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Home My WebLink About3404 LAVENDER LN - Building PermitsAOPlicant to /711 In all soaces except ehose within heavy border lines antl sign all aoorovriate tleclaratlons. CITY.GFCOSTF�MESA PLAN 4 Elev. BR �CC)NSTfiUCTION PERMIT LOT 19 ProjectAt+,dress ��LO4 I avPnder Lane Costa Mesa Applicant's Mailing Address �.�� Owner'sName Cfan.l�v�rl_parifir fnrn PhonedQf+_�7F� Address � ��G_�_�w_;�.,_„a•� M��-+h Rl ��.1 Arch/Eng. n��p�s�{��ree�er License No. '��Q$� Address' �"1 f';�-�lo T.-..;.. �-, 9�1 �k�'— P-a: �—o�,-� �,—. , . „Te Contractoi's Nam�S�ee gwner Phone Address (mailing) C�-C City License No. �� 7 � LICENSED CONTRACTOR DECLARATION 1 hereby aftirm that I am licensetl untler provi51on5 ot Chdrt¢r 9(commencing with 52ctIOn ]000) Of DIvISiOn 3 O7 [h¢ Buslness antl PrOf¢SSIOns CO�e, antl my license is in tull tor<e and ette<t. - 24gn42 L7cense Class - � ns Date �_� � i �_o� Si9natu � WORKERS' COMGENSATION DECLA0.ATION I hereby aftirm that I have a certifitate ot consent to self-inswe or a certiflcvte of Workers' Compen5ation Insurance, or a certlfietl �topy�thereof (Settlon 3800, Ldb. C. aon�v No. Wa-$4-97�-85F comPa�v.Ft'P111011Y.__L[1112111117_t.y_ Certifietl capy is heroby furnishetl'. ' Certifietl copy i5 filetl with the city Builtling Dlvision. Date 19�w_1G_AZ APPlicant�{,��(��j.f�G EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl not be tomD�etatl If the permlt Is tor one huntlrnd (SS00) or less) , � I ceHify tnat in the performance ofthe work for which thiz perm�t is issuetl I shall not employ any pnrson in any mannerso as to become subjec[ to t{te Workers' Compensation Laws of Califomia. - Date �i9na[ure NOTICE: If, after makln9 this tleclaratlon, you shoultl become subject to the Workers' Compensatlon provisions ot the labor Cotle, you must forthwith comply with such �proviAons or thls perml[ shall be tlaemetl revokee. CONSTRUCTION LENDING AGENCV I hereby df�irm that there Is a const�uction Ientling aqency tOr tne pe�fo�mance of the 'work /or whlch thi5 permit is � ISSuatl (SecHan, 3097 Civ. CJ Lentler's Name � . � Lentler's Atltlress OWNER BVILOER DECIARATION I herebv. atfirm that I am ex¢mot irom the Contractor•s Licensu L.aw for tne sa 's LJcense Law (cnapier 9(<ommentlng witn�50cUon )000) or the Business an0 Profe55ion5 Cotle) or that he/she is exempt the basis for the alle9etl exemptlon. Any violation of Section y applican[ tor a parmit'subjects �tha appllcant to a civil more tM1an five nuntlretl tlollars ($500). ' � r of the Oroperty �or�my employoes with �vaqas as their sole will tlo the work�, antl the structure is not Intan4eA or offeretl an owne� o� a p�ope��y wno ou�ias o� rork hlmself/hersolf or through his oi imorovements are not intentletl or o sa�e, tt, nowever, tne bWltling o� Improvemen[ I5 so10 within Ono yeaLot com- pletion, the owner wlll have the burtlon ot proving he/she tlid not builtl or im- ��ove to� the pu�pose of Sale). I, as owner of the property, am exclusively con[ractin9 w��h Ilcensetl con- tractors to construct Ne project (Sectlon 7044, Buslness antl Protosslont Cotla: The Conlractor's License Law does not appty [o an owner of property who builtls or ImOroves [he�eon, antl who contracts for such pro�ects wlth a con- tractor(s) license pursuant to the Contractor's License Law). ❑ I am exempt untler Section B. & P. C. for this reason Date Owner 1 hereby certify that I have reatl thls appiicatlon antl state tnat the abova information is corrett. I aqree to comply with all Uty antl county or0lnances antl state laws relating to building construction, antl hereby au[hori e repra- sentatives ojJ�s cit to��¢¢¢ nter pon the above-menUonatl g( o rtyJ or insoectlon/fu�� % f�/� 5iqnacure - � Da[B �" �W TVPE OFCONSTRUCTION L�NEW IJ ADO U ALTERATION LIREPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p,*. L��L � DESCRIPTION OF WORK - S Main Building: TYPE OF PERMIT GRADING ❑ FOUNDATION ❑ STRVCTURAL T FrOnt �Ji y ❑ TENANT ❑ EIECTRICAL ❑ PLUMBING O MECHANICAL A Rear � ❑ OTHER ' � PROJECT DESCRIPTION 5�. Fr. oCCVPANCv C Right K Left CONSTRUCTIONTYPE VAIUATIONS �%n�RCl4 $ �� ZONE GFADING GU.YDS. ACRES Ping. Ref. # ZE Remarks: � � C Parking Req./Providi , Use of Building: � PLUMBING FEES Planning No[es: Bar Sink Backflow Preventer Backflow Irr:gation Ba[htubs Clarifiers DiShvaasher Drinking Fountains Floor �roins ' Floar Sinks � Gas Service Outlets Interceptors � Kitchen Sink Lavatories P-Trap Roof Orains � Reinspection�Fea $25 Boiler Duct- Under Ground Duct - Structural Duct - Ventilating ExheustSystem ❑ Multiple Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ a� oo,000 eru O i oo,00a Drivers' License or 55 � I I Reinspeetion Fee I $25 CMF0865-46rev.7/83 White-Builtling;Canary-Applicant;Pink-A<countin9:Goltlenrotl-Assessor Showers . Service Sink Sewer Cap Sewer=Connectiort. Solar,Collectors�, Solar Piping - Solai�Tank � Swimming Pool'w/Spa Water Claset Water Heater Water Service i Issue