HomeMy WebLinkAbout3391 LAVENDER LN - Building PermitsPLAN 4 El ev . B A��110ant to (ill in a11 spaces a� 1 those within heavy oorCer Iines anC sign au avPropriate Oeclaratlons.
CIIY OF COSTA ME�A - PERMI NO. TRACT NO. LOT Nq. BLD . .
C�NS�CiUCTION PERMIT LOT 24 ���_,5 �� � / Zn l� Z�7'
Project Atltl��^� �.»-t—uN
Applir^���s Mailing Address
yw er's Name - hone §Q.6-1_�.6.�.
Address 1F6�i IJ Mar�.^th r Rlvri
ArchlEng. c/Ctrao+ov� LicenseNo. ZJQ$�
Address 1 �QA9p.1,. Ck�a 4 f' 7 i �e
Contractor's Nam �@��,,.,@�" Phone
Addreu (mailing) p�
City License No. � � �%W 7G
LICENSED CONTRHCTOR DECLARATION
I hereby attirm that 1 am licensetl untler provisloni ot Char[er 9(commenUng
wltn section 7000) of Dlvision 3 of the Business antl Profa55ion5 Cotle, antl
my Ilcense is In full or e antl eftect. n
LlcenSeClasz '� i<¢ ryp �`*2
Oate �_fz—��-wZ Signahre �
WORKERS' COMVENSATION DECLARATION
I nereby affirm that I have a tertificale of consent to self-insure or a certificate
of Workers' Compensation Insurance, or a-certifietl coOY tnereof (Section
3000, l.ab. C.
Po,;�r No. 4! -84-225-856 comaa�r Fremont Indemnitv
Certifietl cooY is hereby furnishea.
Certifie,tl, co�p,Y is,,t'iletl with the city Buildin9 Dlvision.
Oate�.(.��TS�_Appiicant Standard Pacific
EXEMPTION FROM WORKERS' COMPENSATION DECINRHT10fJ
(This 5ection neeU not be completetl it Ih¢ p¢rmit i5 fOr One huntlretl (E100) or
less).
I certity that In ihe per(ormance ot tne work for which this perm�t is Issuetl I
shall not employ any p¢�Son In any mann¢� 50 az t0 be[om0 suEject to,t�e
Workers' Compensatlon Laws of Califomia.
Date - Si9nature
NOTICE: It, after making thii tl<ClaratlOn, You Shoultl becoma Subj¢Ct t0 lh0
Workers' Compensation provl5ions oi tne Labor Cotle, y0u must farthwith
comD�Y with such provisions or thiz permit snall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby affirm that there Is a cons[ruction lentling agency for the performanto
Of the wo�k fo� wnicn I�Is Oe�mit i5 ISSUBtl (SecNOn 3097 Clv. C.).
�.80d8('S Name
Ixntler's Atltlress
OWNER BVILDER DECLARATION
I hereby attirm that I am exampt from [he Contraclor'z License Law for tha
followin9 reason (Sectlon ]031.5 BuSinesz antl Professional Cotle: Any Gty or
county which requires a permit to construct, alter, imorove, aemolisn or repalr
any strut[ure, Orior lo Ils Isivance, also reqWreS thB apP�icdnt lor Such pormlt
to (ile a zi9natl statement that ha/she is IlcenS¢e pursuant to tha provisions of
the Contractor'S LicCnse Law (Chapter 9(commencing wllh Sactlon 7000) oi
Oivision 3 ot Iho Businosz antl Professions Cotle) or that ho/she iz axompt
lnerairom and ��e basis 10� t�e allegetl exemption. Any violation of 5ection
7031.5 Oy any appliwnt tor a permit sub)ects tM1e applicant to a civil
' enalty of not mOre than live huntlretl t1011arT (E500).
� I, az owner ot the proporty or my employeas with wages as their sole
<ompensation, will Eo the work, and the structure is not inlentletl or oHeretl
for wle (Section 7044, Businass antl Pro/essional Cotle: The Contractor's
License law tloes not apply to an owner o( a property who builtls or improves
[hereon, antl wM10 tloes such work himi¢If/horsetf o� lnrOugh hi5 or hCr own
employeas, provlaetl tnat such Improvementz are not Intendotl or offarea tor
sale. It, howaver, the �uiltling or Improvement is sottl wlthin one year of com-
pletlon, Ihe owner will have tha burtlen Of prOving h¢/She tlitl not builG o� im-
�rove fo� tha putpose Ot Sale).
I, as owner ot the property, am exclusively contracting with Iicensetl con-
trac[ors to mnstruct t�e project (Section 7044, Businesz antl Prolesiion5 Cotle:
The ConVacror's License Law does not appry to an owner at proparry who
builUs or improv¢5 lhereOn, antl w�o conVacts fo� Such prOjetts wltb a con-
tractor(s) license Oursuant to t�e Contra<[or's License Law).
❑ I am axempt untler Section B. d. P. C. for this reason
Date Owner _
I hereby certify that I have reatl tnis
information is mrrect. 1 aqree to compf
antl stat¢ law/� to buil0in9 cons
sentatives his tl to' nter uDon
inspection
Signamre
Driverz' License or 55 � �_��.
CMF 0865-06 rev. ]/83 White - Builtling: Canary - Applicant; Pink -�Accountlng; Goltlenrotl - Assessor
TYPE�OFCONSTRUCTION LI NEW LJ ADD L.1 ALTERATION Ll REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.p.�S
DESCRIPTION OF WORK '
S Main Building:
TYPEOFPERMIT GRADING FOUNDATION STRVCTVRAL T Ffont �
❑ TENANT ❑ EIECTRICAL ❑ PLUMBING ❑ MECHANICAL 8 Reof �
❑ OTHER A �
PROJECT DESCRIPTION SQ. FT. �n oCCVaANCv K Right ,
CONSTRUCTIONTVPE VALVATION$ �'�8�� g Left ��
ZONE GRADING CV. VDS. ACRES P�ng. Ref, dh LE �3 -
qemarks: _�3 � Parking Req./Provided
� . UseofBuilding: ' fj '
. PLUM8ING FFFC Planning Notes:
Sink
Preven[er
Irrigation
king Fountains
�r Drains
ir Sinks
Service
Kitchen Sink
Lavatories �
P-Trap
Roof Drains .
Reinspection Fee
Showers
Service Sir
Sewe� �Cap
Solar Collxtors
Solar Piping
Swimmin9 Pool w�Spe
Urinal
Outlets Water Closet
Wacer Heater
. Water Service
525
Boiler
Duct - Under Ground
DUCt - $truCLurel
Duct - Ventilating
Exhaust System � Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ ai ao,000 eru O i oo,000 eri
Reinspection Fee � §25
Issue Feo
Hood or Typel ❑
Canopy Type I I ❑
fletrigeration System
❑0.700,000 BTU 0100,000
System Repair/Alteration
Issue Fea
Automatic Washer
Construction Pole Sub.
Cooking Unit' '
Dishwdsher
Dryers ❑Gas ❑Eleci
Fan
F.A.U. ,
Device Boxes
Outlets , '
Switches '•
Garhage Disposal
Generotur �0.5 K
g��Reinspaetion Fee
FEES
PUBLIC SERVICES fiEQUIR
Zoning APProvad By �
Application Approved By _
APPliqtion lauad By_
5 3
BUILDING PERMIT
PLAN CHECK
PLUMBING •
PLAN CHECK
ELECTRICAL
PLAN CHECK
MECHANICAL
PLAN CHECK
5i:�a �i.,,; :�.
Zone
Park.Fees 5
0
ELECTHICAL "�
Trensformer ❑ 75-50�KW
❑ SO+,KW
5KW
Meter LJup to 700amp5
Meter �over100amps
Sub Panel '
Motors �Ol HP � 1'h - 8
Inc. Solar �9-15 HP �iG15+
Mivowave
Pole Ligh[
Range
Sign
Standing Sections
Trash Compactor ,
Issue Fee
i
FEES
$ 3
Z
O
N
1
N
G
R
E
�
U
I
R
E
E
N
T
�SUMMARV OF FEES
$ �U.�-3� SMIP $ �.��co_
$ �8��_ PERMIT �
$ ISSUANCE $
$ ENERGY P.C. 5
$ ' GRADING S
$ MICROFILM $
$ TOTALFEE $�jz�.$�
$
t
/
i �riUCTION AND PLANNING POOL & SPA
CONS
� qpppJVALS Permit# � Date Inspector AppROVALS Permit# Date Inspector
7. T�mporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � ' , 53. Steel. Reinforcement
3.� Electrical Conduit Utility�Undrgrnd. 54. Forms �
• 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement � • 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. `. - 57. APPROVAL TO COVER-GUNITE ,
7. Footings , � 58. Electrical Conduit-Undrgrnd. .
8. Foundation 59. Gas Pipe, 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. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
75. Rough Electrical�Conduit � 66. Solar System-Final
16. Rough Electric Wiring , 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling , 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. DuCts, in Structure � 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing , 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing �• 6 B 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing _,. 2 76. Dry Standpipe '
28. lathing & Siding 77. FIXED SYSTEM FINAL �
29. Insulation �Ci 78. FIRE PREV. FINAL
30. Drywall Nailing
HEALTH DEPT. REQUIREMENT I
31. Plaster Brown Coat ,C 79. FINAL INSPECTION ,
32. Electrical Power Meter-Final . 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: �o r
34. Final Heating & Air Conditioning - �
35. Final Gas Pipe-Test .
�
36. Hood or Canopv '7 � � �f£� yL�jrQ,(/,
37. Final Faaory Fireplace � a (i
38. Final Plumbing � • �p �p ��y
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. Hanclicap Regulations �
47. FINAL STRUCTURE & BUILDING (/
48. Special Requirements Completed �
49. Electric Release to Edison
50. Gas Release to Southem California Gas Co � r.
51. CERTIFICATE OF OCCUPANCY
No. Date
Applicant to fill in all sDaas e�pt tBose�in� ieavy Do� r 1" ines antl sign all avD�opriate eeelarations.
cITY oP COS7A E CO TRUCTION PE IT
` � ��� �.�o.K �, ,.��..�A.
Project Address - -
ApplicanYs M 1� Addres l
Owner's N�a .P�.��/ p�� �/y Phon ����V �
Addres�,( i') i� /%�%/1 �t �� /i���/.a
Arch/Eng. License No.
I Address
��)��i Contractor's Na `-7 P o � �
r'i� Addresslmailing�/����^�l q��—� �� .:4�
Q.}J City License No. L
LICENSED CONTRACTOR DECLARATION
I 1 hereby a�tirm tM1at 1 am licensetl untler provi5lon5 of Cnarter 9(commencing
�with section 7000) o/ Division 3 of the Business and Grofessions Cotle, antl
my license is in full torce a e ect.
Licens I ss � � ice� s6/ N
Date � �� 5'g t S.�
WORK (35' COM ENSATION pECLARATION
I hereby a(firm that I nave a certificate ot consent to self-inmre or a certificate
, of Worken' Compensation Insurance, o� a certitietl copY thereo( (Section
3800, Lab.���y /�^.�,,� /7 _
Policy No. �+�j f� Company �%�%�r"
Certitietl copy is hereby turnishetl.
� ertifi o i f'le wrth the city i ing iv' . ,
ate APPlicant
E%EM ION FRO WORKERS' GOMPENSATI N DECIARATlO
(Thissection neetl not be completetl if the pe�mit is for one huntlretl 5300) or
less).
I c¢rti(y that in the pe�fo�mance of th¢ work for which this pe�mit is issuetl, I
Shall not employ any pe�son in any manne� so as to become subject to the
Workers' Compensation Laws of Califomia.
Date Signature �
NOTICE: If, after makinq this tlecla�ation, you shoultl become subject to the
Wo�kers' Compensation provisions of the Labor Cotle, you must fortnwith
Compty with such provisions or tbis pe�mit shall be tleemetl rewketl.
