person in any ma d�r so as to ome subject to Workers' o p n Laws of Calif Date Signature NOTICE: If, a ter eking this declaration, you should become subject t6 the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION. LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of thework for which this permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION ' 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to Its issuance, also requires the applicant for such permit to file a signed.statement that he/she Is licensed pursuant to the provisions of ^,Contractor's License Law (Chapter 9 (commencing with Section 7000) of -"0sion 3 of the Business and Professions Code) or that he/she is exempt ;'z efrom and the basis for the alleged exemption. Any violation of Section 1('531.5 by any applicant for a permit subjects the applicant to a civil VIty of not more than five hundred dollars ($500). BG 1, as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not intended oroffered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of,a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- prove for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who contracts for such oroiects with a Con- traclor(5) license pursuant to the Contractor's License Law). I am aware that Vf o their Worker's Compensation insurance should be provided to me. am exempt under Section - B. & P. C. for this reeson Date /(.[_V/.q.=� Owner f !� I here y c rtify that have read this Information is Correct. 1 agree to comp) and state laws relating to building cons sentatives of tbks City to enter upon Drivers' License.or SS : repre- Y for TYPE OF CONSTRUCTION LJ NEW L`J' ADD LJ ALTERATION LI REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHE DESCRIPTIONWORK/USE FBLDG.-0 44e TYPE OF PERMIT GRADING, FOUNDATION STRUCTURAL 1:1 TENANT ELECTRICAL PLUMBING ❑ MECHANICAL ❑OTHER PROJECT DESCRIPTION SO. CONSTRUCTION TYPE_ ZONE Remarks: t Bar Sink Backflow Preventer - Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets T. .5 7 o OCCUPANCY VALUATION$ GRADINGCU.YDS. ACREYA Kitchen Sink Lavatories , `—Trap Roof Drains Reinspection Fee $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Bit. ICBG =#- Heating Heating System & Ducting ❑0-100,000 BTU 1:1100,000 t Reinspection Fee $15 0865-46, rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto -Wash Issue Fee Hood or Type ❑ Canopy Type 11 Cl Refrigeration System ❑0-100,000 BTU 0100,000BT System Repair/Alteration Fire Dampers Registers Issue Fee FEES $ 3 EES S Main Buildi E T Front B Rear A C Right K' $ . Left Ping. Ref. # 7lannina Notes: Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas =❑Electr Fan F.A.U. Zone Accessory Building: Z O N I N G R Parking Req./Provided E Q M S. ELECTRICAL - Transformer ❑ 15-50 KW ❑ 50+KIN Device Boxes Outlets Switches Garbage Disposal Generator 1:10-5 KW 1:15-15 KW Meter ❑up to 100 amps Meter Clover 100 amps„ Sub Panel Motors 00-1 HP.El1✓'-8 Inc.Solar 09-15 HP ❑16-15+ Microwave Pole Light Range Sign Standing Sections Trash Compactor FEES , 'I Reinspection Fee 1 $15 1 1 Issue Fee t7 1-1 1 $ lir-1 Lei DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By %;- Date Building Approved By All Date Application Issued By, s JDat 131LCI /V ,t'70 SUM RY OF FE S / BUILDING f�IT $ / // MIPrti7 $; PLAN CHECK $ PERMIT, PLUMBING - $ ISSUANCEI ' $ r< PLAN CHECK ' 25% $ ENERGY P.C. $ ELECTRICAL $ .�.,�.��. GRADIfNGy $ -Sy PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTALFEE $ ' PLAN CHECK ' 25% $ 2 $ 3 fit 00025261-00028264 T37JT OP.TEt 03f 41V -"111E; !U:lt 'COMSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector PD SPA APPROVALS. Permit # Date Inspector 1. itMporary Electrical Service or Pole 52. Pool &Equipment Location ^ _i 2. Soil Pip0:6ncirgrnd.l; 53. Steel Reinforcement -3e Electdical Conduit Utility-Undrgrnd. '/ 54. Forms , !I •, 4. -Electrical Conduit-Undrgrnd. 1 r_ 55. Electrical Bonding 5. Ste6ReGi6rcement 56. Rough Plumbing & Pressure Test ^ f' 6.;, Electrical UFER Grnd. r 57. APPROVAL TO COVER-GUNITE i 7. Footings ;; 58. Electrical Conduit-Undrgrnd. 8S•F6und�tion .r 59. Gas Pipe, 0 Undrgrnd., Test 9, ,Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Str.ucfural 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 -1 64. Plumbing System - Final 14. Rough Plumbing .�� 65. Electrical-Final r 15. Rough Electrical-Conduit 66. Solar System-Final 1;6.' 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 1J: Rough-Flgating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 2Q} RougH`Factory Fireplace `' .:211 Ducts, in„Structure 70. Underground Hydro 22. Ducts, V ntilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe-Rough &Test „ • �, X72. Underground Flush •OOil 24. Roof Framing 73. Undergrnd. Storage Tank ❑Gas 25,, Roof Sheathing; ; 74. Overhead Hydro 26. T-Bar,Ceiling (Structural) &,Monocoat 75. Dry Chemical 27. Frame,and Flashing 76. Dry Standpipe 26. Lathing'&'Siding J 77. FIXED SYSTEM FINAL 29. InsulSticin 78. FIRE PREV. FINAL 30. Drywall-Nailing ��'y,. '; HEALTH DEPT. REQUIREMENT 31. Plasted ffiown Coat . ' f r! - 79. FINAL INSPECTION 32. Electrir,`al'Power Meter;Final - * - s - -x,80. FOOD.CERTIFICATE ISSUED- -• - - r ti - -- t 33. Final Electric 7 96) Notes: 34., Final Heating & Air Conditioning 35. Final Gas Pipe-Test ! 36. Hood or Canopy �- 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final ✓`,) �i >,1 41. Solar Domestic-Final 42. Backflow Preventer j'� V•, j- r^�'� '•f °=" 43. Backflow Irrigation �•� �i' '•Ili'. 