Fee . ' � $ 3 Hoodor Typel ❑ Canopy Typell ❑ Refrigeration System ❑o-ioo,oaosru ❑ioo,000 System Repair/Alteration Issue Fee Au[omatic Washer Construction Pole Cooking Unit � � Dishwasher � Fan ' F.A.U.' Outlets 51 58 �/f] � /B4 Zone ELECTRICAL +-., . Transformer ❑ 15�50 KW ❑ 50+^KW Meter ❑up�to 100 amps _ Meter ❑over700amps. � lectric Sub Panel � • Motor5O0.1HPO1X-8 ' Inc.Solar �9-15 HP �16-15+ � Microwave Pole light Garbage Disposal Generator �0.5 KW 05-15 0 � Reinspection Fee � FEES PUBLIC SERVICES REQUI ZoninB ApPioved BY— APPlicdtion Approved BY _ 'APDlication IssUed By— $ 3 ' BUILDING PERMIT � ;PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL �PLAN CHECK MECHANICAL PtAN CHECK Standing Sections Trash Compactor luue Fee �7�'ou:; i 0 $ 3 Z O N I N c R E � U 1 R E N E N T SUMMARV OF FEES . $ G$�_�n SMIP $ R_QFi $ �7 ,�o.�,R RQ pERMIT $ ISSUANCE $ S ENERG� P.C. $ 5 GRADING $ $ MICROFILM $ $ TOTALFEE $ ��- $ �' P� _ _ & SPA ,'CONSTRUCTION AND PLANNING APPROVALS Permit# � Date Inspector AppROVALS Permit# " Date Inspector . �.1. Temporary Electrical'Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement �= 3. Electrical Conduit Utility,: Undrgrnd. 54. Forms � 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding , 5. Steel Reinforcement �' � 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. � p 57. APPROVAL TO COVER�GUNITE ��` � 7. Footings ' 58. Electrical Conduii-Undrgrnd. � 8: Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, O Undrgrnd. � 10. Structural Floor System 61. APPROVAL TO DECK � ` 11. Property Sewer Lirie & House Connection 62. Backwash & Receptor-Final 72. Sewer Cap 63. Heater & Vent-Final � � 13. Roof Drains ' 64. Plumbing System - Final � 14. Rough Plumbing 65. Electrical-Final 15. Rough Electriral-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. 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 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing ,� g� 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ,27. Frame and Flashing �L 76. Dry Scandpipe 28. � Lathing & Siding ..• 77. FIXED SYSTEM FINAL 29. Insulation (�� b // C-- 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: /� �� a 34. Final Heating & Air Conditioning � ' � i 35. Final Gas Pipe-Test - � �5�� ,yd�� .�. � � � i 36. Hood or Canopy !� �D �_ 37. Final Factory Fireplace � 38. Final Plumbing . , 39. Water Service-Final � • . 40. Gas Service-Final � 41. Solar pomesticFinal ; . . ' • 42. Backflow Preventer � 43. Backflow Irrigation � 44. .Landscape Irrigation System � 45. Sound Attenuation � 46. Handicap Regulations . . • � . 47. FINAL STRUCTURE & BUILDING tL V�/ � 48. Special Requirements Completed � � � 49. Electric Release to Edison • - . � 50. Gas Release to Southern California Gas Co � . 51. CERTIFICATE OF OCCUPANCY � No. Date �- /% ��D�� y� Applicant to fill in all spaces exce� ithi neavy bortler li s an sig all appro0riate Ceclarations. � MIT PERMIT NQ� �� TRACT NO. LOT NO. UNIT NO. CITY OF COSTA M�E/n$As/ STRU TIO R ProjectAddress -�'�/r�� Applicant's M�ai�in//Y A��d�dr�e�,g� �/� Owner's �Naj � ��L�iW�A ��C+ /� Phone q' �� Addre� T(��`�% 17� / //�'G� �%% � Arch/Eng. License No. Address Convacto 's Nan � �ql D hon � Address Imailing) ✓ � � CityLicenseNo. ��' � LICENSED CONTRACTOH DECLARATION I hereby affi�m that I am licensetl untler Orovi5ion5 ot Charte��9 (commencing with section ]000) 01 Division 3 ot [he Buslne5s antl Profes lons Cotle, antl my license is in (ull ce a tiect. f Lice , ss �• Li n e o Oa[e Si9nature WORKERS' CO PENSATION DECLARATION 1 hereby atfirm that I have a certi/icate ot consent lo selt-inzure or a certtflGate ot Worke�s' ompen5ation InsuranGq o� a certltietl copY thereof (5¢CUon 3800, Lab. ,3� ��JJ(�j1 Policy No. �% LLL_� Company C rtitied wDY is her¢by fumishetl. er ' IeU coDY is til with fhe c' iltlb �/Isi�n. /�� Daten�a� APPIicaG�i�f��//• {�A �Fif EXE PTION FRO��LWORKERS' rOMPENSATION OECLARATION (TOis seclion neetl not be compleletl il [he permit 6 for one huntlretl (5100� or lesz7. I certify thal in the Derlo�mance of lh¢ work fOr which [his pe�m�t i5 i55uetl, I snall not employ any pe�son in any manner so as to become Subject to the Workers' Compensalion LawS of Calitomia. Date Signature NOTICE: It, after making this tlecla�ation, you Shoultl become subject t0 th¢ Workers' Compensation Provisions ot the LabOr Cotle, you musl forthwith compry with such provisions or [his permit shall be tleemetl revoked. CONSTRVCTION LENDING AGENCV 1 hereby attirm that Ihere is a construction lentlin9 agency tor ihe pertormance af the work for which tM1is p¢rmit is I55ueC (SeCtion 3097 Civ. C.) Lentler'z Name Lentler•s FOtlress OWNER BUILDER DECLARATION I hereby affirm lhat I am exempt irom Ne Con[ractor's LiG¢nse Law for Ihe following reason (Section �031.5 Business ane Professional Cotle: Any city or munty which requi�es a p¢rmit to cons[�uct, alleq improvo, tlemolish o� repair any sVucture, prbr to its issuance, also reqWres the applicant