CONSTRUCTION LENDING AGENCV
I h¢reby affi�m tliat lbere is a mns[tuction lentling agency tor the p¢rtormance
of the work for whith tM1is Oe�mit is issuetl (Sec[ion 3097 Civ. C.)
Lentler's Name
Lentler's Atltlress
OWNER BUILDER DECLARP.TION�� � - �
I hereby attirm that I am exemp[ from the Contrac[or's License Law tor the
following reason (Section ]031.5 Business antl Professional Cotle: Any city or
county whicn �equires a permit to construct, alter, improve, tlemolish or repai�
any structure, prior to iis issuance, also requires the applicant (or zuch permrt
to file a signetl statement that he/she is licensetl Ou�suant to the piovisions of
tne Contractor'S License Law (Chapler 9(commenang with Se[tion ]000) of
Division 3 of tM1e Business antl Profe55ions Cotle) o� that he/she is exempt
therefrom�antl the basis for the allegetl ezemption. Any violation of Section
�03L5 by any applicant for a permit subje<Is Ihe applicant to a civil
�enalty of not more than five huntlretl tlollars ($500).
I, as owner of the O�operty o� my employe¢s with wage5 as [heir sole
compensation, will tlo the work, antl the structure is not intentled or ofteretl
tor sale (Section 7044, Business and Professional Catle: The Con[ractor's
License Law tloes not apply to an owner ot a property who builtls or improves
thereon, antl who tloes such work himseli/herself or through his or ner own
employees, provitletl that such Improvemen[s are not intentletl or offcretl for
sale. If, howeveq the builtling or improvement i55oltl within one y¢ar Of com-
pletion, tne owner will have the burtlen ot proving'he/sM1e tli0 not builtl or im-
�ove tor the purpose ot sale). �
�J I, az owner ot the property, am exolusivery contracting with licensed con-
tractors to construct Ihe project (Section 7044, Business antl Protessions Cotle:
The Contractor's License Law does not apply to an owner of property who
builtls or improves thereon, ana who conVacts (or such projects with a con-
tracror(s) license pursuant-to the Cantractor's License Law). I am aware Inat
proof ot their Worker'S ComPensation insu�ance SM1OWtl be provi0etl to me.
❑ I am exempt untler Section B. & P. C. tor this reason
Date Owner _
I hereby certify that I have reatl this
iniormation is correct. 1 agree to como
antl state laws rel inq to builtling con
sentatives of this ci[y to entrj utlol
Inspection pur
Signature %
orivers' License ar 55 �
CMF 0865-46, rev. 4/84
TYPEOFCONSTRUCTION l.3fNEW LJ ADD IJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT LJ GRADING LJ FOUNDHTION lJ STRUCTURAL
❑ TENANT ❑ ELECTRICAL I�PLUMBING ❑ MECHANICAL -
0 OTHER
PROJECT DESCRIPTION Sa.FT, oCcuPaNCv—
CONSTRUCTION TVPE' VALUATION $
ZONE - GRADING CU. VDS. ACRES—
Remarks: � I 1 �
Bar Sink
Backflow Preventer
Backflow irrigation
Bathmbs
Clarifiers
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks '
Gas Service Outlets
Intercepmrs �
Kitchen Sink
� Lavamries
P—Trap
Roof Dreins �
Reinspection Fee $15
Duct-UnderGround
Duct - Structural
Duct - Veniilating
Exhaust System ❑ Multiple �
Firepl/Fact BIL ICBO #
Heating System & Ducting
❑0-100,000 BTU �100,OOOBT
Reinspection Fee
WM1ite - - Applicant; Pink - Accountin9; Goltlenrotl - Assesso�
$15
Showers
Service Sink
Sewer Cap .
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal . .
Water Closet
Water Heater
Water Service
Issue Fee
FEES
$ 3
A.P. #
S �Main Building:
E
T Front
A Rear
C Right
S Left
Ping. Ref. #
Planning Notes:
�
Zone
Accessory Building: -
Z
' O
N
I
N
G
� R
Parking Req./Provided E
M
T
' S.
ELECTRICAL �
Aummatic Washer - Transformer ❑� 15-50 KW
Constructior PoleSub. ,
❑ 50+KW
Cooking Unit Meter ❑up to 100amps
Dishwasher Meter ❑over100amps
Dryers LJGas LJElectric
Fan
F.A.U. �
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0-5 KW �5-15 KW
Sub Panel
Motors OU1 HP O 1 Y. - 8
Inc.Solar �9-15 HP 016-15+
Microwave
Pole Light
Range
Sign
Standing Sections
Trash Compactor
Reinspection Fee �$75 luue Fee
IANICAL FEES �
Hoodor Typel ❑ DEVELOPMENTSERVICESREQUIREMENTS:
Canopy Typell ❑ Zoning Approved By
- Building Appraved By �
Refrigeration System
❑6100,000 BTU ❑100,000 BTU
System Repair/Alteration
Issue Fee
$ 3
BUILDING PERMIT S
PLAN CHECK $
PLUMBIN� �
PLAN CH CK 5°
ELECTRICAL $
PLAN CHECK 50% $
MECHANICAL $
PLAN CHECK Z5% $
V OF FEES
— SMIP $
FEES
$ 3.
' PERMIT
�I �`���
E R C
GRADING $
MICFOFILM $
TOTALFEE $
aCONSTRUCTION AND PLANNING � � � POOL & SPA .
'APPROVqLS Permit# � Date Inspector AppROVALS Permit# Date Inspector
1. Tempdrar,y Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pip�-Undrgrnd. 53. Steel Reinforcement -
3. �Electrical Conduit Utility�Undrgrnd. , � 54. Forms -'
4. Electrical Conduit-UncJrgrnd. , � 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
. l�
9. Water Pipe-Undrgrnd. -�' .• 60. Backwash Lines, P�Trap, O Undrgrnd. ;
10. Structural Floor System .� � , 61. APPROVALTO DECK
11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final
'i
12. Sewer C�p ���� 63. Heater & Vent-Final �
13. Roof Drains . 64. Plumbing System - Final � ,
74. Rough Plumbing � 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16> Rough �lectric 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, i� Structure . 70. Undergraund Hydro
22.�Ducts,Ventilating 71. ProductPipingOGas ❑Oil
23. Gas Pipe-Rough & Test , 72.� Underground Flush
24. Roof Framing ' 73. Undergrnd.StorageTank �Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Struciural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulatipn 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Qrown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric - . Notes: � � JO d-y�,�
34. Final Heating & Air Conditioning
35. Pinal Gas Pipe-Test �d��L�� (��
36. Hood or �ynopy •
37. Final Factory Fireplace
38. Final PlUmbing t (�,�'�( (��
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. FINALSTRUCTURE&BUILDING �
48. Special Requirements Completed
49: Electric Release to Edison
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY '
No. Date
�':
•
��
AOCIItant to fi11 in all spaces exceDt those within neavY bortler Iines anE sign all appropriata Geclarations.
\
` CITY OF COSTA MESA' � � _ . G4� - PERMIT NO. TRACT NO. LOT NO. . BLD . . � • � � _ . �
� CONSTRUCTION PERMIT ' � '.'7� 5756 3/09/B4 , 38•�" \
ProjeCt AddI255 '3 TVPE OF CONSTRUCTION � EW ' ADD ALTERATION REPAIR '
❑�CONVERSION � DEM LISH ❑ OTHER � � q;p, # � ZOne '
ApplicanYSMaiI' Ad eu�. � ' � '
� � ' S � DESCRIPTION OF WORK
Owner's Name � -G P o� � � S- Main Building: � Accessory euilding: Z
Address I��r7 VUCIl,�Cg�LCy� � �����.. E ,. O
TVPE OF PERMIT GRADIN FOUNDATION STRUCTURAL � T F�ont - . N
Arch/Eng:' LicEnse No., ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MEGHANICAL • B . . � , . ' �
� - - . A Rear _ N
Add�255 C����q1 ❑ �OTHER � , .
Contractor's Nam Phon �L!3 PROJECT DESCRIPTION 5�. FT._ ocCUPANCv — � Right � G
CONSTRUCTIONTVPE � VALUATION$ g� Left . ' E
Address (meiling - �
"'1 p�c� � 20NE GRADIIVG CU. VDS. ACRES � p�ng. Ref. # Park.Fees $� ' Q
City License No. �� { U
LICENSED CONTRACTOR OECLARATiON Remarks: Parking Req./Provided � �
I h¢reby affirm [hat I am licensetl untlar provi51on5 of Char er 9(commenCin9 p
wlth section �000) of Olvislon 3 of the Bu esz antl P esslons Cotle, antl � � Use of Building: E
my Ilcense.is in f W force antl efte t. � e� -��.�q� , .
Llcense Class �— icense .�LS.GJ ✓� PLUMBING PEES P�anning Notes: - M
E
Date Slgnature . � �
WORKEftS' COMPENSATION OECLARATION � � Bef Sink ' ShoWers T
I hereby affirm tnat I hzve a cerUflcate ot wnsent to self-insure or a tertiilcate Backflow Preventer Service Sink � � � � � S
of Workers' Compensatlon Insurance, or a certifietl copy t ereoi (Sectfon
3800, Lab.1i.1 C'Jr � O 1 47U �� � Backflow Irrigation Sewer Cap � ' - ELECTRICAL FEES
Polity No. � Company � ' '
CerHtietl copy is hereby furnlsnetl. ' � -� � Bathtubs Sewer Connection Automatic Washer'� Sransformer ❑ 15-50 KW
Cert 'e <op a le with the city B i ing on
afe Applicant ��u / Clarifier5 • ' SolarCollectors ' _ ConstructionPoleSub.. ❑50+KW
EXEMPTION___�RKERS' COMPENSATION�DECLARATION DiShNldShCf � Solat PIPin9 ' CAoking Unit Meter ❑up to 100amp5,
(This section neetl not be completetl if the permlt Is far ane huntlretl ($300) or�
iess) " � " Drinkin Fountains � ^ -
I certify that in tM1e performance of tne work for whlch this permR Is i55uetl I� 9 � Solar Tank , Dishwasher Meter ❑over 100 amps
shall not employ any person in any manner so as to become sub7ect to ti�e '
Workers' Compensatlon Laws of Ca�l�ornia. • Floor Dreins Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel
�ate Signature �
NOTICE: If,iafter makin9 thlz Declaration, you shoultl become subject to the Floo� Sinks , ' . Urinal " � Fan' � � - Motors 047 HP �7'h- 8 �
Workers' Compensatlon provislons of �the Labor Cotle, you must forthwith . �
comply wlth SucM1 provl5ion5 Or thi5 perTlt'� shall be tleemetl revokea: • Gas Service � Outlets � Water Closet : " ' F.A.U. Ina Solar 09-15 HP 076-15+,
CONSTRUCTION LENDING AGENCV '
I hereby afflrm [nat there ds a constructlon lentling agency for the pertormance Interceptors ' � Water'Hearer ' •� � Fixtures � � Microwave
of the work for whicM1 tnis permit is 155uetl (Sectlon 3097 qv. C.) - •
Lentler'z Name Kitchen Sink - ' ' Water Service ' � Device Boxes � � Pole Light �'
L.ender'S Atltlress L2vato�ie5�
OWNER BUILDER �ECLARATION � ' � Outlet5 Range
I hereby affirm that I am exempt trom tha Contractor's License l.aw foi tha p_T�a �
following reason (Sectlon 7031.5 Buslness ana Professional Cotle: Any city or P ' - � Switches • Sign,
tounty wNcn requires a permit to construct, alter improve, tlemollsh�or•repalr - �
any s[ructure, prlor to It5 issuance, also requlres t�e applicant for such permit RoOf D�ains � ' Garbage Disposal �Standing SectiOns
•to flle a signatl StdtBmeni thdt ne/She is Ilcensetl pursuant to tha provislOns Ot . ,
the Contractor'S Ucense l.aw (Chapter 9(commencing witn Section 7000) ot � -
Division 3 ot tne Business antl Pro(essions Cotle) w tnat ne/she Is exempt � . Generator 00.5 KW �5�15 KW Trash Compactor
the�efrom antl the' basis for the allegetl exemptlon. Any vlolatlon ot Section e
7031�.5 by any applicant for a permit tub7ect5 [he applicant fo a civll +qainspection Fee . $25 Issue Fae $ 3
�enalty oi not more than five huntlretl tlollars (E500). �
I, as owner of the vroDarty or my amployees wiih wagas as tnelr sole MECHANICAL Reinspection Fee i � $25 luue Fee $ 3
compensatlon wlll do the work, antl the scructure Is not Incentletl or of(eretl � FEES
for sale (Secfion �044, Buslnezs antl'ProTezsional Cotle: The Contractor's ' , PUBLICSEqVICESREQUIREMENTS: ' � � '
Licensa Law tloes not appry to an owner of a property who bulltls or improvas Boilec HOod o� Type I ❑ � �
thereon, antl who •Ooes such work himself/herselt or through hls or her own . Zoning ApP�oved By Data �
employ ees, provldetl that suth improvements are not Intentletl or ofteretl tor Duct- Under Ground �nopy TyPe II ❑ .