44. Landscape Irrigation System r , 45. Sound Attenuation _ 'ITS- S-48. 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 4-J 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY' No. Date- 1 p Applicant to fill In all spaces except those within heavy border lines and sign all appropriais: ;;eclirations. clTv of cosrAESAA CO/r+'STRUCTION PERMIT Project Address J, 4C Applicsm's Mailing Address // N FLU,, e Y S /V� Owner's Nam�e� //ted_ [i4 ��� Phone ' 'Address �../ —(y f F 6 'e Arch/Eng. 01r -iP/. License No. Address Contractor's Nam �� Phone Address (mailing) City License No. - 1 LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No. Date Signature l' WORKERS' COMPENSATION DECLARATION 111111 I hereby affirm that 1 have a Certificate of consent l0 self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) Policy No. Company BCertified copy Is hereby furnished. Certified copy is filed with the city Building Division. L1, Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION I (This section need not be completed if the permit is for one hundred ($100) Or less). I certify that in the Performance of the work for which this permit is ITTuetl, shall not employ any person in any ma rler so as to come subject u Workers' 07P l n Laws Of Cd lit a J Dale L` Signature NOTICE: If, itter making this declaration, you shoultl become subject to the ` Workers' Compensation provisions of the Labor Code, you must forthwith h comply with such Provisions or this permit $hall be deemed revoked. I CONSTRUCTION l -ENDING AGENCY 1 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.) Lender's Name k' Lender's Address OWNER BUILDER DECLARATION t I hereby affirm that I am exempt from the Contractor's License Law for the " following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a Permit t0 construct, alter, improve, demolish or repair l any structure, prior to Its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 Of the Business and Professions Code) or that he/she is exempt ( therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil 7lty of not more than five hundred dollars ($500). , as owner Of the property or my employees with wages as their sole 1 compensation will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's �_ License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or Im- i Prove for the purpose Of Sale). ❑ I, asowner of toe property, am exclusively contracting with licensed con- 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 builds or improves thereonl and who contracts for such oroiects with a con - traclor(s) bcense porsuant to me Contractor's License Law). I am aware that p�r off of their Worker's Compensation insurance should be provided to me. l UTI am exempt under Section B. & P. C. for this re on Date Owner 1 here y certify that I have reatl this application antl state that the above Information is correct. I agree to comply, with all City and county ordinances and state laws relating to building construction and hereby authorize repre- E Seri of t City to enter upon th above-mentioned pop rty for Inspection pu,rQy 1s. i +; Signature Os!/(0 �����id-k� Date[ ]� Drivers' License or 5S BP��/ - PERMIT NO. 17 P F_ -37R2 Z TRACT NO. A LOT NO. UNIT NO. A P # I Zone S Main Building: Accessory Building: TYPE OF CONSTRUCTION NEW ADD ALTERATION ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION Of WORK/USE 9pF BLDG. pu,0 u/q /Q 9 ^1 • nd/1 •.o�v..a. 'Ll` iX�_sr—q REPAIR E T Front Z Q B A Rear N I C Right N TYPE Ih PE RM1Tr LJ GRADING LJ FOUNDATION LTSTRUCTURAL ElLJ TENANT ELECTRICAL Q PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SO. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION$ ZONE GRADING CU.YDS. ACR ' S - Left R Ping. Ref. # Parking Req./Provided E Planning Notes: Q MT S. Remarks: .' ELECTRICAL FEES _ PLUMBING: FEES Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW ❑ 50 + KW Bar Sink Showell ,� o Backflow Preventer Service Sink Cooking Unit Meter Drip to 100 amps Backflow Irrigation Sewer Cap Dishwasher Meter ❑over 100 amps Bathtubs Sewer Connection Dryers ❑Gas ❑Electric Sub Panel Clarifiers Solar Collectors Fan Motors ❑0-1 HP ❑1 A- 6 Dishwasher Drinking Fountains Solar Piping Solar Tank F.A.U. ixtures Inc. Solar 09-15 HP ❑16-15+ Microwave Floor Drains Swimming Pool w/S Device Boxes Pole Light Floor Sinks ( Urinal ,, ,,�1t` Outlets Range Gas Service Outlets Water set L :.-• �- Switches I� T Sign Interceptors ter • �'*` Garbage Disposal Standing Sections , Kitchen Sink - ate vice Generator 00-5 KW 05-15 KW Trash Compactor Lavatories &O -Wash P—Trap Laundry Trak Roof Drains O< Reinspection Fee $15 Issue Fee $ DEVELOPMENT SERVICES REQUIREMENTS: -. Zoning Approved By -' Data Building Approved By T`'`�Zi I Date / Application Issued By. I N'-�-^ 'I� / Date Reinspection Fee $15 Issue Fee $ 3 MECHA ICAL FEES Boiler Duct - Under Ground Hoo or ype 1 ❑ Canopy Type 11 ElSUMMARY BUILDING IRMIT PLAN CHECK PLUMBING$ PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% $ $ $ $ $ $ OF FEES SMIP $ PERMIT ' ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ TOTAL FEE $ Duct -Structural Refrigeration System Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU Exhaust System ❑ Multiple ED"System Repair/Alteration Firepl/Fact. Bit. ICBG# Fire Dampers Heating System & Ducting Registgs 00-100,000BTU❑100,000 BT j 11 6� fie_✓ , Reinspection Fee $15 Issue Fee $ 3 AERO -THERM INSULATION AND CONSTRUCTION DIVISION