tor such permit to file a signetl statemenl t�at he/she is IicenS¢tl Pu�suant t0 the piovi5ion5 ot the ConVacror'S License Law (Cnapter 9(tommencin9 with SecHon ]000) of Division 3 of the Business antl Protes5ions Cotle) or that ne�sne is exempt Iherefrom antl th¢ basis tor (h¢ allegetl exemption. Any violalion of $ecHon 7031.5 by any applicant ror a permit subjecls [ne applican[ to a civil �eenalry of not more than five huntlretl tlollars (5500). LJ I, as owner of ihe property or my employees with wa9es as their sole comoensation, will tlo the work, antl the structure is not intentletl or offered tor sale (Set[ion 70G4, Business antl P�ofe55ianal Cotle: The Contractor'S Licenze Ldw tloez not apply to an owner of a property who builtls or Improves [hereon, antl who tloes such work f11T5C1f/h¢I5211 M througb hiz or her own employees, providetl that such imorovemenis are not intenaetl or otteretl tor sale. If, however, the builtlinq cr improvement is soltl wlthin one year ot com- Dletion, the owner will have tne bu�tlen O� Proving he/She tlitl not builtl o� im- �ove fo� lhe purpose ot sale). LI I, as owner oi the proverty, am exclusively contracting wlth licensetl mn- IfdCSO15 f0 COfISLfUCI IhC p�Oj2CL ($CLLIOO %�44� BUSI0055 dOd PfOIC551005 COCB: The ConVactoYs Li<ense Law tloes mt apo�Y to an owner ot property who builtls or improves lhereon, antl wM10 contracts Por such projects with a con- Vacto�(51 license pursuant�to ttle�Contrac[or's LicenSe Law). I am aware that proof of their Wo�ker's Compensation in5uranCe shoultl be provltlEtl to me. ❑ I�am exempt unGer Section B. & P. C. lo� thi5 reason Date Owner I hereby certify thal I have r¢atl inPormation �s cor ect. I agree to � antl sta[e laws re ting to buil0in5 sentatives of h' i to enter inspection pur l Signature Oriv2rs' Licens¢ or 55 � t Uon antl stata that the above all city antl county ortlinanCes i. antl herebv authorize reore- TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION LJ-REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q_p, # DESCRIPTION OF WORK/USE OF BLDG. S Main Buildi TYPEOFPERMIT\ GRADING FOVNDATION ❑STRUCTVRAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL A Rear ❑ �OTHER C Right PROJECT DESCRIPTION S�.F7. oGcuPANCv K CONSTRVCTIONTVPE VALUATIONS S Left � ZONE GRAOING CU. VDS. ACRES P�ng. Ref. # Remarks: � � ��n_ Planning Notes: Sink Preventer Irrigation athtuhs Drinking Fountains Floor Drains F loor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Feinspection Fea $15 Duct - Under Ground Duct � Strucmral Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact Blt. IC80 # Heating System & Ducting ❑ 4100,000 BTU � 7 00,000 BT Reinspection Fee � $15 CMF 0865-46, rev.4/84 Wbi[e - Builtling; Canary - Applicant; Plnk - Accountlng; Goltlenrotl -Assessor Showers Service Sink Sewer Cap Sewer Connection Solar,Col lectors Solar Piping Solar Tank� Swimming Pool w/Spa Urinal � Water Closet � Water Heater Water Service � laue Fee Hood or Typel ❑ Canopy Type 11 ❑ Refrigeretion Sys[em ❑o-iao,000eru ❑ioo,000 System Repair/Alteration Issue Fee FEES Zone Accessory Building: Parking Req./Provided ELECTRICAL Automatic Washer Transformer ❑ 15-50 KW Construction Pole Sub. � 50+ KW Cooking Unit Meter ❑up ro 100amps Dishwasher Meter ❑over100amps Dryers �Gas ❑Electric Sub Panel Fan Motors �0-1 HP 01 h� 6 F.A.U. Inc.Solar �9-15 HP �16-75+ Fixwres � Microwave Device Boxes Pole Light Outlets Switches Garbage Dispoul Generamr �0-5 KW �5�75 KW Sign Standing Sec[ions Trash Compactor � $� Rainspection Fee $15 Issue Fae FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Aooliqtion luued Bv � $ 3 SUMMARV OF FEES ' BUILDING PERMIT $ SMIP � $ PLAN CHECK $ PERMIT PLUMBIN $ �^ PLAN C CK % $ r ELECTRI L $ � G�� PLAN CHECK 50% $ �MICROFILM $ MECHANICAL $ TOTAL FEE $ PLAN CHECK 25% $ FEES $ 3 Z O N I N G R E Q M T S. CONSTRUCTION AND PLANNING POuL & SPA Date Inspector Date Inspector APPROVALS Permit # APPROVALS Permit # �1. Temporacy 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, 0 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 Electric Wiring 67. Fencing & Access Approval 17�. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating , 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test - 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank �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 � �7idct (,�/J 36. Hood or Canopy � � 37. Final Factory Fireplace 38. Final Plumbing /��o( ,[�� ' 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.. Electrie Release to Edison � 50. Gas Release to Southem Califomia Gas Co �- 51. CERTIFICATE OF OCCUPANCY � No. Date ,(��/ . _ . Aoolleant to fill in all spaces axcept tnose within neavy GorEer Ilnes anE sign all aDV�opriate tleclaretions. �V . CIT:Y F COSfA�MESP,i,.� .�� PERMIT NO. TRACT N0. LOT NO. BLD . CON�TI#UCT�ON PERMIT ' � ' ProjeCt Address - • TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR Applicent'SMeirl-l��ng Ad tE55. - ❑ CONVERSION ❑ DEM LISH ❑ OTHER � �q,p, # OWner'S N2ma .