sale. I!, however, the bulltling or improvement is soltl wlthln one year of com- � Building Approved By � Date
pletion, tne owner will have tha burtlan of provin9 he/sne tlltl not bWltl or Im- � , �
�rove for the purpose of sale). ' , Duct - Structurel Refrigeration System Applintion Issued By ; � Dat g". �
LJ I, as owner of the properiy, am excluslvely contracting with Ilcensetl con- ,
trattorstb construct the o�oject (Sectlon 7064, 6uslness antl Protesslons COGe: . Duct - Ventilating _ ❑0.100,000 BTU ❑100,000 BTU SUMMARV OF FEES �
The Contractor's Llcense Law does nof apply to an owner of property who � BUILDING PERMIT
builtls or Improve5 thereon, antl who contracts for such projects wlth a con- ' Exhaust Syst2m ❑ Multiple ❑ System Repai�/Alteretion $ SMIP; $
tracmr(s) Ilcenze pursuant to,the Contractor's License Law). . . PLAN CHECK . '$ �T PERMIT
❑ 1 am exempt untler Saction B. & P. C. for this reason � Firepl/Fact. Blt. ICBO # PLUMBI NG ' $ :--�� //�— �SSUANCE $ ,
Date Owner ' Heating System & Ducting � PLAN CHECK 25h $ � � ENERGV P.C. �$
I�hereby certity tnat I have reatl thls applitatlon antl state tnat the abova � ❑O�t00,0008TU �100,0008 - ELECTRICAL ' GRADING $
Information I5 correct. I a9ree to comply with all <Ity antl county ortlinances ' $ '
antl state laws relatlng [o bulltling constructlon, antl hareby authoriz¢a repra- - � PLAN CHECK 50% MICROFILM ,$ '
5entatives of tnls city, to enter up n the above-mentlonetl pr p rt f r �. � ,
:InsDectlon Ourp Es. � `-� MECHANICAL $ . ' � .
'Slgnature ' Date � �/ . TOTAL FEE '$ �
� Drivers' Licanse or 55 �. - Reinspection Pae $p5 - Iwue Fee $ 3 ' PLAN CHECK 25% $ -
,ZCMF 0865-46 rev. 12/83 White - Builtlinq; Canary - APplicant; Plnk - A<counting; Goldenrotl - Assessor �
_ ' CONSTRUCTION AND PLANNING ' - � • � POOL & SPA • • .- _
` APPROVQL$ Permit # � � Date Inspector � `•APPROVALS �Permit #� - - Date Inspector ,,
_ a
� 1. Temporary Electrical Service or Pole 52.` Pool & Equipment Location�-; � ,
� 2. Soil Pipe-Undrgmd.- � �27�y�/ :.QjD 53. Steel Reinforcement ' . � - • -��
/ , 3. Electrical Conduit Utili[y-Undrgrnd. , 54. Forms _ - r " - • ,
k
� 4. Electrical Conduit-Undrgrnd. �- � � � � � 55. Electrical Bonding • . - . ' . � - ; ��
5.' Steel Reinforcement' . �- - . � ' 56. Rough Plumbing & Pressure Test - - �."�
. 6. Electrical UFER Grnd.� - . � 57. APPROVAL TO COVER-GUNITE �'` •�
�7. Footings � � _', ' 58. Electrica6Conduit-Undrgmd. : � � ,
8. Foundation �. ' �� 59. Gas Pipe, � Undrgrnd., Test ���:� �+ �,;
�
9. Water Pipe-Undrgmd. � t��j��at� (,iErj 60. Backwash-Lines, P-Trap,'� Undigrnd. � �� _
10. Structurel Floor System � . � 61. APPROVAL TO DECK �� - '
- 71. Property Sewer Line & House Connection 6/r1�Y�+ �� 62. Backwash & Receptor-Final�- -, _�
<�6
12. Sewer Cap . 63. Heater &'Vent-Final' . � � ' � � -
73. Roof Orains � ' ' ' ' � 64. Plumbing,System - Final - . �
14. Rough Plumbing � ' 7l/6�}'�I (,F✓I 65. Electrical-Final - - - � ` - ' °
�
15: Rough Electrical-Conduit . � ' 66. Solar System-Final i "-- "' - � - '
�
,16. Rough Electric Wiring � � 67. Fencing & Access Apprdval • - ' "
17. Rough Wiring Sign � . � 68. APPROVED FOR PLASTERING - -
� 18. Rough Electrical-T Bar Ceiling 1 69. POOL/SPA SYSTEMS FINAL �
19. Rough Heating & Air Conditioning FIFiE DEPT. REQUIR�EMENT� �
. ,< <
20. Rough Factory Fireplace � APPROVALS Permit.# , -' � - ,
21. Ducts, in Structure . , 70. Underground Hydro . ' !� j
22. Ducts, Ventilating � � 71. Product Piping OGas-AOOiI ' I •
. 23. Gas Pipe-Rough & Test -- .- Z2. Underground Flush � � �
24. Roof�Framing 73. Undergrnd.StorageTankOGas,O�OiI j '
'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 i � �
32. Elect�ical Power MeterFinal , � 80: �FOOD CERTIFICATE ISSUED �
�33. Final Electric , , Notex' . ' �
34. Final Heating & Air Conditioning ' � • •
35. Final Gas Pipe-Test � . �' � � . � • ' � _ ..
36. Hood orCanopy �, � � ._ _ , . . • � '
�� � _
37. Final Factory Fireplace � , � • , � � � ' , , . -
38. Final Plumbing � . �d � ��L �� . , _ � - � � �
39. Water Service-Final , • , . . . � � '„ � ' �
40. Gas Service-Finaf � . �� ' � � ? � ' ' ' ' '
47. Solar pomesticFinal � . . - - - - -- � = -- � - �- �
42. Backflow Preventer . � � ' � -' . � '� ' �
. _ . 1
43. Backflow Urigation � � � -. � • •
44. �Landscape Irrigation System . . � � ' '� �
45. Sound Attenuation , � � � . i � ' ' ! ' : ' _ "
46. Handicap �Regulations � � � - � � ' � �` �
47. FINALSTRUCTiURE&BUILDING ' �� ' `
48. Speciaf Requirements Completed � , „' � � � � -` � �
�
49. Electrie Release to Edison � - � - -- - � �
� i ..
50. Gas Release to Southern California Gas Co � - j� . ,
•, 51. CEFi-T FICATE OF OCCUPANCY - � ; � �
1 i ' � ,.
` No. � Date ' ._ . . � .._ . � . , �
, � : �
AOPllcant to fll� In all s0aces a%eepl Ihose within �eavy bortler Iinas antl sign all aDo�oo�iata tleclantians.
CI'YY OF COSTA MESA L/ PER T NO. TRACT NO. LOT NO BLD . 3O��J E/2]/ij4 ��o.�: i-T�
CON3TRUCTION PERMIT .���'I� �7 � �
PlojeCt AddfC � TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
AppliCent'S Mailing Addreii ❑ LONVERSION ❑ DEMOLISH ❑ OTHER q,p, # Zpne
�DESCRIPTION OF WORK �
Owner's Name / nhone S Main Building: Accessory Building: z
Address �LA�i_�,�� %%�%�C , T/��I�J/� E . O
1 TVPE OF PERMIT GRADING ' FOUNDATION STRVGTVRAL T.Ffont N
1
A�ChIEng. ��7� PS� L!c^_^'-° N^. - � ❑ TENANT'❑ ELECTRICAL ❑ PWMBING ❑ MECHANICAL • 8 Rear � N
Address - ❑ �OTHER ' %1
Contrector'sNa m f h PROJECT DESCRIPTION 5�. FT. oCCUaArvcv C Right � � ' G
�// CONSTRUCTION TVPE VALUATION S S Left R
Atltlress (m`aiTifig . ' E
City LicPnSe No. ZONE GRADING cU. vo5. ACRES ping. Ref. # � Park.Fees $ n
U
LICENSED CONTRACTOR DECLARATION Remarks: , Pdrking R¢q.�Provided � �
I her¢by attirm that I am Iicensetl untler provislons of Gnarter 9(commencing R
wl[h section 7000) ot Divtsion 3 ot t�e Business anE Professions COGe antl � Use of Building:
my Iicenso is In full{� ce a fte<t. _� �3�Q� . M
L1cen CI ` / en -No PLUMBING - FEES Planning Notes: �
Dat� � Si9nature E
WORKERS' COh1PEN5AT10N DECLARATION Bar Sink ShoWers N
T
1 nereoy aftirm tnat 1 �ave a certiticate of consent ro self-insure or a certlfi�ate gackflow Preventer , Service Sink S
oLWorkers' Compensatlon.lnsurance, or a certltied coOY.thereo7.(Section
3800, �ab. Y,yy���� Backflow Irrigation Sewer Cap - ' - ELECTRICAL FEES
PoliCy No. �% � company
BCertlfietl copy is nereby furnisnetl. Bd�htubs Sewer Connection AutOmatic Washer ' Transformer � 15�50 KW
�C4rUfietl oPY � letl�i ��the city Buil n9 v 7 .. - ❑ 50+ KW
Dato � �—�_.o�`l�plicant � / C�larifiers SolarCAllectors � :ConsttuctionPoleSub.