OF W , GOL L v SPECTRUM LIBRARIES INC. IYL N� r. A I "Conserving Tomorrow's Energy, Today" clfico Santa Ana - 953.0815 A2805 ENERGY CONSERVATION CONTRACT Anaheim - 937-1351 Name _ Fd LIAR/( E�- W,¢-1?rI Nf l _ Job # � 41Address Z �`/ L// -AC LAn+E _ Date Phone( GO$%N /'/i'SA BUILDING PERMIT INFORMATION Collectors flat plate Type H K K SCLfc To R Model IAPMO S Z7 -ZZ ASHRAE L.A. City _ Gross Weight /y Z S. Gross Area — 3/.6� square feet Load per square foot lbs. Other Storage Tank Type OQEiM Model 2D �c c -�� / i/ /Zr9 Gallons _ or /Zo U. L. Other Plumbing Size Type Insulation 3/4" wall Therma-cel or Ru M Pump 47-17 Model Watts Other Controls Model Other Miscellaneous Setbacks Variances Roof Mounting Hardware i Penetration minimum 2" into rafter with 3/8" lag bolt; Mounting clips mfg aluminum or heavy duty �ti SFAS 9� w s wDE�EwaEwr c -3a E.vE�c y G v A)VEcTo.� P IPA ' A is I ,, Buiidiny Flashing galvanized steel with EPDM Clearance minimum 2Y:" ?, a 318"x 6" lag bolt — —� 2" minimum penelrationj into rafter. / 2x4 Redwood Sleeper `314" ASS Kicker injected wlHenry's 208 plastic roof cement Collector mounting bracket 3. 214 Redwood Sleeper \ \ Lagged to ratter every 4'0" TOP VIEW SIDE VIEW Solar Collector 8"x 6" Lag bolt; minimum penetration , to rafter. Collector Roof Mounting Collector mounting bracket 2x4 Redwood Sleeper i Cole UfCior #1 - Collectors 2 - Storage Tank, 3 - p=p for S olar 4 - Check Valve - Tampering 1 Valve .3/4 Divertiry Ball Ya -Iv( Pressure & 18,,12- Temperature 10 - *Win Air Vent 11 - Gas Backup I Tank - Bypass loop H11' I13 for Gas BackL; (Contractor 4- i l Option) 00 D L'7S 6.6 AERO -THERM INSULATION AND CONSTRUCTION DIVISION OF )`1 L w , GO[-L�,✓ j SPECTRUM LIBRARIES INC. "Conserving Tomorrow's Energy, Today" i34 tea cifico Santa Ana - 953-0815 AMSEI A, E; 2805 ENERGY CONSERVATION CONTRACT Anaheim - 937-1351 Name _ fOU/ARO W,41—?r1(/f 1 — Job# — -�—, Address Z g-9 L/LAG Z-4/vi Date Phone 1 G O$ %/4 /1,1�SA ?11-65;v - Z836 BUILDING PERMIT INFORMATION Collectors flat olate Pump 4V Type y x g SCLE`TO f! t{ Model (2) t//vDAA-5- Model ASModel I Watts �'� w IAPMO ZZZZ " Other UL -eeo ASHRAE Controls 1 n nEPEw?�FU/ L.A. City Model Gross Weight ^ /y Z lbs. Other Gross Area square feet feet Miscellaneous Load per square foot ._1 lbs. Setbacks Other Variances Storage Tank &)VC 6 7-,1< Type pl'Ei.� G n yso Model Gallons 120 _ _ p % _tom✓ U.L. Other Plumbing ! _.--- Size 314" wall Therma-cel or RubLe,tex__ Type MT,; Insulation Root Mounting Hardware Penetration minimum 2" into rafter with 3/81 lag bolts -J Mounting clips mfg aluminum or heavy duty: Flashing galvanized steel with EPDM Clearance minimum 21/2" 0 i fll - Collectors 2 - Storage Tarek, 9 - pip for } S 012r j 1 4 - Check Valve 5 _ Tempering Valve 7 d .- .4 3/ Divert-ir, f{ gall valves ! Temperature 10 - Air Vent Gas Backup Tank Bypass loop for Gas Baekc; (Contractor Option) U { I I i I 316'x 6' lag bolt 2' minimum penetration Into rafter. 2x4 Redwood Sleeper `ala'S Kicker injected vr:Henrp's 206 plastic root cement Collector mounting bracket J. Lia Redwood Steeper �\ \ Lagged to rafter every 4'0" TOP VIEW SIDE VIEW Solar Collector 6'x 6' Lag bolt; minimum penetration to rafter. Collector Roof Mounting Collector mounting bracket 2xa Redwood Sleeper I1�_ SOLECTOR° Sear Energy Collectors General Description Soleclor " V' solar energy col- leclors are high-quality, top- perlonnance 3'xB', 4'x8', and 4'x 10' collectors with extruded aluminum frarnes, low iron tempered glass, glass fiber insulation, copper absorbers, and copper water passages. "C' collectors are also made with black chrome selective surfaces on nickel substrates. Specially designed for commercial and institutional not water and heating sys- tems, " L' collectors offer the lowest cost per BTU installed of any comparable collectors available. Features Soleclor " L" collectors have all the quality features you'd expect to find in higher - priced models: • Low iron tempered glass is 5/32" thick, with one-piece glazing gasket. Removable glazing cap protects glass in shipment and makes glass replacement easy. • Extruded aluminum frame is 4" deep and is made of 6063-T6 alumi- num with a .024" aluminum baCksheet. • Heavy insulation on the back consists of V glass fiber and I/," isocyannurate, with a cornbined value of R- 10. The sides are insulated with I" R-4 glass fiber. • All -copper absorber is a .010" high-temperature sheet with metallurgical bond to the riser tube. • Copper water passages are nom 1" Type M copper (header) and 3/d" O.D. copper (riser). • Selective surface is black chrome on nickel substrate. • Internally manifolded headers may have inlels and outlets on the side, lop, bot- tom, or rear, depending on application requirements. • Rugged baked enamel finish resists corrosion and fading, and pennits installa- lion in most any commercial or institutional application, regardless of climate. • Copper slip coupling connectors are.prefonned to assure consistent, uniform quality. Quality Check Construction Soleclor -L- collectors are manufactured by expe- rienced I.A.M. union cralls- people at our modern Wind- sor, Connecticul, facility. Every aluminum Immo corner is mitered and sealud to assure weather tightness. Weep holes are drilled to pwo vent condensation during col- lector operation. Stainless steel screws are used throughout to maximize col- lector life. In addition, each collector undergoes a 10 -point quality check before