��a PhOnES''I� DESCRIPTION OF.WORK ' � - `^. .� S Main Buildin9 Addreu 1�� Yv�- ��-� TYPEOFPERMIT GRADIN FOUNDATION STRUCTVRA� T Front � Aroh/Eng. -, Lic2nse No. ❑ TENANT 0 ELECTRICAL LUMBING ❑ MECHANICAL B Rear AtJdl255 ❑ �OTHER � A Contracto 's Na '�I ' P_ho e.�� Adtlress (ma'i��'� �L.�l �i �s . � .,�.... ,� � � -t �iw -s., Ciry License No LICENSEO CONTRACTOR DECLARATION I nere�y affirm that I am Iicensetl untler provislons of C arter 9(commencing wlth 5ectlon 7000) of �ivlsion 3 of the Buslness antl oTesslons Cotle, antl my Iicanse i5 in ful force antl eff t. ' Llcense Class Licanse o.�� Date ^ Signature � WOfiKERS'COMPENSATION DECLARATION I hereby afflrm that 1 have a certlfltate of con5ant to self-insure or a<ertiflcate of Workers' Compensation Insurance, or a certifletl. copy thersof (Saction, ao��r no. ��7 c51 n q�47@omaa�v S. �.�� :� �Certlfietl copy is heraby furnlzhed. ' er i'tl < p i letl wlth tha Fit Iltl�$� vlsion. ��1-�.��— APPIi<ant� JLi�C�c.�-�'LAr'�'�� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION � (This section neetl nat be completetl it the permit I5 for one huntlretl (5300) or lessl. ... . ' . . I certify that in the Oertormance of the work tov which this perm�t is issuetl I sM1all not employ any person in any manner so as to become subJect to t�e Workers' Compen5ation Laws of California. Date Si9nature NOTICE: If,iafter making this tlaclaration, you snoultl become sub7ect to the Workers' Compensatlon Orovlslons ot the Labor Cotla, you must torthwlth� comply with such provislons or.Ihis permit shall be tleemetl revoketl. CONSTRUCTION�LEN�ING AGENCV 1 hereby aftlrm that there is a constructlon lentling agen<y tor the performance . of t�e work tor which this permit I5 Issuetl (Section 3097 Civ. C.) Lentler's Name tander's Atltlress� OWNER BUILDER DECI.ARATION� I hereby atfirm tnat I am exempt /rom the'Contractor's Licensa Law for tha o tile a slgnetl sta ne Contvactor'S L JIVISion 3 of the ihereiroT dnA ihf 7031.5 by any a �enalty oi not moi 1, as owner o1 compensatlon wiU for sale (Sec�lon LI[ense Law tloes e allegetl exemptlon. Any violacion oT Sectlon a permit subjects the applicant [o a� dvil untlretl tlollars ($500). - � ty or my emplOyeeS with wages as thelr 5ole k, antl ihe structure Is not Intantletl or offeretl ess antl Professional Cotle: The Contractor's an owner of a D�operry wM10 �bulitls or Improves or the iot intenaetl or otferetl far � Htl wi[hln ona year of com- he/she Oltl not builtl or Im- itracting�with Iicensetl con- ine55 antl Profes5ions Cotle: an owner of property who r suth pro)ec[s with a con- isa Law). LJ l am ezempt untler Sectlon B. & P. C. tor Ihis reason Date Ownet� I hereby certify that I hava reatl thls applicatlon antl 5tate that the above' Informatlon I5 correct. I agree to comply wlth all <ity antl <ounty ortlinances antl state laws relating to bulltlln9 �onstructlon, antl haraby authoriza repre- santatives of thls clty to enter. upon che above-mentionetl pr pe for Inspettion pur e5. � PROJECT DESCRIPTION 5�: FT. oCCUaANCv - C Right K Left �CONSTRUCTIONTYPE VALUATION$ $ 20NE GRADINGCU.VDS. ACRES PIng.Ref.# Remarks: .�%j //.�/ � � � Parking Req./Prov Sink Preventer Irrigation Dishwasher Drinking Fountains Floor Drains FloorSinks �' Gas Service Outlets Interceptors � Kitchen Sink . Lavatories P-Trap . . Roof Drains Fea � $25 Duct- Under Ground Duct-Strucmrel , Duct _Ventilating " Exhaust System ❑ Multiple ❑ F irepV Fact. Blt. I CB O# Heating System & Ducting ❑0.700,000 BTU �0100,000 BT Slgnature » Date Reinspection Fae §Z5 Drivers' License or�55 � CMF 0865-46 rav. 12/83 Wnite - Builtling; Cana�y - AP�Iiwnt; Pink - A<counting; Goltlenrotl - Assessor FEES Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater WaterService ' laue Fee - $ 3 IANICAL . FEES Hood or Type I ❑ , ' Canopy Typell ❑ ; i iefrigeration System 70-100,000 BTU ❑100,000 BTU System Repair/Alteration -- laue Fea � $ 3 Planning Notes: Automatic Washer Construction Pole Su Cooking Unit ' ' Di'shwasher • Dryers ❑Gas ❑EI� Fan " F.A.U. Fixtures Device Boxes Outlets Switches . - Garbage Dispoul Generator �0.5 KW � 5759,'3/09/B4 " ' Zone : . - Accessory Building: � Park. Fees $ 38.00 TI, 2 O N I ' N G • R E Q U 1 R E M ' N T ELECTRICAL � Trensformer ❑ 15-50 KW ❑ 50+KW Meter �up to 100 amps ' Merer ❑over100amps Sub Panel Motors 00-1 HP �1 %- B Inc. Solar 09-15 HP �16-15+ ' Microwave � Pole Light Range �Sign' ' Standing Sections 5 KW Trash Compacmr I Reinspection Fee I$25 � �ssue Fee PUBLIC SERVICES RE�UIREMENTS: Zoning Approved 6y Building Approved By FEES $ 3 SUMMARV OF FEES • - BUI�DING PERMIT $ SMIP � $ � PLAN CHECK $ �� PERMIT . PLUMBING' '$ r d,— �SSUANCE $ , PLAN CHECK 25% $ �.� ENERGY P.C. $ ELECTRICAL .$ � GRADING - '$ � PLAN CHECK 50% $ ' MICROFILM $ �[� MECHANICAL $ TOTALFEE $ �'_[L PLAN CHECK 25% $ - � � . F�• l` :f ' CONSTRUCTION�.AND.PLANNING ' � PG, _ & SPA - . - - . - - Date Inspector � _ � . -Date � Inspector � � � �-APPROVALS , Permit# APPROVALS Permit# _ �,1�. Temporary Electric8l Service or Pole - . 