EXEMPTION FROM WORKERS' COMP NSATION DECLARHTION
Dishwasher SolarPipin9 � �- Cookin Unit � - Meter Du ro.t00am s
(This sec[lon neetl not be completatl if the permit is for one hunEretl (SI00) or - � � 9 P P
loss). ' � Drinkin Fountains �
I cer[ity tha[ in tne Oe�fo�mance o( thG work for.whlch thls pCrTk I5I55Uetl, I 9 5013� T2nk � Dishwasher . 'Meter �Ever 100 amps
snall not employ any porzon in any manner so as to become sub7ect to the � . '
Workers' Compensation Laws of Calitornia. ' Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel � � D
Daro � Si9nature
NOTICE: It, atter making this tleclaration, you ihoWG become zubject to the FIOOr SinkS U�inal Fan' � Motors �67 HP 01X- 8 �
WO�ko�s' Compansalion provl5ions Ot the La�or Cotle, y0u muzt fortbwitn . -
comply witn su<h provisions or this Oermit snal� be tleemetl ravoketl. Gas S¢rvice OutletS Water ClOsel F.A.U. Inc. Solar �9-15 HP �16�15+
CONSTRUCTION LENDING AGENCV • , _
I neraby alflrm that Nere is a construction Ientling agen<y for the performan<e Interceptors' � Water Heater Fixtures � Microvrave
ot tha work for wh{ch this permit is iuuetl (Sectlon 3097 Civ. C.) ,
I�ontler': rvamx Kiichen Sink � Watei Service Device Boxes � Pole Light
Lentler's Aatlwss. Lavatories
OWNER BUILDER DECLARATION . OutICtS ' R2�9¢
I heroby afBrm that I am exempt trom the Contraclor'S LlcOnse L.aw tor t�e p_Tra ' '
tollowing reaion (Sectlon 7031.5 Business antl Professional Cotla: Any city or P - Switches Sign
county whith reqWres a permit to construct, alter, ImDrove, tlemolish or repair
any structuro, prbr to Its Issuauce, also reqWrM the applicant for sucn pormit Roof Drains ' Garbage DiSpoSal Standing Sections
t0 flle a SlgnOtl stalement that he/sne is Iicensetl purSUant to [he prOvisions of
Jthe Contractor'S Litense Law (ChaD�er 9(commen<ing with 5ection 7000) of • . ' � ' � Generator �0.5 KW 0615 KW h25h Com ctor
Division 3 0l the Business antl Profe55ions Cotle) or t�at ho/sne is exempt Pa
tneretrom antl lha bazis tor the alle9etl exemptlon. Any vlolation ot Section ,
7031.5 by any applicant for a permit sub�ects the aOP��canl [o a civll Reins ction Fee S 3
�enalty of not moro than Bve huntlred tlollars (E500). � Pa $25 Issue Fee
LJ I, as owner of the property or my-omployoos with wa9es as their sole •MECHANICAL Reinspection Fae $25 �uue Fee $ 3
compansatlon, will tlo tha work, 5ntl the structura is not Intontletl or otferoa ' ' � ' FEES
tor sa1o. (Soction 7044, Buslness antl Protessional Cotle: The Contractor's PUBLIC SERVICES REOUIREMENTS:
Llcenw Law tl0¢5 nOt apply to an ownor of a property who bulld5 O� Improvos goiler ' � Hood or TypC I� ❑ '
theraOn, antl who tloes Su<h wOrk hiTSelf/ne�sell o� InrOu9h ttls or har own ZOning App�OVed 8y Dete
emplo eos, provitletl that such Improvements are not intendntl or olferetl �tor �nopy Typf I I ❑
Duct - Under Ground
salo. I, howaver, tna building or improvement Is zoltl within one year of com- Applieation App�oved By Date
pletlOn, tlte Own¢r wlll have Ihe bu�Uen Ot p�oving he/sne tlIU nOt buIIC or im- ` � ' ' L
�rove for tna purposa of sale). • , � Ouct - Structural ' Refrigeration System . � Appliption Issued�By- �f'�M� - Dal��
I, as ownet of �he properry, am ezclu5ively Contra<tlng wlth IIc805¢d cOn- � o .
tra<tors to conslruct the D�oject (Section 7044, Businasz antl Protessions Cotle: Dutt - Ventilating . � ❑0-100,000 BTU ❑100,000 BTU ' SUMMARV OF FEES
The Contractor's LI<ense Law does not apply to an owner of pro0erty who � '
builtls or improves thereon, antl who contracts for such projects witn a con- ExhauSt System ❑ Multiple ❑ System Repair/Altera[ion BUILDING PERMIT $ SMIP 1$
tractor(s) Ilcanse pursuant to tne Contractor's License Law). , PLAN CHECK $ PERMIT
❑ 1 am exempt untler Se<tion B. 6 v, C. �or this reason , Firepl/Fact. Blt. ICBO�k ' , PLUMBING '§ � ��UANCE $
Data �' Owner Heating System & Ducting PLAN CHECK $ � ENERGV P.C. $
I hereby certiy that I have reaa this application antl stata that the above ❑4100,000 BTU �t00,0008T .c��i J�� GRADING '$
iniormation Is corract.� 4a ree to compry with all Nty antl couney ortlinances � . ELECTRICAL § /
antl state laws relating b tling conztruction antl hereby authoriza repre- � � MICROFILM 5
PLAN CHECK
sentaUves ol� tnis ciry to n n e a ove-menuo a oJ r J � S
inspection purveses. � �p-/ ��� MECHANICAL , $ G�
Si9nature D te . TOTALFEE $
Drivers' Llcense or 55 � — ' Reinspac[ion Pee $25 Issue Fee S 3 � PLAN CHECK $ � � • �
CMF 0865-46 rev. 7/83 White - Builtling; Canary - Applicanh Pink: Accounting; Goltlenioa - A55essor ._ ,
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. Elec[rical Conduit Utility-Undrgrnd. � 54. Forms
4.`�Electrical Conduit-Undrgrnd. ' 55. Electrical Bonding
5. �steel. Reinforcement . ' 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings • 58. Electrical Conduit-Undrgrnd.
8. Foundation , 59. Gas Pipe, O Undrgrnd., Test
'�. 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structurel 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 Elec[ric Wiring �/ � ,��_ 67. Fencing & Access Approval
17. Rough Wiring Sign . 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SY§TEMS 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. RoofFraming 73. Undergrnd.StorageTankOGas ❑Oil
25. Roof Sheathing - 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoa[ 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. ,landscape Irrigation System �
45. Sound Attenuation '
46. Handicap Regulations
a7. FiNAL STRUCTURE & BUILpING �
48. Special Requirements Completed
49. Electrie Release to Edison � �
50. Gas Release to Southern California Gas Co �
51. CERTIFICATEOFOCCUPANCY -
No. Date . . �
Applicant to fill in all ipaces exceD� thase wit�in heavY eorOer Iines antl sign all aoo�oD��ate eeclarations.
PERMIT NO. TF T LOT NO. UNIT NO.
CITY OF COSTn m r�, O S�RU Tt0 •IV PER,JVIIT I� Z � 361,2 7/06/84 A.�� Tt
Project Address ✓"/ !-�K� _
Applicant's Mailing ress �. TYPE OF CONSTRUCTION NEW noD ALTERATION REPAIR
' ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p, # 2one
Owner's Name �%" ne DESCRIPTION OF WORK/USE OF BLDG.
Address S Main Building: Accessory Buildin9:
E Z
Arch/Eng. Licenu No. TVPE OF PERMIT GRADiniG FOVrvoA7iO�N �❑,STRUCTURAL T Front �
Addr¢s5 ❑ THERT ❑ ELECTRICAL ❑ PLUMBING l_`3'FAECHANICAL A Rear N
Contrector's Nam �Phone � C Right � N
PROJECT DESCRIPTION 54. FT. oCCUvarvcv
Addre551mailing) CONSTRUCTIONTYPE VALUATION$ S Left G
City License No. �' ZONE GRADING CV. VDS. ACRES R
LICENSED GONTRACTOR OECLARATION Ping. Ref. # Parking Req./Provided E
I hereby at(irm that I am licensetl untler provisions of Charter 9(commencing qemarks: //� �/ PIdMI�g NOt¢5: �
with section ]000 of Division 3 of [he BuSiness antl Professions Gotle, yntl M
my Iicense � in �� antl effecL / �/v ' � T
Llcens lice S'
Date Signature PLUMBING FEES
WORKE 5' OM ENSATIONDE LARATION BarSink ShOwE�S
I hereby ztfirm tnat I have a certitiwte o� consent to sel -Insure or a certlficate ELECTRICAL FEES
of Workers' Compensation Insurance, or a certifietl copy the�eo (Sectlon gackflow Preventer Service Sink
3eoo, �ap.
� Automatic Washer Trensformer ❑ 15-50 KW
PolicyNo. � Company Backflowlrri9ation SewerCap ConsVuctionPoleSub. �50+KW
eCertifi tl c py i hereby fumishetl.
C s filetl with the city B i - Bathtubs Sewer Connection Cooking Unit ' Meter ❑up to 100 amps
Date Applicant -
EXEMP 10 F OM WORKERS' COMPENSATION ECLARATION Clarifiers Solar CollectOrS Dishwa5her MeLCr �over 700 amp5
(Thissection neetl not be completetl if tne pe�mit is fo� ane huntl�etl ($100) or . .
less). , Dishwdsher Solar Piping ' Dryers OGas ❑Electric Sub Panel
I certiry that in the performance of tne work for wnich this perm�t is issuetl, I
snall not employ any person in any manner so as to become subject to the Dfinking Fountains ' Solal Tank Fan
t�� Workers' Compensatlon Laws ot Calitomia. , Motors 00.1 HP �1 %- 8
Date Signature Ploor Drains Swimming Pool w/Spa -
NOTICE: It, afrer making this tleclaration, you shoultl become subject to the F�A�U� Inc. Solar �9-15 HP �ifi-15+
Workers' ComOensation provisions of the Labor Cotle, you must fo�thwlth FIOOfSi0k5 ' U�indl � Fixtu�25
. comply with such provisions or this permit shall be tleemetl revoketl. Microwave
CONSTRUCTION LENOING AGENCV GasService �utleLS WaterCloset Device6oxes
I hereby affirm Mat there� s/a conrt�uction lentling agency for the performance Pole Light
of the work tor wni7lVa��mit is issuetl (Section 3097 Civ. C.) Intereeptors' Water Heate� Outlets Ran e
Lentler's Name �� 9
LenCer's Adtlress , Kitchen Sink Water Service Swi[ches Sign
OWNER BUILDER DECLARATION�� � ' �
I hereby affirm that I am ezempt from the Con[ractor's LicenSe Law for the LavdtOlieS Garbd e Dis OSdI
followin9 reason (Section 7031.5 Business antl Professional Cotle: Any city or 9 P ' Standing Section5
couniy which �¢quires a pe�mit to <on5truct, alte�, improve, tlemolish o� r¢pair P—T�dp
any structure, prior to its issuance, also requires Ne applicant tor such permit Generator �0.5 KW 05-15 KW TraSh Compactor
to file a 5ignetl siatemenf that he/sne is licenzetl pursuant to the provisions of Roof Drains - '
tne Contractor's License Law (Chapter 9(commencing with Section 7000) of
Division 3 of [he Busine55 antl Protes5ion5 Cotle) or that h¢/She is exempt
therefrom antl the basis for the allegetl ezemption. Any violation of�5ection
7031.5 by any applicant for a permit subjects the applicant to a civil
pe0alty of not move than live huntlreG tlollars ($500). - � . $ 3
❑ I, as owner of Ihe property or my em0loyees with wages as their sole ReinspBttion Fe9 $15 ISSue Fee
compensation, will tlo tite work, antl the structure is not intentletl or otteretl
for sale (Section 7044, eusiness antl Professionai Cotle: The Contractor's MECHANICAL Reinspection Fee $15 Issue Fee 3
License Law does not apply to an owner oi a property who builtls or improves
FEES
thereon, antl who tloes such work himselt/herseli or through his or her own - . DEVELOPMENT SERVICES RE�UIREMENTS: -
employees, proviaetl tnat such improvements are not intentletl or offeretl for Boiler Hood or Type I ❑�
sale. If, however, lhe builtling or improvemen[ is soltl within one year of com- CenOpy Type II ❑ 2����9 App�OV¢d By Ddte
pletion, the owner will have the bu�tlen of p�oving M1e/she tlitl not build or im- DuCt - Und¢� G�Ou�d Building App�oved By Datx ��n
�rove tor the purpose oi sale).