it's shipped. Certification Solector " L' collectors are tested in accordance with ASHRAE 93-77 by an inde- pendent testing laboratory; rated and certified by SRCC; approved by IAPMO, FSEC, TIPSE, CEC, the City of Los Angeles ;Ind the State of New Mexico. " L" collectors meet rnpinum wind load standards required lot FSEC approval. Options A wide variety of options arc available, including precut/ predrilled Solector mounting racks, balancing Inserts for increased array sizes, mounl- ing clips for direct fool of actpstable rack mounting, U - clips and spacers. Consult your Soleclor wholesaler or Solector sales departnrenl for detalls, aq. jn'°aT�, rata ',f .t Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. �F COSTA MESA CONSTRUCTION PERMIT y M E PEA NO _ ,1 TRACT NO. LO I" NO. .UNIT NO. oject Address Z �Y L / L �4 C "L f1Alef L Of %!f 17r4A Applicants Mailing Address 2891IE hC L'A A/C ft' 11 Owner's Name )i_:!1/;yA/(0 IE WA hone 6 ;� Address Z ��, Ll LAC LA,v,I£ C'o�l A Of5S7.4 - Arch/Eng. License No. - Address--/'7- Contractor'sName �E/1 rl ff����NfILA� Phonev+14 Address (mailing) ,wZ D , _ I_ ILA C CN.�' je_ys/.j ffegW _.City License No. LICENSED CONTRACTOR DECLARATION - '.I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Cotle, and my license is in f I force and effec . .LicDate I2-1 ��� I Signature WO R KERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a-Certifirate of Workers' Compen tion In Surance /orrg certified copy thereof, (Section, 3800, Lab. CJ73 �(jC00;LComp' /VA((ON wrOa 1A4, CerPolicy No. Company Cert)f.'�oed Scopy is Pay is�tfie�r dby fi with rthe adty ByNtli�}' Division.- f Dat e rL — y f 'q Applicant L �"�G,¢j EXEMPTION FROM WORKERS' COMPENSATION D CLARATION (This section need not be completed if the permit is for one hundred ($100) or less). 1 certify that in the performance of the work for which this permit is issued, I+ Shall not employ any person in any manner so as to became subject to the, Workers' Compensation Laws of California. Date Signature 'NOTICE: If, after making.this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions 'or -,this permit, Shall be deemed revoked. CONSTRUCTION LENDING AGENCY, '°) I hereby affirm that there is a construction+lending-agency for the performance of the work .for which this permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION j I hereby affirm that I. am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: AHy,cityor county which requires a permit to construct, alter, improve, demolisWor repair any structure, prior to its issuance, also requires the applicant for sucIn permit to file a signed Statement that he/she is*Iicensed pursuant to the provisions of he Contractor's License Law (Chapter 9 (commencing with Section 7000) of vision 3 of the Business and Professions, Cotle) or that he/she Is exempt arefrom and the basisforthe alleged exemption. Any violation of Section J31.5 by any applicant for a permit Subjects the applicant to a' Civil enalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply t0 an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such. improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden Of proving he/she did not build or im. rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a con- tractors) license. pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation Insurance should be provided to me. ❑ I am exempt under Section B. &.P. C. for this reason Date Owner tate that the above d county ordinances :by authorize repre- ioned property for Backflow Preventer -- - Service Sink Backflow Irrigation Sewer Cap TYPE OF CONSTRUCTION -LJ NEW ADD' El ALTERATION 11 REPAIR _❑ CONVERSION ❑DEMOLISH ❑ OTHER DESC IONR F��rr7�p/�K/USE OF BLDG. s/ Wvl/IC�• -�-( � A.P. # , S, Main Building: TYPE OF PERMIT LLyyII GRADING FOUNDATION STRUCTURAL - ❑ TENANT ELECTRICA1 PLUMBING ❑ MECHANICAL K ❑ BOTHER - _ E T B A Front Rear PROJECT DESCRIPTION SQ. FT. - OCCUPANCY - CONSTRUCTION,TYPE VALUATION$ ZONE - GRADING CU.YDS. ACRES' C Right S' Left Ping. Ref. # ' Remarks: L -�SS Planning Notes: Floor Sinks Urinal PLUMBING Gas Service Outlets - FEES PLAN CHECK 25% Bar Sink I Showers $ Kitchen Sink Backflow Preventer -- - Service Sink Backflow Irrigation Sewer Cap - Bathtubs Sewer Connection Clarifiers 2- Salar Collectors s Dishwasher. Solar Piping $ Drinking Fountains Solar Tank $ Floor Drains Swimming Pool w/Spa Floor Sinks Urinal ✓✓ ISSUANCE Gas Service Outlets - Water Closet PLAN CHECK 25% Interceptors Water Heater $ Kitchen Sink Water Service - Lavatories Auto -Wash t P—Trap - Laundry Trays „! Roof DrainsU �^ PLAN CHECK 1 50% $ I MICROFOLM $' Reinspection Fee $15 - Issue Fee � 3 $ / Under�Ground Duct - Ventilating _ Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑ 0-100,000 BTU ❑ 100;000 ST i inspection purposes OJ/' lni L-20-6( Signature La,L�'` % - Date /IV W I CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $15 Hood or Type I E1__ Canopy Type I I ❑ Refrigeration System 00-100,000BTU ❑100,000 System Repair/Alteration Fire Dampers Registers Issue Fee $ 3 Washer' InTole Sub. 2 Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator 00-5 KW ❑5-15 KW I T Accessory Building: _ Z ' O N N G R Parking Req./Provided E Q M T S CTRICAL ,.FEES Transformer 'El 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter Elover 100 amps Sub Panel Motors ❑0-1, HP ❑ 1 % - 8 I nc. Solar 09-15 HP 016-15+ Microwave Pole Light Range t Sign ! Standing Sections Trash Compactor Reinspection