52.- Pool & Equipment Location . � � ' . • , r. 2. Soil Pipe-Undrgrnd. � Id'� 53. Steel Reinforcement . _ ' " 3' Electrical Conduit Utility-Undrgmd. ��, " 54, Forms ' � � - � _ " � . " 4L Electrical Conduit-Undrgmd. . - . . �� 55.� Electrical Bonding � ' r _ . - ' . '�� . Steel Reinforcement . = 56. Rough Plumbing & Pressure Test ' - - : � 6. Electrical UFER Grnd. ' '� ? 57.. APPROVAL TO COVER-GUNITE . - '� 7. footings' ' � � . . 5S: Electrical.ConBuit-Undrgrnd: � � ' 8. Foundation " 59. Gas Pipe;:O Undrgrnd., Test � - '. ; �` �� - : � 9. Water�Pipe-Undrgmd. . � ' (�0 � 60. Backwash Lines, P-Trap, O Undrgrnd.. . � ' � � � 'r . 10. Structural Floor System ' ' . ' ' 61. APPROVAL TO DECK , • 11. Property.Sewer Line &'House Connection /� � , : . � (o��y � � , 62. Backwash & Receptor-Final . ., �12. Sewer Cap � ,` , _ ' � 63. Heater & Vent-Final - � - r c 13. Roof Drains � 64. Plumbing System - Final . � �� . . 14. Rough Plumbing " S � 7��7�� (�/� 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�Elecirical-T Ba� Ceiling 69. POOUSPA SYSTEMS FINAL � - � 19. Rough Heating & Air Conditioning . , FIRE DEPT. REQUIREMENT - �' �� 20. Rough Factory Fireplace APPROVALS Permit # � ' '., i;� , , , 21. Ducts, in Structure 70. Underground Hydro , _ � 22. Ducts, Ventilating 71. Product Piping OGas.�OOiI � � . „� � ' 23. Gas�Pipe-Rough & Test � 72.;� Underground Flush � � 0 24. Roof Framing � � � 73. Undergrnd.StorageTank �Gas'OrOil ; � � � 25. Roof Sheatfiing � 74. Overhead Hydro , •. � � 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical �� - 27. Frame and Flashing � 76. Dry Standpipe . � _ • ' i � 28. Lathing & Siding , 77. FIXED SYSTEM FINAL ' � � � . 29. dnsulation - ' 78. FIRE PREV. FINAL � � � �30. Drywall Nailing . HEALTH DEPT. REQUIREMENT , � 31. Plaster Brown Coat 79. FINAL INSPECTION � ' � � 32. Electrical Power Meter-Final � �.4' "' 80: �FOOD�CERTIFICATE ISSUED : ' 33. Final Electric ��Notes:�r - � � ' ' . 34. Final Heating & Air Conditioning ' � ' 35. Final Gas Pipe-Test � � �(� � . -� � 36. Hood or Canopy � . � ` ' - - ' � 37. Final Factory Fireplace � � • • ' � . � 38. Final Plumbing . � �� G�(� . - , � � , - " . -. . 39. Water Service;Final , � ' , � � ' 40. Gas Service-Final � �' ' ' ' � 41. Solar porriesticFinal • - - - , . '- ' ' � 'r 42. Backflow Preventer - � _ � � � � � . .. , � 43. Backflow Irrigation . � � , 44. ,Landscape Irrigation SYstem � � � • � � 45. Sound:Attenuation � • ' ' . . � � � � � � . . 46. Handicap Regulations � ' ' ' ' . � � 47. FINALSTRUCTURE&BUILDING � i � 48. Special Requirements Completed . ' • ' - � � � .� 49. Electric Releaseto Edison � ' . - " i - � �- ' ' � ., � 50. Gas Release to Southern California Gas Co ' , � ' � . ;�� 51. CERTIFICATE OF OCCUPANCY � - - - - . - � • ' ' � - ' No. � � ' Date' . , -' -I , � � � ' . J Applicant to iill in all spaces ezceot those within heavy poraer Ilnes anO sign all appropriate aeelarations. Ctrv FGOSTA MESA,- _ 3010 6/27/84 86aG5 '. 9 �� j PERMIT'NO_ � �TRACT NO.- , . LOT Np� , �BLDG. N — , _ `CONSTRUCTION PERMIT ' '�` C �v � / , , ' ' ' . , • Project Address � TYPE OF CONSTRUCTION ' . NEW ADD ALTERATION REPAIR . AppliWnt'SMailingAddlCss 1 ' � � ❑CONVERSION ❑DEMOLISH �OTHER � q;p,# 2one' �� 7 � . '. DESCRIPTION OF WORK $ Main BUilding: � ACCessory BJilding: . - Z Owner'sNameS ��e� - � Address t�1 � . E � . . . O TYPE OF PERMIT GRADING ❑ FOUNDATION STRUCTURAL T Front . N Arch/Eng � License No. ❑ TENANT ❑ EI.EGTRICAL ❑. PLUMBING ❑ MECHANICAL � B .Reaf - ' ' � � " ' ' A _ N Addre55 ❑,�OTHER " ._ . Contrector's m _P e, PROJECT DESCRIPTION 5a. FT. oCCUPaNCY � C Right - -� . � G / K Left I R AddtC55I a� n� /(� / O ��, CONSTRUCTIDNTVPE VALUATION$ S - E ��U � � ZONE , GRAOING CU. V�S. ACRES _ p�n9. Ref. #- Park.Fees $ ' n Ciry License No. U LICENSED CONTRACTOR DECIARATION ` Remarks: � � �S � P3�kinJ REq./P�Ovid2d � � � � � � � �- I herebyaffirm tM1at I am Iicensetl' untler provisions oi Chartec 9(rommencing � ' . R with section 7000 of Division 3 of the Business antl Pr fessio otle antl � � Use of Buildin : — E my Iicense is in I tor ntl efiect. � ��" � QJ.`' � ' � 9 - , License lass - � ' c ns o. PLUMBING FEES Planning Notes: . M �ate � � i9nature . . E WORKERS' COMPENSATION �ECLARATION ' Bd�Siflk i $hOW¢�5 . N 1 hereby aHirm that I have a certificate of consent to selbinsure or a certiticate , . � � . T of Workers' .Compensation. lnsurance, or a certified copy Ihereot_(Sectian . Backflow Preventer Service Sink S 3800, Lab. Q�/��/�/� � : �`/� �UnQ _.BaCkflowlrrigation SewerCap � ..r ELECTRICAL , . FEES Policy No. /�y � Company �'�� _ _ n}�{ �ertitietl copy is nereby tumishetl. Bathtubs � Sewer Connection � j`� • Automatic Washer Transformer ❑ 75-50 KW IFSCertifi tl cq�, I5 f11ey with the city Buil ing i� - � 50�+ KW Date �`��`.T7 ��-Y-f%" qppiicant � ' ' ��arifiers � Solar Collecmrs . Construction