I, as owner ot the property, am ezclusivery contractin9 with licensea con- Duct-Structural Refrigeration Sys[em - Application Issued By � Dat
t�actors to construct the project (Section ]044, Business and Prote55ions Cotle: �
The Contractor's Liwnse law tloes mt apply to an owner ot property who Duct - Ventilating ❑0-700,000 BTU ❑700,000 BTU � SUMMARY OF FEES '
builtl5 or improves the�eon, antl who contracts to� such projects with a con-
tractor(sy license oursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provitletl to me. PLAN CHECK $ PERMIT
❑ 1 am.ezempt untler Section e. & P. C. for tnis reason Firepl/Fact.8lt. IC80 # PLUMBING $ ISSUANCE $
Date Owner - - Heati System & Ducting PLAN CHECK 25% $ ENERGV P.C. $
I hereby certify hat I have reatl tnis application and state that tne above / 100,000 BTU �100,OOOBT � GRADING $
information is co ect. I agree to co ly wrth ail city antl county ordinan es ELECTRICAL
antl state laws r lating to builtli on tructron, antl hereby authon r re- MICROFILM $ �
sentatives oi t is ciry to ent po the bove-mentionetl pro rt for PLAN CHECK 50°k � _LG��
in5pecfion pur s C
Signamre oate ✓ MECHANICAL �%� TOTALFEE $
Drivers' License or 55 � Reinspection Fea $15 Issue Fee $ 3 PLAN CHECK 25% $
CMP 0865-46, rev.4/84 White - Builtlinq; Canary - Applicanh, Pink -Accountin9; Goldenrotl -Assessor -
CONSTRUCTION AND PLANNING , POOL & SPA
` APPROVALS Permit # Date Inspector � AppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole �J, 52. Pool & Equipment Location ,
2. Soil Pipe; Undrgrnd. � 53. Steel Reinforcement '
3� Electrical Conduit Utility-Undrgrnd. 54. Forms
4:. �lectrical Conduit-Undrgrnd. � . 55.-Electrical Bonding
5. Steel Reinforcement� . . 56. ,Rough Plumbing & Pressure Test
6� ,Electrical UFER Grnd. ' 57. APPROVAL TO COVER-GUNITE
7. �Footings. .. , � . "� 58. Electrical Conduit-Undrgrnd.
�8. Foundation , � � 59. Gas Pipe, � Undrgrnd., Test
i
9� Water Pipe-Undrgrnd. � ' 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System � � � 61. APPROVAL TO DECK
i i. Property Sewer Line & House Corinection 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 Electriral-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning 7�Cr��t� �� FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. pucts, in Structure , 70'. Underground Hydro
22. pucts, Ventilating , 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush �
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. 7-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. Orywall 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 .
47. Solar pomestic-Finai �
42. Backflow Preventer �
43. Backflow Irrigation , . _
44. Landscape Irrigation System
45. Sound Attenuation �
46. Handicap Regulations �
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed _
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY
No. Date
� - Applicant [o /ill in all spaces exceD� those witnin heavy borOer lines anG sign all a0Pro0�iate Eeclarations. O(%II � �/ � 2/
CI7Y OF cOSTa nnESa • CONSTRUCTION PERMIT PERMIT NO. � TRACT NO. LOT NO. UNIT N0. . , �4 �. 7G TL
ProjectAddress ���j ��vender LdI10 �
Applicant'S Mailing Addreu TVPE OF CONSTRUCTION NEW /�DD ALTERATION REPAIR
SYandard Pacific �0�' Phooe546-7161 �CONVERS�ON ❑DEMOLISH ❑OTHER q,p,# Zone
Owner's Name P-. DESCRIPTION OF WORK/USE OF BLDG.
Address r �o�+a Mes�9���� S Main Building: Accessory Building:
_ E Z
Arch/Eng. LiCense No. � TVPE OF PERMIT GRAOING FOurvoATION STRVGTURAL T Front p
Add�255 ❑ TENANT ❑ ELEGTRICAL �PLUMBING ❑ MECHANICAL B Rear N
e�iew—�lumbi ng Phone � � 4n �'OTHER A �
Contracmr's Nam 528— C Ri9ht � N
Address Imailin9) � ��% N Fca 4na Anaheim PAOJECT DESCRIPTION 5�. FT. OCCUPANCV
� CONSTRUCTIONTYPE VAWATION$ S Left G
. City LicenSe No. ?�8.]! ZONE GRADING CU. VDS. ACRES E
UCENSEp CONTRACTOR DECIARATION Ping. Ref. # Py�kiny R¢q./P�OvidCd
I hereDy allirm lhat I am Ilcensetl untler provi510 Charter 9(commenCln9 Remarks: S� I l l� Planning Notes: - � M
wlth section 7000) of Division 3 0l tne Busin E a Protessions Cotle, antl
Ty IIC¢OS¢ i5 i0 }ull 10 C¢ tl e}f2CL T
�ice�sc ciass �' �g �� nse No. 426109 S�
Date�.Q��.n�p Si9nature PLUMBING FEES
WORKERS' COMPENSATION DECLA ION Ba� Sink ShOw¢�5 �
I hereby af/irm tnat 1 have a certiticate ol consent fo self-insure or a certificate ELECTRICAL FEES
ot Workers' Campensation InsurSnce, or a certi(ied mpy tnereot (Settlon BackflowPreventer ServiceSink
3800, lao. Automatic Washer Transformer ❑ 15-50 KW _.
Polic No. P�J�C-1777141 Com anv HOf112 Backflow Irri ation Sewer Ca � ❑ 50+ KW
v P 9 P Construction Pole Sub.
�Certifietl copy is hereby furnishetl. '
�r,(If�iGQ�cpJj� is tiletl with the city Bpiltling visi n, Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Da[e1.LL�LV�13P}_. Applicant IVeW �umi�i ng � � . ..
EXEMPTION FROM WORKERS' COMPENSATION DECIARATION Clarifiers SOId/ COIICCt0�5 � Di5hwd5h¢� Merer ❑OVC� 1008mps
(Tbis section neetl not be wmpletetl if the permit fs for one huntlretl (E300) or
less). � � Dishvrasher Solar Pipin9 Dryers ❑Gas ❑Electric Sub Panel '
I certify Ihat In the pertarmance of thB work fo� WM1ich thi5 perm�t i5 issuetl, I i
shall mt employ any person in any manner so as to become subjeat to the Drinking Fountains Solar Tank Fan Motors DO-1 HP �1'h - 8 '
Workers' Compensation LawS of Calitomia.
Date Si9nature Floor Drains Swimming Pool w/Spa F.A.U. InC. Solar �9-15 HP �16-15+
NOTICE: If, dlter making thi5 tlecla�ation, y0u StlOultl become subjecl t0 the
Workers' Compenwlion pravisions ot the LaDor �oUe, you must torthwlth Floor Sinks Urinal
comply wilh such prOvisions or [hi5 pe�mit snall be tleemea revoketl. - Fixtuf¢S Mi�rowave
CONSTRUCTION�LENDING AGENCV ' - . GdSS¢rvice 6 OULIetS WatefC105¢t 'L �jo
1 he�eby af(I�m tnat [here is a conitruction lentling a9ency (or the pe�formanCe � DEVIC¢ BOxCS Pole Light
ot the work for w�ich this permit is Issuetl (Section 309� Civ. C.) Interceptors Water Heater '
Outlets Range
LenGer's Name
�ender's Aetlress Kitchen Sink Water Service Swihhes
OWNER BUILDER DECLARATION� � Sign
I he�eDy af(Irm that I am exempt from th¢ Cont�actor'S License Law tor the �avatories
following reason (Section 7031.5 Business and Protessional Cotle:�Any tlry or Ga�bage Disposal Standing Sections
county which requires a permit to construct, alter, imp�ove, demolish or �epalr P—T�ap �
any structure, prior to its issuance, also requires the aoP�icant for such permit Generator DO-5 KW �5-15 KW Trash Compacmr
to file a signetl statement that he/she is Ilcenzetl pursuant to the provisions of Roof Drains
[he Contraclo�'S License Law (ChaOte� 9,(<ommehtlng with $ection ]000) of
Division 3 of the Buziness antl Protessions Cotle) or that ne/she is exemv� -
theretrom antl the Dasis for.the allegetl ¢x¢mption. AnY violation of $ectiOn
7031.5 �y any ap0�icanf ror a permil 5ubjeC�S the appliGan[ to a civil
�enalty ot not mote lhan five huntlretl tlollar5 (5500). '
I, as owne� of the property o� my emPloy¢e5 with wages as thei� sole Reinspection F08 $15 ISSue Fee � 3
CompenSaHOn, will Oo the work, antl the 5[NClur¢ is not intentletl o! ofter¢tl (�einSpeCtiOn F¢¢ $15 IssuC F¢B $ 3
�or wle �Section 7044, eusiness ana Pro(essional Cotle: The Contractor's MECHANICAL FEES
Licenie Law tloes nol apD�Y to an owner of a Oroperty who builtls or improves -
thereon, antl who aoes such work himself/nerzeli or through his or her own goiler Hood or Type I ❑ DEVELOPMENT SERVICE$ REQUIREMENTS:
emplo ee5, prOvitleC ihat such improv¢men[z a�q not intentletl or offeretl fo�
sale. I% however, the bulltling cr Improveinent is soltl witnin one yoa. ot com- Canopy Type I I ❑ Zoning Approved By Date
pletioq the owner will have the burtlen of proving he/she tli0 not builtl or im- Duct - Under Ground guilding APP�oved By Data
�rov! fo� tM1e purpose of sale). Z
I, as owne� of the proDerty, am exclusively Cont�ac[ing with Iicen5e0 con- DUct - StfuCtu�dl Refrigeretion System Applicati00 ISSIIBd By�� Ddt �
tractorsto consVuct the project (Section ]044, Business ana Professions Cotle:
The Contractor's License Law tloes not apply to an owner of prooerty who Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU
Duiltls or Improves thereon, antl who contracts tor such projects with a con- SUMMARV OF FEES
tractor(sl Ilcense pursuant to the Contracror's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of tneir Worker's Compensatlon inwrance snoultl be provitletl to me. PLAN CHECK $ �PERMIT
❑ I am exempt un0er 5ection B. & P. 0.!or Ihis reason FirepVFacL 81t. ICBO # PWMBING $ S��i� ISSUANCE $
Date Owner Heating System & Ducting PLAN CHECK 25% $ ENEflGY P.C. $
I hereby certity that 1 have eatl tnis application ana state thac tne abova ❑U100,000 BTU O100,0008T ELECTRICAL $ GRADING $
information is correct 1 agree o comply with al1 city antl county ordinantes
antl state laws relatin ro builcing construction, antl hereby aumorize reore- PLAN CHECK 50% $ MICROFILM $
5entaHveS of Ihis Cit to en[�� u0on th¢ abbve-mentionetl O�operty lo�
Insoection —�t� MECHANICAL $ �j,'jd
Signature Oate LQ /lo � TOTAL FEE $
Drivers' License or 55 � � � — Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
CMF0865-46,rev.4/84 White-Builtlln9:Canary-qpp�i�ynpPink-Actounting;Goltlenrotl-Assessor - -
CONSTRUCTION AND PLANNING � POOL & SPA
APPROVALS Permit# Date Inspector � AppROVALS Permit# - Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
� 2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgmd. 54. Forms �
4. Electrical Conduit-Undrgmd. 55. Electrical Bonding� �
5. Steel Reinforcement � . � 56. Rough Plum6ing & Pressure Test _-�'
6. Electrical UFER Grnd. ' 57. APPROVAL TO COVER-GUNITE �,
7. Footings � 58. Electrical Conduit-Undrgrnd. �
8. Foundation 'r 59. Gas Pipe, O Undrgrnd., Test
i:
9. Water.Pipe-Undrgrnd. ` " 60. �Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System ' � 61. APPROVAL TO DECK �"
i t. Property Sewer Line & House Connection 62. Backwash & Receptor-Final . �
12. Sewer Cap � 63. Heater & Vent-Final .-
13. Roof Dreins . � . - 64. Plumbing SYstem - Final
14. Rough Plumbing 65. Electriral-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 Electrica6T Bar Ceiling 69. POOUSPA 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. Storage Tank O 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. 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 p(�z ,� LeQ
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
i
50. Gas Release to Southern California Gas Co . •
51. CERTIFICATE OF OCCUPANCY
No. Date
}' ` Aoo�i[ant to fill in all soaces excevt those within heavy border 11nez anG sign al1 aporovriate Oeclarations. .
Ci7Y oF COSTa nnESA CONSTRUCTION PERMIT PE�IT NQ /��S TRACT NO. LO; NO. UNIT N6. Fi045 I 2/0�/B5 gL, �;,
. Projec[ Address 3 39� ���16��d � G,�/. ��" • L . ���� . - �
ApplicanYs Mailin9 Address �.Ow�L • TYPE OF CONSTRUCTION NEW ADD AI.TERATION REPAI R
Owner'sName Phone � CONVERSION ❑ DEMOLISH OTHER
/I'%ar G��6KOE3/�/� .�S�L-77s' . A.P. � !� � — Zone �
—� DESCRIPTIO FWOfi�C /USEO BLDG.