Fee $15 Issue Fee $ 3 ` s(, DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved ByI'sate Building Approved By Date `691/4 '-� SUMMARY OF FEES 1+ BUILDING PERMIT, $ SMIP I $ PLAN CHECK $ PERMIT. PLUMBING $ ✓✓ ISSUANCE $ i r PLAN CHECK 25% $' f S ENERGY P.C: $ !! GRADING $, ELECTRICAL' $ �^ PLAN CHECK 1 50% $ I MICROFOLM $' MECHANICALS $ 'TOTALFEE $1� PLAN CHECK •25% $, I ' NSTRUCTION AND PLANNING PPROVALS Permit # Date Inspector PO SPA APPROVALS Permit # Date Fnspectoj r1. Temporary Electrical Service or Pole N - 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 i._ 56. Rough Plumbing & Pressure Test -, 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundaiionv - 59. Gas Pipe, 0 Undrgrnd., Test ',-9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. •, -d 10. Structural Floor.System 61. APPROVAL TO DECK -' 11. Property Sewer Line & House Connection �'- 62. Backwash &• Receptor-Final 12. Sewer Cap _ ',' 63. Heater & Vent-Final ' 13. Roof Drains - 64. Plumbing System - Final 14. Rough Plumbing, 9' : ' 65. Electrical-Final Y 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 APPROVALS Permit# 20, Rough Factory Fireplace 21. Ducts, in Structure `� 70. Underground Hydro . 22. Ducts, Ventilating 1 71. Product Piping 0 Gas 0 Oil _ 23. Gas-Pipe-Rough & Test n 72. Underground Flush 24. Roof Framing n 73. Undergrnd. Storage Tank OGas DOil - 25. Roof Sheathing fi - 74. Overhead Hydro ' 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 6._ 9 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 Heaiing & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy ' 37. Final Factory Fireplace - 38. Final Plumbing_ _- 39. Water Service-Final t 40. Gas Service-Final 41. Solar Domestic-Final �r - 42. Backflow Preventer. - �a - 43. Backflow Irrigation 44. Landscape Irrigation System ' 45. SoundAttenuation 1 r 46. Handicap Regulations - 47. FINALSTRUCTURE &BUILDING - 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co ' I 51. CERTIFICATE OF OCCUPANCY No. Date f<' 1 A 471 . U Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. :ITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. _ TRACT NO. , LOT NO: UNIT NO rProject.^pidress Z-" LIL'h(' L/10Wt_.'-COfjl� fl")A Applicant's Mallingg(,Addressss.,t� Z • -11-AC L,",f 1, If Owner's Namg r- Address L�y L 1 L4 L LAWE Arch/Eng. License No. p Address r� - Contractor's Namn &to -- / f�"? ,07 %/yful-t or Address (mailing) _ 7 L��' City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000).of Division 3 of the Business and Professions Code, and my license is int II Tc ce and effect. Licens la r__ Lic se No. Date Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance or a Certified copy thereof (Section 3800, Lab. C. �63-ddbl " Pol1licy No. -' IdIC �iJd L' Company !0-/i% 16 AJ HSS Cer13s Certif ed copy Py !s thereby withrthehc furnished. Byil Date Applicant E EXEMPTION FRO WORKERS' COMPENSATION DECLARATION (Thissection need not be completed if the permit is for one hundred ($100) or less). 1 certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Signature - NOTICE: If, after making this, declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a sianed statement that he/she is licensed pursuant to the Provisions of e •eretrom and me Da515 Tor me anuegea exempliOn. Any violation o, O lu_ul ,.031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500). 1, as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section,.7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement is sold within one year of Com- pletion, the owner will have the burden Of proving he/she did not build or im- prove for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed con- tractors to const ruct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds.of -improves thereon, and who contracts for such projects with a-con- tractor(s) license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Sect !on, B. & P. C. for this reason'" Date. Owner 1 herebylcertify that I have.read this application and state that the above information is correct. I agree to comply with all city and county ordinances antl sta toflaws relating to building construction, and hereby a th orize repre= sent ativesl of this city to- ent r upon th bove-mentioned p,- erty {or inspection pur s 7 Signature` a 41 ate P- J10_3}r TYPE OF CONSTRUCTION L1 NEW tADD 0 ALTERATION LJ ❑ CONVERSION ❑•DEMOLISH ❑ OTHER 7 ma' 'A5 1- DESCRIPTION OF WORK/USE OF BLDG. got-2111 WA REPAIR A Pc ' S Main Buildings: TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL ❑ TENANT I LECTRICAL [N PLUMBING ❑ MECHANICAL ❑ OTHER , FEES T Front L 5 B A Rear -7 P. PROJECT DESCRIPTION Sq. FT. 1 OCCUPANCY CONSTRUCTIONTY_.PE VALUATION$ ,ZONE . GRADING CU. YDS. ACRES - IC Right - S Left ' Ping. Ref.,# Remarks: l FEES SMIP i$ PERMIT- - - ISSUANCE $ ENERGY P.C7 $ GRADING. $ MICROFILM. '$- TOTAL FEE$�4'��. - r - Planning Notes: I i ' - $-3 PLUMBING -FEES, + ' Bar Sink Showers 1 -' Backflow Preventer Service Sink - Automatic Washer Backflow Irrigation ' Sewer -cap Construction Pole Sub. _ Bathtubs Sewer Connection Cooking Unit '• . Clarifiers SolarCollectors - L O Dishwasher D ishvvasher Solar Piping - Dryers ❑Gas '❑Electric Drink ing' Fountains Solar Tank. `L 60 Fan ' Floor Drains Swimming Pool w/Spa' F.A.U. " Floor Sinks- Urinal - Fixtures Gas Service Outlets Water Closet Device Boxes Interceptors Water Heater - Outlets Kitchen Sink _ Water Service, Switches. Lavatories • Auto -Wash Garbage Disposal ' P -Trap Laundry Trays Generator ❑0.5 KW.