Pole Sub. � EXEMPTION FROM WORKERS' COMP N ION,DEGLARATION Dishwa5hef -. Solar Piping ' - - Cookln Unit �, , Metef ❑u Lo 100 am 5 / (This seclion neetl not be completetl if the permit is to� one huntlretl ($300) or � ' ' 9' P P " ' Ie55) I celtify that �in the pelfolmance ot th¢ work fOr which thls perm�t is Issuetl, 1 ' Dflnking FOUn[8105 S013f T2pk Di5hWd5h2f ./ MEt¢f �t10EI 100 dfllp5 shall not employ any person in any manner so as to become subject to.the workers'. Compensation Laws ot California. ' ' . FlOor Drains Swimming Pool w/Spa ' ,Dryers ❑Gas ❑Electric Sub Panel ` ' � Date � Signature ' ' � . � rw�� /' NOTICE: If, afte� making this tleclaration, you ShoUltl becorpe subject to the � FIOOf Si�ks � � Ufine) ' 3 Fan � Motors �0-1 HP �T'/x- 8 . (/ Workers' Compensation provisions-of the Labor Cotle, you must forthwith�- . - compty.with such.provisions or,this permit shall be deemetl revoketl. GasService :(Jutlets WaterClose[ F.A.U. ' InaSolar�9-15HP�16-75+ CONSTRUCTION IENDING.AGEIVCV � ' - _ I hereby atflrml tnat the�e is a const�uction lentling a9enGy for thE pertormance Interceptors '' ' + Water Heater , � Fixtures Microwave � of tM1e work �for which this permit is, issuetl ,(Sectlon 3097 Civ. CJ • Lender•s Name '�� KitchenSink WaterService � ' ' Device6oxes Pole�Light � L.entler's Atltlress ' ' � - OWNER BUILDER DECLARATION. - . . ' - �2v0[Of125 '� � ' ' OutICtS ' / Rd0y2 � �� I he�eby a(fl�m that I am exempt from the Cont�acto�'S License Law for the � . following rea5on (Section 7031.S�Business antl Pro(essional Cotle: Any city or ' P-Tiap' - � ` . Switche5 � . Sign . ' ' county which requires a permitJo construct, alter, improve, tlemolish or'repair . , _- _ . _ ' / a �any structure, prlor lo Its issuance, also requires tne applicanYfor such permit . Roof Drains - �� ' ' �• � � - Garbage Disposal '� Standing Sections to (il¢ a Signetl 5[a[ement that he/she is licensetl pursuant to tha provisionz of . . . the Contractor's License Law (Chapter 9(commencing with Se<tian ]000) ot Genetator �0-5 KW 05-15 KW Trash Com actor ' Division 3 of the Bu5ine55 and Profes5ion5 Cotle) o� that he/she i5 ex¢mpt . " � " � - ' � P tnerefrom antl the' basis for [he allegetl ezemption. Any violation of Section , 7031.5 by any applicant tor a permiC subjects tM1e 'appllcant'to a civil t Reins ection Fee '� enalty of not more than tive huntlretl tlotlars ($500). , - P . � $25 Issue Fee . '$ 3 I, as owner of the property'or my'employees with wages as their sole � Reinspectian Fee $25 Issue Fee $ 3 compensation will. tlo the work, antl the structure is not intentletl or otferetl " MECHANICAL FEES - tor sale, (SecFion 7044, Business and Pro�essional Cotle: The Contractor's ' PUBLIC SERVICES REQUIREMENTS: License Law tloes not apply to an owner ot a propertywho builtls or improves ' .- _ . � � thereon, antl who tloes such work himselt/herselt or through his or her own ; gOilCf ; � . HBOd O�� 'TypE I i �� . � Zoning Approved By � Data ' employees, p�ovitled that such improvements are not Intentletl Or otterea tor � ' Canopy I TypE 11 ❑� � � sale. It, however, the builtling or improvement is soltl within one year of com- Duct - Under Ground � � � - Application Approved By Date ' ' pletion, the owner will have the burden of proving he/she tlid not builtl or im- ' � - � �rove for the purpose of zate). : Duct - Structural . Refrigeration System -' � ' Application Issued By �,� Date__� I, as owner ot the property, am exclusively conbacting with licensetl con- ��-IOO,OOO BTU ❑700,000 BTU ' ' tractors to construct the project (Section 7044, Business antl Protessions Cotle: ' Duct - Ventilating � ' . SUMMARV OF FEES ' . The ContractorY License Law tldes not apply to an owner of proDerty who ' ' builas or improves thereon„antl who contracts for such proiects witn a mn- E�lhaust System 0� MWtiple ❑ System Repaii/Alteretion � BUILDING PERMIT $ SMIP ,$ tractor(s) license oursuant to the Contractor's License Law�. ' ' � , - PLAN CHECK $ PERMIT ❑�I am exempt untler Section B. & P. C. for this reason FirepVFact. Blt. ICBO�# ' , ' p�,UMBING �$ ISSUANCE $ Date - owner' ' Heating System & Ducting ' PLAN CHECK $ ENERGV P.C. �$ I hereby certiry tnat 1 have read this application antl state tnat Ihe above ❑0.100,000 BTU �700,0006T GRADING $ �information Is wrrect. I-agree to compry with all clty antl county ortlinances - — _ � ELECTRICAL $ �i antl sfate Iaws relatin9 to bwltlm9 �onstr tion, antl nereby authonze reDre- . ' - PLAN CHECK $��3�'L'• � MICfiOFILM '$ seni0tives of this i4y tO enter on e above-meniiopetl p/�erty,.tqt , $ ?�-�/ �� inspection purp05 . q �O / d'S� - MECHANICAL � $� TOTAL FEE V'_t� S�gnature _ � Date . . Drivers'�Li cs yi Reinspection Fee �$25 Issue Fee $ 3 PLAN CHECK � ,$ � ' t,imr oom-�/o rev. �/p;� wm[e - tlWlaing; Canary - Hppucani; r�nR -�icwununy: momenruu -Ms�eawr _ , _ . � � . . _ _ _ _ . _ . � � CONSTRUCTIONAND�PLANNING ' POOL&SPA ' APPROVALS Permit # � Date � Inspector qppROVALS Permit # Date Inspector 1� Temporary Electrical Service or Pole : 52. Pool & Equipment Location � 2. Soil Pipe,Undrgrnd. , � � 53. Steel Reinforcement � 3. Electrical Conduit Utility-Undrgrnd. ' , 54. Forms � : 4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding � 5. Steel Reinforcement ' 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grrid. 