Address 9��� �,G}-�.'f(U— ��✓ � S MainBuilding: AccessoryBuildin9: - .
TVPEOFPERMIT LJGRADIrvG FOVNOATION STRUCTURAL E Front Z
Arch/Eng. License No. T �.�. O
Address ❑ OTHERT .O ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear I N
Contractor's Name �� Phone � � � � ' f
PROJECT DESCRIPTION 5 FT. ocCUPANC -C� Right N
Addfe551mailing) CONSTRUCTIONTVPE VALUATION$� g Left � ' R
City LicenSe No_ ZONE GRADING CU.YDS. ACRES E
LICENSED CONTRACTOR DECLARATION . Plny. R¢F. # P3�king Req./P�Ovid¢d
I hereby atfirm tha[ I am licensetl untle� provisions of Charter 9(commencin9 Remarks: Planning NOtes: �, M
,with section ]000) o! Divisian 3 of the Business antl Professions Cotle, antl
my license is in full fo�ce antl e�fect. � " � T
License Class License No. , .� , S
oate Siynature PLUMBING ' FEES �
WO(3KER5'COMPENSATION DECLARATION Bd�Sink ShOw2R ' ELECTRICAL FEES
I hereby affirm Ihal I have a certiticate of consent [o Self-insure or a certificate
of workers' Compensation Inwrance, or a certitied copy thereot (Section BackflowPrevenrer Service5ink
3800, �ab. CJ ' Automatic Washer Transformer ❑� 75�50 KW
Policy No. Company Backflow Irrigation Sewer Cap Construction PoleSub. � 50+ KW
BCevtifietl copy iz hereby furnishetl. �
Certitietl copy is tiled with the city Builtling Division. , Bathtubs $ewer Connection Cooking Unit Meter ❑up to 100 amps
Date ' APPlicant � ,
EXEMPTION FROM WORKERS' COMPENSATION OEGLARATION Clarifiers SOId� COII¢CLO�S Di5hwd5h¢� M2L¢� ❑Ove� 1002mp5
(This section neetl not be completetl if the permit is for one huntlretl ($300) or
less). Dishwasher Solar Pipin9 Dryers ❑Gas ❑Electric Sub Panel
1 cerlify that in tne performance of tbe wo�k tor which this perm�t i suetl, I
snall not employ any person in any manner o a bec ct to tn Drinking Fountains Solar Tank Fan Motors �0-i HP �1 %- 8
�Worker o�r�pen5�tipp�Laws of Cali(or a ,
Date ��' `'�" � Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc Solar 09-15 HP 016-15+
'NOTICE: If, after making this tleclar n, you shoul ecome ject to the
Workers' Compensation provisions � f the. Labor e, you ust forthwith Floor Sinks Urinal Fixtures
comply with such provisions o� tM1is pe�mit shall be tleemetl revoketl. Mic�Owdv¢ -
CONSTRUCTION IENDiNG AGENCV GasService Outl¢t5 Wdt¢fCIOS¢t DeviceBoxes POIeLi ht
I nereEy affirm lhat there is a construction lentling aqency for the OerPormance - 9
of the work for which this permit is issuetl (Section 309� Civ. CJ Interceptors . Water Heater Outiets Ran e
Lentler's Name —�{—�j�� 9
�ender's Atltlress /`� `�' �"' ^ Kitchen Sink Water Service Switches
OWNER BUILDEH OECLARATION Sign
I hereby affirm that 1 am exempt from,tne Contractor's'License Law for the Lavatories ' Auto-Wash
followin9 reason (Section 7031.5 Business antl Professional Cotle: Any city or Garbage Disposal , ; Standing Sections
county which requires a permtt to construct, alter, improve, tlemolish or repair P—Trap Laundr Tra s - -
any structure, prlor lo its issuance, also requires the applicant for such permit Y Y Generator �0-5 KW �5-15 KW Trash Compactor
to tile a signetl Stalement tM1at he/she is licensetl pursuant to the provisions ot ROOf D�ainS
the Contractor's License l.aw.(Cbapter 9(commencing with Section 7000) of
Division 3 of the Business antl Professions Cotle) or tnat he/she is ezempt
thePefrom antl [he basis tor the allegetl ezemption. Any viOlation of Sec[ion -
703L5 by any applicant for a permit subjects Ihe applicant to a civil �
�nalty of mt more than five huntlretl tlollars ($500).
I, as owner of the property or my employees with wages as their sole Reinspec[ian Fee $15 Issue Fee $ 3
mpensation, will tlo the wo�k, antl the structure is not intentletl or ofteretl ReinSp¢GtiO� Fe¢ $15 ISSUB F¢e $ 3
for sale (Section �044, Business antl Professional Cotle: The Contractor's � MECHANICAL FEES
License Law tloes not apply to an owne� of a property who builtl5 or improves �
thereon, antl who tloes such work himsell/herself or tnrough his or her own goiler - Hood or T e I ❑ � DEVELOPMENT SERVICES REQUIpEry� ENT .
employees, provitletl that such imp�ovements are not intentletl o� offeretl for YP y�y� L. �
sale. It, however, the builtlin9 or improvement is soltl within one year o� com- � Canopy Type I I ❑ Zoning Approved By v' /G � Data ' �
pletlon, fbe owne� wlll M1ave the burtlen of proving M1c/sha tlitl not builtl or im- Duct- Unde� GrOund 9uilding Approved 8y Date
prove tor the purpose of sale).
❑ I, az awner ot the property, am exclusively contracting with licensed can- Duct-Structural _ Refrigeration System Applitation Issued By Dat
tractarsto construct the project (Section 7044, Business antl Protesslons Cotle: � � ,
The Contractor's Liwnse Law tloes not apply to an owner of property who Duct - Ventilating ❑0-100,0008TU ❑100,000 BTU SUMMARY OF FEES ' �
builtls o� improves tM1e�eon, antl who cont�acts for sucM1 projects with a con- ' ' /�
tractor(sllicense pursuant m tne ConVacior's License Law). I am aware mat ExhaustSystem � Multiple � System Repair/Alteration BUILDING PERMITi $ �Z .SO SMIP $. V�Sa
proof of their Worker4 Compensation insurance zhoultl be pro Itletl to Te. _ PLAN CHECK $ Z�• �2 PERMIT
❑ 1 am exempt untler Sectiy �/— & P. C or this re� fon FirepVFact.6lt IC80 # Fire Dampers ISSUANCE $
_ (J���xyry�`�i /J � / PLUMBING ' $'
D t o � � � Heating System & Ducting Registers PIAN CHECK 25k $ ' ENERGV P.C. $
I heretiy-certify that I have reatl)� is applica n antl st that the above ❑0400,000 BTU �t00,000BT ' -� �- � $,
intormation is correct. I agree to mmpty wit all city ntl county ordinances Y ELECTRICAL, , $, GRADING
antl state laws relatin9 to buil ing onztr wn, antl ereby authorize repre- P�AN CHECK 50% $ � MICROFILM' $
sentatives of this cit fo� e e abov entionetl Prope�ry fo� • �
inspection purpases ' MECHANICAL $
Signa[ure Date�'�._Z.��_ : TOTAL FEE $ � �Z
Drivers' Licen ar 55 � Reinspee[ion Fee :$15 Issue Fee ; $ 3 PLAN CHECK 25% $
CMF OB65-46, rev. 10/84 White - Builtling; Canary - Applicanh Pink - Accounting; Goltlenwd - 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 Reintorcement
3. Electrical Conduit Utility-Undrgrnd. - 54. Forms �
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
� �
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test , .
6. Electrical UFER Grnd. � 57. APPROVAL TO COVER-GUNITE
7. Footings ,'�� ' _�� 58. Electrical Conduit-Undrgrnd. •
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test �
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
1 t. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap � 63. Heater & Vent-Final
13. �Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit _ , 66. Solar System-Final ._
16. Rough Electric Wiring 67. Fencing & Access Approval
17.. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18: Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21'. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-fiough & Test , 72. Underground Flush �
24. Roof Framing � 73. Undergrnd. Storage Tank O Gas ❑ Oil -
25. Ftoof Sfieathing . 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 Ges 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. Electrie Release to Edison .
50. Gas Release to Southem California Gas Co - � �
51. CERTIFICATEOFOCCUPANCY " � •
No. Date
CAUTION
ELECT(�i��1L L�NC C�kARANCE REQUIREFJiENTS
IN ACGOf�DAf�CE 1NI � F! STATE S�IFETY REGULATIONS, IF
COIV'ST�?;; � i iOPI REfl�,'I!:�S'J.'QR;(ERS,. EQUIP�1rFNT, CRANES
OR HOiS71PlG QEVICES TO E3E I"1 PR�Y,I�siTY OF GVERHEAD
ELECTRiC'•.L LIP!ES, OR U".DEftGF.O'iND ELECTRIC
FACI�lTicS, C:4� L �GU i Fi'��;i�l .^„aLlFCR^fIA EDlSON COMP.INY
IPl;' icDlnT�LY (i 14�� �S.n -�d
I Ii�o �"� a� �is�Q�
Il_l UNTIL C .�iPLETE Sil3C0id7':
�Y G1TY USiNESS LICCNSE
APPROVAL
SEPARATEPERMi�" R'.pUIF
FOA ELEL7RICAL, PLUt+i ING,
HEATI"�G, VENTILATING ANO
R��RIG:RATION WOIX
1'�'.7°:`;�3� '�:`0_
T!'IC ?: ,r.:s:. � r� ua; ,,,;!;1�� •�aNY
nE! �r;s�rr..ria;,� e,�auEsr�
hOP BUILD;NBS Y�9�EPf FcR50�y5 A:i, T� B
EMPLOYEq V5'F,iUoCIF.SI 1HA7 (NE G;Aic L'
CALIFCBNIq pPJIS10N Ct INOUSikIAL SAFET
BE CONSI;LTEO fOR AGOITIONA
flE�UIFEh1ENTS.
�
�i�� i�e 1!/lade
i LEST IS AI'PROVED
' ��PRO�ED
�City of Go Mesa Building De t. �i
i eY pA �Z Z 13�.r
THESE PLP.DiS MUSi 0E OP4 JOB AT ALL TIMES i
I�qKE NO CHANGES WlTNOUT PRlOR APPROVAL �
OF DEPT. �
THE ISSUF.P:CE GR GRi-.tiTINC OF A PERNIi OR APPRO'JAL �
CF FV�@S FtiD SPLG'TRTIGIS SHALL NOi BE W.`73TRuED
TO GE A FE^V,I? f�•R, OR A�J AFPfiO4AL Of, fiNY VIOLALION
CP l,NY OF THE PROI^._`-1015 Of THIS CODE. fJ0 PCR�HI! PNE-
SUN,ING TO Ci5'E Fi:TH�RITY i0 VIOLAf[ OR CF�CEL THE
FFOVISIO�$ CF THiS CCDE SHALL BE VA! 16, [XCCPi IN $0 �
f,1R F.S THE SYOFS( CR US� P.'NICH IT AU1dORIZES IS LA'N,FUL.
THE ISSUFNCc OF A PER�Y�i7 BPSED UPCV FCrtA> A�v,.
SPCCI"ChTIC4S S�A�L ACT PREVCtlt TfiE E7I:61.V� OF::�I; -
fROM1d Tt(Ef,ELFTCR kC�7lRL"�G 1HE CO �RECTI� I C E.Lw.S
I"� �AID RL;:S f,I�D SCcC!(ICAT!O:iS OR F^�•' '3C'l6riGo1
� F!'ILDIRS C°Ei2:1�:CI:S BE:.�G Cf.n"BIED 0:� iHEd:75�:.d �..117
� itl l'�CLf.TIC� CF THIS CGUE OR OF ANY OTi,�d 03DI: 1;lC�
�' TFiE CI�iY.