❑5-15 K Roof Drains - Reinspection Fee I $15 Boiler Duct - Under Ground Dict - Structural Exhaust System 11 Multiple Firepl/Fact. Bit.'ICBO # Heating System & Ducting [-10-100,000 BTU 0100,000 Reinspe rs' ction Fee $15 DriveLicense or SS"y! CMF 0865.46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Issue Fee Hood or Type ❑ Canopy l Type I1 ❑ Refrigeration System ❑0-1 00,000 BTU -0100;000 System Repair/Alteration - Fire Dampers - Registers Issue fee - - 9035 11/04/87 . ? - Zone Accessory Building: Parking Req./Provided 1 ELECTRICAL Transformer .❑ 15.50 KN ❑ 50+KW Meter ❑up to 100 amps Meter. ❑over 100 amps Sub Panel Motors 00-1 HP.❑l%-8 Inc.Solar 09-15 HP Old Microwave Pole Light Range Sign' Standing Sections W Trash Compactor Z O N I N G R E O M T S � f . FEES $ 3 Reinspection Fee $15 Issue Fee -' $ 3 FEES ' DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By _ Application Issued By - Date Data4.1 Dat I - OM7 - .- U' t BUILDING PERMIT' PLAN CHECK ` PLUMBING _PLA N CHECK 25% ELECTRICAL l PLAN CHECK 50% MECHANICAL PLAN CHECK 25%. SUMMARY OF $ $' $ • OO $ .$' I $ $ FEES SMIP i$ PERMIT- - - ISSUANCE $ ENERGY P.C7 $ GRADING. $ MICROFILM. '$- TOTAL FEE$�4'��. - r - - i ' - $-3 7 CONSTRUCTION AND PLANNING APPROVALS Permit # Dater Inspector _ POOL &SPA - APPROVALS Permit # Date Inspector) 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Banding 5. Steel Reinforcement -• -56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE' 7. Footings - '. - 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. - -. 60. Backwash Lines,.P-Trap, 0 Undrgrnd. 10. Structural Floor System - .- 61. APPROVAL TO DECK 11. Property Sewer Line & House*Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains - 64. Plumbing System - Final'. 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring - - 67. Fencing & Access Approval 17. *Rough Wiring Sign ' - '68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POO L/SPA' SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # ' 20.- Rough Factory Fireplace 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 OGas 0Oil %•i 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 3T, Final Factory Fireplace .. {'! r« -'r• '"' 38.!Final Plumbing 39'Mter Service -Final 40. Gas Service -Final - ° -I •.! •' 41. Solar Domestic -Final 42kBackflPreventer _ y low : l '43' Backflow Irrigation } �{ 4. i. -144. 'Landscape Irrigation System l 45: Sound Attenuation 46. Handicap Regulations 47! FINAL STRUCTURE & BUILDING C�1 7 if 48. Special Requirements Completed w�• e-, '• 49. .Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. = Date „,pueCT0r_s � Y,sJXhU4UH I ner :7 4, 7 ..r . _7'..ti r. E. S, ERR f ..�., q o.” I , y qj, ,j 10- V. T1, �4 . . . . . . . . . . general -'-Heavy insulationhe, Every aluminumAra-mc . 'n bac k consists Fit I glass corneris werad and paled ule weather lfghIlluss.-. isocyannufalL 116er at tal 'v,' De C r i P jibn will, a combillud.value of A: Wee p holes are drilled to : Ul"ior Solar energy CGI- husio6s are,insulated candunsatcondensationduting Qclofs are hign-qualily, lop-. wilt) I" A-,4 g6sqiber. lectu( o0ofation. Stainless 4 xB* and - All -copper absorber is a,' steel screws are used 1 x i'0"Coll'eCibr with .01 W-high-lernpufato( e Sh(M 1hf0u0hQUI 10 maximizecol.`., z., . ;1, .,x tuded aluminum Irarnes.,. wit h metallurgical bond lathe leCtOr-lile. OW In addition -each collector glass. asci tube, h )16ss:ltbc,r,ifisulation,.copper:, Copper, Water,passages underguesajb-poiniqualily� I" I" 16s6r66'fs.'an6 copper.wate('- check before it's shipped at(., nurn V� Typo�lvl dopper. )9s,sages "L--colluctOrS are i (header) and V O.D: copper also flladdwlh black chrome �'Certfficafibn >Ci�lclrve Suflaef;s (in nickel Selective surlace is black Solecloi `L" collectors are chrome Oil flickul substrate. IF, Sled in accorda�cu wtlh'� 'Specially,clesigned lor . -'Inter INA nally manifolded A$HRAE 63-71 by an lade -r -'in',or'ia'and if headers nwy have ifilvIS and' pc�irjeflt lesting laboratory: tir o nstilLitional ,lot wafer and huaiilg sys- Liullels un the Side, lop, U61,- rated and cedliLa by SNUG ems;- L" collectors ,ollerthe tum of Fear, depending of approved by IAPMO, (SLC, owust cost per Bill Installed application tuquitunrierils. TIPSE CFC th6rC"y of Los :,I Anany comparable collectors . `, ,pugged baked elwmel . geles; and Ihu State of>;'. available* N�- InClUdi... 1.� I/ ,I � �11 i ra/J2jj!-ljLoFFvjro&tempereq qiaq3mg-�g Illy! Hir';, no PfUCUI _4 Ii with one= Iecu racks;balanCing InSLFF`j8:IU(:. cls:.glij (Jdlify�_`Ch' Check Increased darray sizes mount for direcCroo zM-C=SUUCTIICF le '-lack inou6fi�U rfg;--''; SoloClOt -L , COI]CClufs 11� It spacers Ireme I, 4" deep unU is ui,nulaCtwed Cly exlx ItYOUT,So le6jor n I it - rjncea"LA.WuIon I I i , �t � "! � "wholesaler of soluctur, sates,;*% i 'will a 4" -1 1 1 1 flun people al in di artrnwit for delail, C heul.. 'Suf Con"L UCU 8 7, -A l6x.� A4e;, 707-- ppr yse;. 4 istomer" WA? 2 VL' Ceilings das x walls St at loped s. 106r'g y riea walls s ories:, - Ext:.- Finis — -T. 7 Wood Stucco "k C' h ock eatr S Other. z� N Approx. Star t;p.?:'DaLe:, 8 -A l6x.� A4e;, 707-- ppr yse;. 8 STA .. .... Ivis 0 0 ISO ,r,$PECTRUM, fipR RlEs .,Conserving Tomorrow's Ener y Today', to ;&Ptciicd.: 7j &-j? JAN 2505 W&ENERGYYCONSERVATION CONTRACTii Anal Riot Q 11 ;W 5t W A T 7Iaad - T Gallons Zv T„3qVWT. tr, t", -1v, actairdSM No %mpuirdom,?"