57. APPROVAL TO COVER-GUNITE �� r 7. 'footings . 58. Electrical Conduit-Undrgrnd. . '�'8. Foundation 59. Gas Pipe, � Undrgrnd., Test ' 9. Water�Pipe-Undrgrnd. � ' 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System � 61. APPROVAL TO DECK 11: Property Sewer Line & House�Connection , 62. Backwash & Receptor-Final '12. Sewer Cap , - 63. Heater & Vent-Final 13. ,Roof Drains 64. Plumbing System - Final 14:.Rough Plumbing � 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar SYstem-Final 16. Rough Electric Wiring �6 C(__, 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 � Gas ❑ 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 (Structural) & Monocoat -, 75. Dry Chemical �,27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Sidin,g 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 /B 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 47. FINALSTRUCTURE&�BUILDING : . 48. Special Requirements Completed ' 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co , � 51. CERTIFICATE OF OCGUPANCY � No. ' - Date � � . - i CITV OF COSTA MES N T Project Addres5 Applicant's Mailing ress Owner's Name Address Arch/Eng. Addreu Contrector's Nam � Address Imailingl ' • City License No. IICENSED CONTRACTOR DECLARAI 1 her¢by aHirm [bat 1 am IiClns¢tl untler wilh Section ]000) of Oivlsion 3 of th� my Ilcensejs in jWl�}o�ppa ei�ect. _, WORKERS I hereby at1 oi Worke�s 3800, Lab. Policy No. Certitie� Cert�� IUCT ON PfRMIT C Pho —Licenu No. � one � ON rovisions o1 Charter 9 (d 6usiness antl PrOfeSsions Si9n8Wre � iMG NSATION DECLARATIO (hal I have a certificate o/ consent >mpensatiOn Insu�ance, or a Cert �1T/ COmpany �urni5hetl. 'Rh the city Bw Rg APPliwnt / 1. AVVlicant to fill In all spaces exceo� thoi6 within heavy Goraer Ilnes ana sign al1 approvriate aecla�ations. . PERMIT NO. . TRAGT.NO. � LOT IyO. UNIT NO. TYPE OFCONSTRUCTION I�NEW LJ AOD LJ ALTERATION LJ REPAIR ❑ GONVERSION ❑ OEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TVPE OF PERMIT LI GRADING LJ FOUNDATION 1.J STRUCTURAI ❑ TENANT ❑ EIECTRICAL ❑ PLUMBING 11�GECHANICAL ❑ OTHER PROJECT DESCRIPTION Sq.Fr. - oCCuvANCv_ CONSTRUCTION TVPE VA�VATfON $ ZONE GRADINGGU.VDS. ACRES_ Remarks: //�� Bar Sink or a certifiwte �ereot ectlon gackflow Prev¢nter '7— Backflow Irrigation p t /! i _ . . (This section nee0 rfot be comple[etl if the permit is for one huntlratl (E300) or Icss). 1 cerlity tha[ in [be pertorrt�anCe ot tbe wo�k for wM1ich Inls pe�TR IS ISSu¢tl, I shall not employ any person in any manner zo as to become subject to the Workers' Compensation Laws of Califomia. Date Signature NOTICE: If, atter making tryis tletlara[iOn, you sM1oultl become subject t0 the Workers' Compensation prp��sions ot tbe Labor Cotle, you must forthwilh compty wi[h sucn provisions or Ihis permit" shall be tleemed revoketl. CONSTRUCTION LEN NG AGENCV � I hereby affirm that th r is g construction lentling agen<y for tne performance of tbe work for cAyx}ys permit Is Issuetl (Sectlon 309] Civ. C.) Lentler's Name ��/ LCi Lentler's Atltlress OWNER BUILDER DECLARATION I herCby affirm that I am Bxempt frOm [he Contractor'S LiG¢nse Law fOr tne following reason (Seclion 7031.5 Business antl Professional Cotle: Any city or counly whlch �equire5 a peYmit to construct, alte�, improve, tlemOlish o� r¢pair any sVucture, prlor to its i¢suance, also requlres the appllcant fOr such permlt [o file a signetl statement Ihaf he/she Is IlcenS¢tl pu�suanl t0 thE p�ovislons ot the Contractor's Llcense t�w (Chapter 9(<ommencmg with Section 7000) ot Olvision 3 Of Ihe Business antl Prole55ion5 Co�e) o� that Ite/Sh¢ is exempt therefrom an0 the ba5is for the allegetl ezemptlon. Any violation of Section 7031.5 Dy any applicant tor a permi[ subjecl5 Ine appliCant to d civil �enalty of not more tnan fiye nuntlretl tlollars (§500). I, as owner ot ihe pr4pe�ry or my employ¢es with wd9e5 a5 thel� sole compensatlon, will Oo the work, antl the structure is not intentlea or o(teretl for sale (Section ]044, Business antl ProteSsional Cotle: The Contrac[or's Lic¢nse Law tl0¢s not apply to an Owne� of a p�operty who builtli o� im0�ov¢5 [bereon, antl wM10 tloes suCh work himself/he�setl or throu9h his o� he� own employ ¢es, O�ovitletl [hat such Improvemen[s aro not inlontlatl or offoretl for sale. If, however, th¢ buil01n9 G/ ImprOvement I5 sola wlthin One yedr Ot com- pletioq the owner wlll have the burtlen ot proving he/she tlitl not bulltl or Im- �rove fm Ihe purpose o1 sale). I, as owner oi the prop¢rty, am exclusively tontractlng with Iicensetl con- I�actor5 t0 construct thG P�Oject (Section 7044, Business antl Profe55ion5 Cotle: TM1e ContractoYs License �aw tloes not applY to an owner of property who builtls or impwves thereon, antl who conVacts for such proiects with a con- , t�actor(s) license putsuant to lhe Cont�actor'S Llcense Law). 