�
�
❑�
e
��g ��sp������
�a�➢�
����� V�
�
��
r�i�T� o� r� c� � rra,v �
OGJ,t1ER^6/JLP�E2: i'Yl._. ^L•/E'���5/C/.
2E'SIDC(!!_'€: 3�9/ L4%�.VUCYZ L./J, -
COSTq i'1')GSd Ca .
APPR,
�m' � co:
-!�L OT �L a,U J —�, ��
�/B'= /=0 ':1lY"„--.-..�� p�n
/ o� � ���
_�
N
��i
S7AUCTURAL PPHOVi� ntt
SEPARATE PER ITS ARE P:FpUIRED
FGR ELECTB �Al. PLUMdING.
HEAT���!G V� tdTILAT:N6 ANO
"�=c�6; Y =TIi a� '�vCRK
�� _.>;�.�',»� ?�
:� ;.'� , . - . : ,
1J �� ' :+L'31." P�IiST VIj.J•W!`V�Y
li,lr •J.
�:�. :i':�.iYf.ri.��V ^4U11c_J��
F�7R 6JIL�iixGS 1'JFIERE �ENEt17:S AAE ?a CE
Ef9?LOYEU. WE SUGGESI fNAT THi Sl'ATE OF
.r,A"FOHhIk DIVi510R OF INOUSTA,AI SAfETY
�B� COFSUlTEO FQR AG6I1i0NAl
�I HEOUIREN�ENT5.
�'+— -
J
� ll ������ � I
Q e�Tv bF �i�sTA MESA `' _
pIANNING DEPL �,�
SUBIEC7 i0 BIDG. DEM. � r=:�
�A� �c.? � —
gY D�O� pIANNINO
�"
�
a
❑
a
�
�
i
;
;
I
I ��'��
; IVED
I
; iA MESr► v�
{ DEPT. �`'`'
o�r �, �;`E
�� nI1T l 0--=a =D 61 Ti017_
j - ���f- (�L7J�--
I v„•_,�
F
2x�-7'-6":
2y''_�. C
STRUCTL'RAL APPROVAI Oidl1' I
SEPkRATE P[AMITS l`RE F�pUIR�U
fOR ELELTRICAI. P_':� "d�ti ;. 1
HCATii\G. VE�•"; ^',1;:" ; �,
fiEFtIICLLf,IiL'id i:'[�Fei ;
� . �_
����1i"ti' ` -- - '
rHIS i'�'Uh16f.' PIltS' hGf„' ,.r � . � �
iS1'= ,l �rd��E�2�x3 �LFAT-f{.=N%"iDC.
L- - - -----
�-- - - — -- - -
Fon ew.e;r:cs w�,�f: ::,s�.�� ��: �. r-
rR�Q�nvcn u.r.�,ir.r.r< ,r,— T�:c . .
�e7}�pNylq P�V�qO'J nc �F�� ql i ��S;�ii. � i
..s�' x:g�ks62'e.,UF�L•1,lpE2, ��.�a� ( i
1, , `- _ �
.�O-'-_ �� �i_.
.
�.
�
\/ � . r_
`�_ �V-x4.GL1L. POS�- ..�1.2"x72 xlSf�'. -
J-nticup2=rYP �oar-iu�- �
� I �Y.IP:—
• G
-o_a-_2�= y��v" 6LOCKliUG_`�!5/a"_6dLT.
T20UG I-i IJC/�DE?Z _
r----,�
2� /0'x !8' WE-/a�
0 - - - - -
--z��� r�:.-rn�mee-
/ --�� �
�- ._L-X l�-CLA1.G__3.%z'_PaTID_SLIS�
�LJ -Cl�f_T-�-FD2=�'DflTi�(3G5
z=�Z=Z�LES-----
� _y x YJD, F l�OST -
7-5� P.
'I��'
4'
�
' =' y ��°/ �t/.G:_7YR
_ - %'�/.._ �,
�
,��
�rz � m-i��__::r�� � �u
- 3/B"-/-D"
�-- 3 CB'-----�
� �y
�nnnnnnnnn�ir
�i . .
— :�. "�i
j� � �l
,
SCC._.SR :
\:
���'CTURAI APPR�JUAL L�P��Y
ylliJ
� =PARA.TE ?ERi,�ITS ARF P,;�iJiReD
� EOti EIECinICJ.�, P[L'n'zi'JG,
HEA71'`F, `-.'sid?:LC7l;�G G.f�i:J
T.�: ;,
r'ta:':•�i;;:,��,� �n:; ;x:i
___��_�.__� �=%z" 601
� ,_ � �_ ` :;'; _._.i�OSI'-� /��
I i z:�;� ,.:;.-� __-,,�- _,..- �
, 4/ ' j
/ �� - ____._.__�.______ r(___...�� I
� Ja
afe_._._,_._�..""".e_�.....�.�.._"," ._—_� �
� � �=G$ �:;;_'.:�,^, y::e?Eii_ @d>�';d't . . IU 3f.
ctyf�iG�Y�?7 � tilir,r;:v, ^p - �T�Tt OF
iii,.. +ii; .-
C::iIF��:`•;��.'. j-_��ntii'u"V P,F i���;.'3� H::il $Af[1Y
nE C??t;;ptTED F"uN :OC'�l71UNAl I
fltQUlA:i:ich'. S.
S'= LI'x y" 6lDCKI k!G (3ETCUEE.iJ-_
--_- TI E..�IJ SO IST ul U•5!g' 60LT�
0
' ' _ ' .� _ 'r" ' � _ .
- 'd i'�� � � I —
--2-r$'sarg
� � � _�,�t�.
�I �
�
`I
I I � ,����f�—
' - c-.r,.. �..-.--�
t �
I i
L _ _
SL• C::2`
�
0
a
�
�,
e'
u
�n
c �
\1
3'
�
v
a:.
�'
�
N'
+ _s�.-�nu�Qr��.-
� -3Z8":=i'_D"=
�
�
,
�
t
' ,UCj�RAI APPftO__ Uq�_ R��Y
-P�18ATE PEiiMITS ARE R_p�l(�ED
FOR E;.EGTAICAL, PLUN,pIP!G,
HEA7t1�f. VEN?u_qTIP�G o�p
REFRi3FRATICP�1 GVi;P,�
'- -----"-�'
j' �7•�_'n�} -V.
lt���
rr;s r�;;��;���� �;usr acccrr���
— t?l. +MS?EC�Iu"a: :��Qi;ES1� .Y
vea �,ra;sc� .:•Nea[ �Et�sovs c�
EM1�PIi:M'�D. 4l" SUG"ui51 1NAT �° BE
C,kLIFCAiv:A 0I495i0v �' y_ . siHiE Or
BE COf:SUC!"^ 'F�nISaFEiY
flE�11H5LtE�'� , R AGGITIUNAI
� .2C/J �LZLEU/�T/O,(:f=
.�8�._�_o�,_
t
r-
___ _____" —____T_____
i
�- -- - � - - -�
�l ,
� I
____� ��
. �
I
�
NAL ONLY ��
�
\
`� — —
�TflUCTURAI APPRO
I SEPA9ATE FERMITS ARE R:QUTAEO
' FOR ELEGiRiCAI. PLUMOING.
rEA.TItrG. VENTI!.4TiNG A�G
� 'iEFRiGERATiQN !NOk<<
_.�.—�
i
�} . �/. f
I f"�'NfLLu1i 'it _ t f
'
THIS Piuia:8Ea i',SL'.;T >�r(:."; `". ,,; ! ;
Q�! I(ti'.ipEuTliJ�'d ti�;li.Ji-.:�c � 7
__.-�� �
FOR B�A�UINli� vvkERk ?EFcONS AFE T� I
Eh1PL0YED. �;'E StiG6ES1� itlAT iHc SiA�f pP (�
CALfFO�VIA C7141510M1 U'r INDUSI�fliAl sAt''f'r
BE COi,SULTED fOF AGOiTIUNAL
HEQt11REAiENTS.
� i
O
�a
-2�0.� AL-%�/.._.-
'��Pi'" �� Or
'��„J (�La.V �\��� ADD�ieant to till in all ipaces exceD� �nose within �eavy CorEer lines anE si9n all appropriate Oeclarations. _
- 9
CITY OF COSTA MESA . CO STRU TION PERMIT PERMIT N �R� CQT NO. LOT NO. � UNIT NO.
- / o o S `I ��� loc• ��' o2�/y/rr✓ 3(� 7435 8/30/�4 la -o'='
Project Address . �
V C Q � h :' TYPE OF CONSTRUCTION NEW ADD ALTERATION RE� I R � �
ApplicanYs Mailin aA-ddress p � r �7
��1N7G/J I"4CRSG �c�i C i r � CON�I/ERSION ❑ DEMOLISH ❑ OT R A.P. # � � � 3 / '�� �j . Zone
, � Owner'sNam^ � Phone L . .
DESCRIPTION OF WORK/USE OF BLDG.
Addreu � rn4C V � � Z S Main Building: Accessory Building:,�LO
ft'1 Arch/Eng. � 'tT`/� Licen No. - TVPE OF PERMIT GRADING FOUNDATION ❑ STRUCTURAL .. T Front �� /�� �p lOZ Q
W � � SK✓F�V�C Ci• �Vily�� ❑ TENANT ❑ ELECTRICAL ❑ PLUM6ING ❑ MECHANIGAL , A Rear ' � N
� Add�255 —�� � ❑ �OTHER - �
T Contractor'sName' � � _Phone��� • - C Righ� � �' 3� N
V PROJECT DESCRIPTION 5Q. Fr. ocCUPnNCv
� Address (mailing) � �� • ��'�'-� ���"� ` � � Q, K � , G
CONSTRUCTIONTVPE VALUATION$ I � g Left I 0 P
� City �iCense No. - pO�Qi ZONE � GRADING CU. VDS. ACRES E
LICENSED CONTRACTOR DECLARATION � ' Ping. R2f. # arking Req./Provided
I hereby at(irm that I am licensetl un�e� pravisions of Charter 9(commencing Remarks: , , Pldnni0g NOt¢5: � � — � M
witb section 7000) of Division 3 of the Business antl Professions Cotle, antl .
�'my license is in I force antl effecL � ' � � , �� �('f� � T
Licens Class "� � Licef�q No.y�,32j� c�Ty�,� . S.
Date �^Zd' S'g t �' ���f��++n.t��li�-�' PLUMBING � FEES — '
WORKERS' COMPE SATION DECLARATION � Be� $ink ShOwE�S
1 hereby affirm that I have a certificate of consent to self-insure or a certificate ' • 6LECTRICAL FEES
oi Workers' Compensation Insurance, or a cer[ifietl copY thereoT (Settian gackflowPreventer Service5ink
38oq �ab. (/ /� Automatic Washer Transformer ❑ 15-50 KW .
aoiicy No. �� w����� S7�1J'Company ��SS '�"� Backflow Irrigation Sewer Ci ' ❑ 50+ KW
P Constructior Pole Sub.
\/ Certifietl copy is be�eby fumishetl. �� ' '
t\ Cer 'fie m ii iletl wich the city euiltlin9 Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
ale � G \ APPlicant�'sc.�4-r�[� VH0.4e.t%�/ �
E%EMP ION FRO WORKERS' COMPENSATION DECLARATI N CI21ifi¢�5 $Old� COII¢Ct0�5 � Di5hwd5hE� M¢L2r ❑Ov2� 100 2mps.