? �,4t . "M too WIS a -�X 0 1. Model Pxx ix Yy 11APMO Othdr-, .2 . . . . . . . . I$ M68 .. ... . all . igG r 6 s s,,,Wei ht` 4rbssArew; square -feet Y *11scallan I ba Jet sfud"ra -toot r - SUN Seib' ,071 MAN-Vwian'ces'. -001W. Sm j T. 44 &Q, cc 7 -All JAI, Or /Z(f Model Gallons Zv a Roping i ts, s SA" .2 I s Until jd. �41z, E� �O1ZiEC COBS FRO 21110. RAM N go_ti -,4, x, storage ,arc. JXV Q, "y KFAMOST AN A j MOM A Ova 7"S A WA ZY.- -1 Pam -for Check ,calve `Pampering Q Valve On,AS, too" BWh A T* JQ- .0, MAN 4, Owls" know. Q IN 17 E�� ,, , 'Ey—fly, meh MCI'x Air 11P.M - 00 into .IT 'AST., -"j. 0 , TO& loop13 gYpass WNN & 12 —1d Q Ask. W y 4y cotorr F T ON p- QNOW, yam I'll's 00. now _Z" pq STOP _41 WtIVEO MAY 13 1963 ��77--- C/• L1 A B O Rrr A T O R 1 E 1 1113,,1lesa Es• X30+ ✓eefin9 andJnopection (Jn9<neara S tl/g0 COMPRESSION TEST REPORT Test made for Anthony Pools, 5871 Firestone Blvd., South Gate Job Identification MELVIN LUKNANN, 289 LILAC LANE, COSTA F:IESA Location in Structure SVJIi '4ING POOL �T GUNITE LABORATORY DATA Laboratory Number 80782 80783 Mark 1 2 Date moulded 4-4-63 4-4-63 Date tested 4-18-63 5-2-63 Age, days 14 28 Weight per cu. ft., lbs. Dimensions, (inches) 5. 90x12. 1 6.0x12. 2 Area, sq. in. 27.34 28.27 Compressive Strength Total Load lbs. 74,000 11.0 , 000 Lbs. per sq. in. 2,707 891 MIX: 1:4.5 Cement Sand No. 4 No. 3 No. 2 Water ,moi -Costa Mesa Bldg. Dept. 1 -Anthony Pools a2 FIELD DATA Specified Strength @n 28 days 2000 Slump Admixture Ready Mix Plant Cyls. made by Don McBee Date cyls. delivered Builders Pick Up 4-16-63 Cement: Riverside I 235 WEST TWENTY-SEVENTH STREET Respectfully submitted, RAYMOND G. OSBORNE LABORATORIES, Inc. By--------1�fq'lI�kl.................. LOS ANGELES 7, CALIFORNIA • RICHMOND 9-3111 I_ICATION FOR A BUILDING PERI, Tract Block Lot BUILDING PERMIT NO. v1.—D ElectrPermical al BU llding^ � �g Address f L L,/ -S1 (._ Plumbing Permit No. Cross Mechanical Area Street Permit No. Ownerq�W W � rr�� Type of Project: ❑ New ❑ Alter L'y Addition Address ❑ Repair ❑ Convert ❑ Demo ❑ Occupancy Pmt. Cit ' °U(:1-9 A— Zip Phon 6 2 A.P. Sup. Dist Insp. Area Architect/ Designer License No. Zone SPI. Pmt. No. Address Setbacks P/L Front C/L St. Street Width City Zip Phone Vards Left Right ear ave Proj. Leftig . Engineer License No. rking Spaces Required rovicle Quare Address City Zip Phone SV Oct Height No.of Stories No. of Family LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 Park FeesYNo Required C.T. Fee Receipt Zoning Approved By: Date (commencing with Section 7000 of Division 3 of the Business and Professions Code and my license is in full force and effect). License Class 1p— t Number � /J'L{,,cense Date&r`rt� t, Contractor (jail $iF_c-(� IQJi'-i�� Misc. Address Proposed Use Of Structure ).J C it y a nd Zip C`�sE. 1'J C-44 Phone Phone9�Z�Y73 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). Occ Class Type Const. Code Year USE/OCCUPANCY SIZE SO. FT. Lender's Name Lender's Address 1. OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law , for the following reason: ❑ I, as owner of the property, or my employees with wages as their 2. _ sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with 3 licensed contractors to construct the project. ❑ I am exempt under Sec. , B&PC for this reason 4. Det Owner WORKERS' COMPENSATION DECLARATION Total Valuation Encroachment Permit Required ❑ Yes ❑ No I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof, Policy No. Company .5T-11-TF.-�N� Certified copy is hereby furnished. Certified copy is filed with Cr7� tee/= Cµ I���af JSS `1� Date ili.1=ig Applicant Ji Grading Pmt. Required ❑ Yes ❑ No Grading Pmt. No. Rough Grading Approved by: Date CERTIFICATE OF EXEMPTION FROM WOR KE RS' COMPENSATION INSURANCE (This section need not be completed if permit is for $100 or less). I certify that in the performance of the work for which this permit is PERMIT FEES issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Deter Applicant NOTICE TO APPLICANT: If, after making this Certificate of Structural $ Plan Check $ Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shell be deemed revoked. Electrical E Special Invest. Is Plumbing Is I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTH- ORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON Mechanical $ Pre -Grade Inspection $ THE ABOVE MENT ONED PROPERTY FOR INSPECTION PUR- PO S. rn ignatur of Alfplic.nt or Agent Date IJSSrcCL �Cx9ii Print Applicant's/Agent's Name - Pre -Grade Rec. No. E Permit Issue $ All spaces within this box must be completed to process Plan Check BY: Issuance Approved: CMF 0335-46 (BU -28) rev. 6/80 OWNER LUHMANN? Melvin DATE 3-8-63 JOB ADDRESS 2b9 Lilac Lane BUILDING PERMIT NO. 31 GENERAL. CONTRACTOR Anthony P0016 VALUE $ 2.000,90 AP No.118-153-4P LOT TRACT FIRE ZONE DESCRIPTION OF WORK Pyt. SW3II1 POOL INSPECTIONS Signature DATE GROUP J TYPE III ZONE R-2 Soil _-- SUBCONTRACTOR PERMITS ISSU. Gas /� /3 =s -K. DATE NUMBER Water Rough Com. Refrig. ❑ Air Cond. ❑ Rough Heating Rough Plumbing, LL Miscellaneous_ _ Prop. Swr. Line E] House Con. [I St. Swr. ❑ - -- �_ _6 r _-7-; Sprinkling System Construction Pole Underground ❑ Power L Zough Wiring renc es ❑Forms ❑ Steel Reinf. ❑ FZ;- .