(Thissection neetl not be com0leletl if the permit is for one huntlretl (5100) or � -
less). ' • Dishwasher Solar Piping Dryers �Gas ❑EleMric Sub Panel �
I certify�that in the pertormance of tbe work tor which this petm�t is issuetl, I
shall not employ any person in any manner so,as to become subject to the Drinking Fountains Solar Tank Fan Motors �0-1 HP �7 %- B
Workers' Compensation Laws a� Calitornia. �
oate Signature Floor Drains' Swimming Pool w/Spa F.A.U. . Inc. Solar 09-15 HP �76-15+
NOTIGE: If, after making ihis tleclaration, you shoultl become subject to the ,
Wo�ker5' Compensation provisions o( the Labor Cotle, you must fo�thwitb � FI00� Sinks ' � U�in21 Fixtu�¢5 � �-
comply wittt such provisions or Ihis permlt i shall be tleemetl revoketl. Mic�Owdv2
CONSTRUCTION LENDING AGENCV -�- Gd552rvic¢ ��OutICiS 'WdIE�C1052t D¢viC¢BOx¢5
I he�eby affirm that thete is a construcfion lentling agency fo� the pertormance POI¢ Light
ot the work for which rois permit is issuetl (Section 309� Giv. G.) InterCeptors ' Water Heatet . Outlets • Range
Lender's Name
Lentler's AGaress . Kitchen Sink Water Service i Switches Sign -
OWNER BUILDER DECLAR/ITION .
I hereby atfirm that I am exempt �rom the Contractor's License Law for tne Lavatories Garbage Disposal ' Standing Sections �.
following reason (Section 7031.5 Business antl Protessional Cotle: Any city or �
county which requires a permit to construct, alter, improve, tlemolisn or repair P—Trap '
any structure, prior ro its issuance, also requires the applicant for such permit Generator �0-5 KW �5-15 KW Trash Compacmr
to file a si9netl statement tnat he/she is licensetl pursuant to Ne provisions of 'Roof Drains � '
the Contractor'S License Law (Chapter 9(commencing with Section 7000) of - '
Division 3 ot the Business antl Protessions Cotle) or that he/she is ezempt ,
the�efrom antl the basis for the allegetl exemption. Any violaLon of $ection -
7031.5 by any ap0licant for a permit 5ubject5 fhe applicant to a civil
�nalty of mt more than five huntlretl tlollars ($500�. . . ,
LJ 1, as owner of the propertY or my employees with wages as their sole Fi0in5peCtiOn FBe $15 Issu¢ Fee $''
tompensation, will tlo the work, antl the structure is no[ intentletl or offeretl Reinspection Fee $15 Issue Fee $ 3
for sale (Section 7044, Business antl .Protessional Cotle: The Contractor's . . MECHANICAL FEES '
License Law tloes not apply to un owner of a property who builtls or improves DEVELOPMENT SERVICES REQUIREM NTS: /
thereon, antl who tloes such wotk himself/henelf pr throu9h M1is o� her own � �� /�� ,
employees, provitletl [hat such improvements are noi intentletl or offeretl for BOile� HoOd O� Type 1 ❑
Zoning Approved By � Date
sale. If, howeve�, the builtling cr improvement i5 soltl within one year of com- Cd00py TypC I I ❑ � �
pletion, tne owner will have Ihe burtlen of provinq M1e/she tlitl not builtl or im- DuCt - Und2� i�iroUnd Bpilding Appfov¢d By DetB
�ove for the pu�pose ot sale). � � n
I, as owner of the property, am exclusively contracting with licensetl con- Duct - SLfuctu�21 flCfligElatiOn $y5t¢T AppliCdtiOn ISSUBd By Ddt �
{IdCLO(SLO COOSI(UCi i11C pYOjECi ($CCSIOf1 JOA4� BI1510M5 dlld PIOfE55I005 COGE:
The Contrac[or's.License Law �3oes not apply to an owner of property who Duct- Ventilating . ❑0-100,OOOBTU ❑100,000 BTU , SUMMARV OF FEES
builtls o� improves [hereon, antl who cont�acts for such projects with a con- '
lractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ MWtiple ❑ System Repair/Alteration � BUILDING PERMIT $ ��•� SMIP $ •�0
prooi of their Wo�ker's Compenzation insurance shoultl be provitletl to me. PLAN CHECK � '$ y2'3� PERMIT
❑ I am exempt untler Section B. & P. C. for this reason FirepVFact. Blt. ICBO # P�UMBING $ �SSUANCE $
Date Owner Heating Sys[em & Ducting PLAN CHECK 25% $ ENERGV P.C. $
I hereby certity mat I have reatl rnis appiication and state that the above ❑0-100,OOOBTU �100,OOOBT � ELECTRICAL $ GRADING $
information is correcL I agree to comply wiih all city antl munty ortlinances -
antl state Iaws relating to builtlin9 construction, antl hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ -
sentatives of [his city to enter n the dbove-m ntionetl property to�
inspection pur /es. � �-�c6 MECHANICAL $ TOTAL FEE $ � 3, S Z
Signature /l �_ XX nate� ,
� peinspection Fea $15 Issue Fee $ 3 PLAN CHECK 25% $
Orivers' License or 55 � .�
CMF 0865-46, rev.4/84 White - Builtling; Canary - Applicanh Pink - Accounting; Goltlenrotl -Assessor �
CONSTRUCTION AND PLANNING .' POOL & SPA
APPFiOVALS - Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole� � 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcemeni �
3. Electrical Conduit Utility-Undrgmd.. 54. Forms '
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding .� _ '
•5. Steel Reinforcement � � y (i 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. � � 57. APPROVAL TO COVER-GUNITE
�- 7. Footings � v 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 �
71. Properiy Sewer Line & House Connection 62. Backwash & Receptor-Final • �
12. Sewer Cap 63. Heater & Vent-Final '
73. Roof Drains• . 64: Plumbing System - Final '
14. Rough Plumbing 65. Electrical-Final �
15: Rough Electrical-Conduit 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FtRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit # ,
21. Ducts, in Structure � � 70. Underground Hydro
2?. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72.� Underground Flush
2. Roof Framiny 73. Undergmd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing - 74. Overhead Hydro � �
26. T-Bar Ceiling (Structural) & Monowat � 75. Dry Chemical
27. Frame and Flashing - 76. Dry Standpipe ,
28. Lathing & SiUing 77. FIXED SYSTEM FINAL
29. Insulation � � 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. PlasterBrown Coat 79. FINAL INSPECTION
32. Electrical Power MeterFinal 80. FOOD CERTIFICATE ISSUED - �
33. Final Electric Notes: � �a /d
34. Final Heating & Air Conditioning ,
35. Final Gas Pipe-Test .
36. Hood or Canqpy �
37. Final Factory Fireplace
38. Final Plumbing � - .
39. Water Service-Final . ' .
40. Gas Service-Final . �
4t. Solar pomestic-Final' ,
42. Backflow Preventer � '
43. Backflow Irrigation: _ � . _
44. Landscape Irrigation System � �
45. Sound Attenuation �
46. Handicap Regulations � � �
47. FINAL STRUCTURE & BUILDING b 8 8'j
48. Special Requirements Completed , .
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co . �
51. CERTIFICATE OF OCCUPANCY �
No. Date
� • �
���13C�'91RA1 AFr�b'J�;i �i;�i�1 �
y� ^ /� �r..�'� t
(i��li(`�tlr,y� ¢-.�i�,4r f � _ :r�� !i'�
¢4� b�.L1��..I.•.. . � .
���n��..n ._ ... . . _ ..�1
11vL.. y . - ♦
i:ki'�i� _.. . . t
� n i��'�7Z f�_�1��_
� fiF.�� .,�, •_i ' :���.;PH�;Y
� j Al � I,.�, (' •,: � 3 STS
t �' _ ..�,;ftcT9
; P� _. . _ ltiii 11fi
S'�Tc C� StJ:V' Q�
� I�ID'JS���l.� o _ .::1LTED FQ3
ADD;T�QirAl ���141..EMefv�S:
�'�
��`�� .
�; ��
�
�
d
TYPICAL 6�� CONCRETE BLOCK FEiVCE
Cement Copi�g Optional ��
Channel Block With O� ?�8���
Horizoetal Top of eU �
Fences
For Fenees 5' or Less �
Vert. Bars 3/8'� at 4' •0" O.C. —
For Fences Higher Than 5'
Vert. Ban 3/8'� at 32" O.C.
fill Cells Solid With Grout
Where Steel Occurs
Reinforcing Steel.Shall
Con(o�m to See.A-15-39
A.S.T.M.
All Steel to be Lapped C '� �
Ib " or to Code
NATURALGRADE
eO �I.ed
TWO 3/8^ BARS D
CONTINUOUSTOP �
8i 90TTOM � � �
O.
�
o �O e
z
�
u
W
x
z
�
0
�
a
—WID7
SEE CI
BE LO W
FOOTING REQUIREMENTS
GENERAL- NOTES
MORTAR: One Part Plaatit Cemflnt, and
Thret Parfs Sand
GROUT: One Porf Cement Tlvee and
One Holf Parts S�and
COPING: One Parf Cement, Three
Parfs Sand
CONCRETE: Weil Mixed I: 2� : 3%2
Mak. of 7%2 Gollons of
Wafer Per Sack of Cement
CROUT MAV BE POUHED FROM THE TOP
OFTHEFENCE
CELLS AND AREAS OF HOR120NTAL REIN-
FORCEMENT SHALL BE CLEAR, CLEAN &
FREE OF ALL MORTAR DEBRIS, ETC.
BONDS SMALL BE PROV�pED BV LAYINC
BIOCKS IN STRETCHER COUHSES SO THAT
VERTICALJOINTSALTERNATEINEACH
COURSE.
fH OF E4RTMTCOTH
i/3 THE HEIG7H OF FENCE
BELOW BOTTOM OF FOOTING.
SCALE: I/2° = I'
WALL HEIGHT 6� 5� � 4� 3�
WIDTH OF FOOI�NG I4'� 14" 12" 12"
THICKNESS OFFOOTING Ip" IO" 9` g"
DEPTH OF EARTHTOOTH 24'� 20" 16" 12"
SPACING OF EARTHTOOTH 12� 14� 16� I6�
OWNERS NAME: _ _ _ _ _
_ _ — _ _ _ _ — _
C� 1 y � I V�51 �.1 Mesa, California �OB AODRESS: _ _ _ _ _ _ _ _ _ _ _ _ _ _
Buiiding Department ` � � '
i ---; ��
-��/
!�^fiL�°JvLS
CML ENGINEERS, INC.
PROJECT -�����, 110 ��D' I CALC. BY pG� �
�V
CHELKED BY 12 � y
JOB N0. ��� z�g DATE � 29I� PAGE � OF �
� �� G�� �. � f k ,
�� h��d �io;Njs
�o7'E .'
"Ga?.?�/ 9�OC/J�P� �7�� GG'/�s'
/
�'s= 2o,oa��s�' (�AsT�I,�Gis�r��e�o�
ls - /S�g'i
U = /oo/�s�'
fE' = ZOOO�Si�� ����
u�;Hd. is'`/�6'
�.f:�= Qo��f'.
Or/E2jU.E'/✓/iUG '
N= /s x G = 90'�
i
Mar = 90 x �'= 270 �
/ZF>/ST/NG . �
/! u>a //= qox 6 = z8o �
i
tiltca��- Z£30x. 58 = /G7.1/'�
}�j�,/,i�_ isox./•Sx/.i7-2�3�`
��,
/L�Fa��il��_ 2�03 �x. D..�3 = /52.7
�Eqr/G� = 30x?SZ = �J3.7�`
a �
�Porf�i = 93• 7 x � �2 s� _ /SG . / �
��ff= ZBO f 2G3 � 93, T= G3G • 7'�
c-M= �1�Z�41�s2.7-��Sl.�_- q7�2.��
I
A
S�IFETY/�ACTo,�/,E.��i/.1�7 O;/E�jC(.P.U/�tJC
FS; = 47/.2 /2�0 = /. 7S �/ Ox
u/ALL UE5/G.t/
1�`= 90 '� �1;, � �
r'rqy = C �O
,�S = o.o7S (��C� �Z'' o. �� d= 3 �i
f� - 14�i z>�s,re7 = i�ts > zsz� ok,�
l3 2�
C� _
U =
yo
/Zh ,87x 3
�o
/.Sx •87s 3
: Z,$ %� /S� 6�
= z3 Cloo b/co