- Floor System Bond Beam F1 Steel ❑ _Reinforce Sheathing _ Frame and Flashing _ Lathing — In ❑ Out ❑ Plaster, brown coat �^ Refrig. ❑ Air Cond. LJFinal _ Heating, Final _ Plumbing Fixtures, Final Final Gas Test _ Electric Fixtures, Final _ Building, Final �- OCCUPANCY isosr FEF RECEIVED COSTA MESA BUILDING -SAFETY DEPARTMENT c P.O. BOX 817 COSTA MESA. CALIFORNIA CE . DEPT. For Applicant to Fill In Completely APPLICA (R �P�T MESA TYPE OR PRINT For Office Use Only BUILDING 289 LILAC LANE ADDRESS RECEIPT NO. P[RMIT NO. COSTA MESA. CALIFORNIA q[c[1 D [e By eD Dw Dwr[IsaueD OWNER MELVIN LUHMA BUILDING 289 L SAME LANE / MAIL SAADDRESS ADDRESS lYLi . TEL. ZONE FIRE TYPE GROUP clrY NO. APPROVED 'ITECT TEL. BY DATE (O 'GINEER `�"'�" No. ZONING p' ADDRESS No. OR USH OF NE CONTRACTOR ANTHONY POOLS PLANE 'v BDILDING 5871 FIRESTONE BLVD. ^ LEGAL Q DESCRIPT ADDRESS CITY SOUTH GATE A. P. No. NOTE: NO SAVE OVERHANG SHALL BE LESS THAN STATE TEL. 80' TO SIDE 3 REAR . L. LIC. NO. r� NO. 8OX76 EAVES SIZE I rvo. OF SLOGS. ALLOWED (U. B. C. REQUIREMENT) OF LOT NOW ON LOT USEOF YARDS APPROVED YARDS APPROVED . EXISTING BLDG. RES AND PAR MAIN BUILDING ACCESSORY BUILDING r (FROM C/L STREET) / SETBACK LINE FROM C 5 C CENTER OF STREET REAR YARD V FR NT FT. FT. SIDE YARD I LEFT 421 I RIGHT - r R. SIDE FT. iFT. DESCRIPTION OF WORK L. SIDE FT. Fr. d N, MOVING ALTERATION ADDITI DEMOL 6H REAR FT. FT. DISTANCE BET. BET. MAIN 8 REPAIR MAIN SLOGS. ACCESS. BLD e. I ING NO.OF VAR.#' DATE wW ROOMS STORIES• C.U.P.# APPROVED V) IOR WALL ROOF APPRO D — (Y RING COVERING BY DATE - O. USE OF BUILDING ANb WORK TO BE PERFORMED 1 ' IT•I SWIM POOL PRIVATE p N ' SD. FT. . BY ACK AT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE S TATE TH HE ASO IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O ITHA CITV OflDINAHCEB AND STATe 80�ypLUATIONNG NBTRU 10PERMITTEE $ mT 2000. OO 0ORIZED AGENT T z TOTAL FEE U a r dC W a 0 9. 4 Z w 3 yltu II,/I2/8d A@11,1,6 TL` COSTA MESA BUILDING -SAFETY DEPARTMENT APPLICATION FOR'STRUCTURALPERMIT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 ,. For Applicant to Fill in Completely — Use Ink Only REC BY PERMIT s+, �6 J •!1- BUIL ESS -Z5cl LIQ � L 4 -NE ADDBUILDING A.P. NO. /Q OWNER OR I I. /t��j r� TENANTUNIT n /� Qzei ADDRESS S ( r Q.G C OR SPACE NO. MAILING, ADDRESS SA_lAAq__ TR.NO. LOT BILK. .TEL'. �/ CITY A NO.'C [Z NEW ADD ALTER REPAIR I MOVING DEMOLISH CONSTRUCTION LENDER BRANCH OWNER ADDRESS lVALUE / USE f �t-a/ $ ARCHITECT TEL. OR ENGINEER N 0. ZONE YPE GROUP "--� ADDRESS CONTRACTOR U S C`(� J )— APPROVED // BY DATE ! �Z ` " ADDRESS SS 2 "W jVi.Cc_1%-A E� TEL CITU NO. '?3 STATE�j! n LIC. N O. LIC. NO. 2G I _3 C_ APPROVED SETBACKS SIZE OF LOT X, I t� NO.OF BLDGS. NOW ON LOT (FROM PONT USE OF EXISTING BLDG. C!F—S C) LJ Separate permits are required for electric, plumbing and heating work. L. SIDE REAR S FT.!� USE OF BUILDING AND 2W K TO BE PERFORMED ID PLANNING ACTION DATE APPROVED �* I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or 1 am exempt from the provisions of the State of California Business end Professions Co Division 3, Ch ter 9. Signature of Permittee ` ? �J SO. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION-- $ 6 �(� I PERMIT FEE $ O PLAN CHECK $ D TAXor 9 AuthorizedAgent Date / �` TOTAL PAID $�Z OWNER pp�ppr DON DATE 11/12/80 JOB ADDRESS 289 Lilac Lane BUILDING PERMIT NO SnQr4 LOT TRACT FIRE ZONE VALUE E it sin nn INSPECTIONS Si nature Date TYPE V GROUP I-3 ZONE Rl so1L7/ 12 fl) SUBCONTRACTOR MITS ISS GAS Date Number Si nuture WATER Plu bin ROUGH PLUMBING - • �J - — PROP. SWR. LINE HOUSE CON. SPRINKLING SYSTEM L. / r✓wg MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER 0 ROUGH WIRING ��` L (Z "e%r' Heati.0 and Vent. TRENCHES FORMS STEEL REINF. FLOOR SYSTEM yo ,Qv' $ BOND BEAM STEEL REINFORCE Om SHEATHING _ �- FRAME AND FLASHING LATHING — IN OUT tE _ PLASTER, BROWN COAT STRUCTURAL, FINAL HEATING, VENT., REFRIG. AND A.C., FINAL J,$f,LL AlST PLUMBING, FINAL AND GAS TEST4-LEC-7— I ELECTRIC. FINAL BUILDING. FINAL i e tip li© COSTA MESA BUILDING -SAFETY DEPARTMENT P.,O. BOX 817 COSTA MESA. CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT ■ BUILDING RrCEIV ED APR 261861, FII NCE DEPT. CITv OF COSTA MESA APPLICATION FOR PERMIT . BUILDING COSTA.MESA..CALIFORNIA For Office Use Only Irvin C. Jordan _ RECEIPT NO. ,, PgqERMIT NO. WNER Newport Blvd. ��� DA�*s�RECEIVED DATE IBBUeD DDRESS 100 - flPR2 8 oal Newport Beach NVR38611 [ADDRESS BUILDING 1r ADDRESS GIEERD. Southworth NoL185161COSTA MESA. CALIFORNIA FIRE / Costa Mesa ZONE TYPE L/ GROUP CONTRACTOR r APPROVED BY DATE Same ZONING - ADDRESS CITYZONE NO. OF PLANE �-BDILDING U88 OF N 1, y [�. �1- STATE 5 � TEL. OR3 HHll B1-82 LEGAL LIC. NO. NO. DESCRIPTION SIZEOF LOT....2,5—, S D No. OP BLDGB. O NOW ON LOT A. P. NO. USE OF EXISTING BLDG. YARDS QKti'LQ� EVES APPROVED 5�C6-,3 u3 'T- ALLOWED SETBACK LINE FROM (CENTER LINE ST.1 CENTER OP STREET REAR YARD FRONT FT. IN. SIDE YARD I LEFT 1 I O 11 RIGHT 171 011 R. SIDE / FT. IN. DESCRIPTION OF WORK - L. SIDE FT. IN. NE I x HALTERATION I ((ADDITION REAR FT. IN. REPAIR i (MOVING (DEMOLISH / APPROVED y 1 DATE v UBILDING NOOMOSF STORIES 2SIZE RO HOLD FOP SPECPAL = U?RL FXTERWALL St11CO ROOF ICOVERINGShin les NO FINAL UNTIL COVERING USE OF BUILDING AND RK TO BE PERFORMED 1. Dedim�im of bpw%dTel: Res. wW att,gar a e t llation of res. sidewalk Plan #1615A 2 1682 sq. £t. J 642 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLIG TI IE TE AMOUNT SHOWN UNDER VALUATION IB FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF, ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION PERMIT FEE $ 37.00 BUILDING CONSTRUCTION. SIGNATURE OF Zr PLAN CHECK $ 18.50 PERMITTER{ $ 171,752 CC AUTHORIZED AGENT TOTAL FEE -CO 777 L/