1 am aware that '� proo/ ol tM1eir Worker'S Compensa[Ion insurance ShOultl be provitled to me. ❑ I am exempt untler Sectlon B. & P. C. fOr this rea5on Date Owner I hereby certify tnat I have raatl tM1is applicatlor Intormatlon is mrt1�ecL I agree to compl with all antl s[ate laws fe�p••ng to builtling < s ctlon, a sentatives Of tM C�fY to enter u pn t abov InSpection purp 5 5. Signatura Driver5' Licenze or 55 � Floor Drains Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories� P—Trap Roof Drains Reinspection Fee Outlets $15 Ducl - Under Ground Duct - Structural Duct - Ventilating Exheust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # 'H�e�a "9 System & Ducting L70100,000 BTU � 700,000 BT' Reinspection Fee � $15 CMF 0865-46, rev. 4/84 White - Builtlln9: Canary - ApOi��anl; Pink - At<ountin9: Goltlenrotl - Assessor $howers Service Sink Sewer Cep Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fae Hood or Type I ❑ Canopy Type I I ❑ Refrigeration System ❑0.100,OOOBTU ❑100,000 System Repair/Alteretion Issue Fee $ 3 $ 3 A.P. ;W S Main Building: E T Front B Rear A C Right g Leh Ping. Ref. # Planning Notes: Auromatic Washer - Consttuction Pole Sub. Cooking Unit Dishwasher Dryers �Gas ❑Electric Fan F.A.U. Fix[ures Device Boxes Outlets Switches Garbage Disposal Generator �0-5 KW �5-15 3609 7/06/84 Zone Accessory Buildinq: Parking Req./Provided ELECTRICAL Transformer ❑ 75-50 KW- ❑ 50+KW Merer �up to 100 amps Merer ❑over100amps Sub Panel Motors � 0-1 H P � 1:4 - 8 Inc.Solar �9�75 HP �76-15+ Microwave Pole Light Sign Standing Sections Trash Compacror � Reinspection Fee �$15 � � Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: 2oning Approvad By Building Approvad By Aooliratian Issued BY BUILDING PERMIT 3 PLAN CHECK $ PLUMBING 5 PVINCHECK 25% $ ELECTRICAL $ PLAN CHECK 50% $ MECHANICAL %9 PLAN CHECK Z5% $ E7e�l T� � Z O N I N G R E Q M T S. FEES S 3 SUMMARV OF FEES � SMIP $ PERMIT ISSUANCE $ ENERGV P.C. $ GRADING $ MICROFILM $ � TOTAL FEE $ � � CONSTRUCTION AND PLANNING POOL & SPA - Date Inspector Date Inspector , APPROVALS Permit # . APPROVALS Permit # . 1. Temporary Electrical Service or Pole _ 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd. �' .� 53. Steel Reinforcement �' 3. Electrical Conduit Utility-Undrgrnd. _ 54.,Forms . �4. Electrical Conduit=Undrgrnd. � � � 55.�Electrical Bonding 5. Steel Reinforcement � _' , 56. �Rough Plumbing & Pressure Test . 6. Electrical UFER Gmd. 57. APPROVAL TO COVER�GUNITE . 7. ,Footings . � � 58. Electrical Conduit-Undrgmd. 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 17. Property 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 Electrica6Conduit . -' 66. Solar SYstem-Final ' i 6._ Rough Electric Wiring � � 67. Fencing & Access Approval 17.� Rough Wiring Sign � � 68. APPROVED FOR PLASTERING 18: Rough Electriral-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19.-Rough Heating & Air Conditioning Z/��1c� L�,p FIRE DEPT. REQUIREMENT 2�. Rough Factory Fireplace APPROVAIS Permit# 21 . Ducts, in Structure � 70. Underground Hydro 22. Ducts, Ventilating 77. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test ' 72. Underground Flush 24. Roof Framing ' 73. Undergrnd. Storage Tank 0 Gas ❑ Oil 25. Roof Sheathing -' � 74. Overhead Hydro � 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � 79. FINAL INSPECTION � 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning ��t� L� . 35. Final Gas Pipe-Test 36. Hood or Canopy � 37. Final Factory Fireplace ' 38. Final Plumbing • . 39. Water Service-Final ' 40. Gas Service-Final 41. Solar pomestic-Final . � 42. Backflow Preventer � 43. Backflow Irrigation . . - � ' 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed 49. Elec[ric Release to Edison - - � � 50. Gas Release to Southern California Gas Co ; 51. CERTIFICATE OF OCCUPANCY No. Date AVP��ant to filt in all spaces exeept t�oza within heavy Dortler lines an0 sign a11 aoorovriate Eeclarations. 'CITvoF �oSTA MESA CONSTRUCTION PERMIT ProjectAddress i404 lavPndPr �dll2 Applicant's Mailing Addreu ' Owner'sName Stan�ard pacifir Cnr'P_ Phone546-1�E� Address �.565_W_._.MdLA1'tYlilr fncta Maaa 97676 Arch/Eng. License No. Address Contractor'sName—�Jgy��Ip�Tq� Phone59R_114(1 Address�mailingl�_ri- FP A�td Anaheim CityLicenSeNo. �%�� LICENSED CONTRACTOR DECLARATION - I hereby affirm that I am licensetl untl¢r provisio �Charte� 9(commencinq with section 7000) of Division 3 ot the Busl ss an Professions Cotle, antl my license is in full fqr.ce36d ertect. QZ6� OJ Licenlsne C,llas�s�p� �' Li nse No. Datew�/�u;yL Signa[ure WORKERS' COMPENSATION DECLARA O . ' - 1 hereby aftirm [hat I have a certifiCat¢ ot con5ent to self-inmre o� a certificate ot Worker5' Compensafion Insu�ance, o� a certifietl, copy Ihereof (Sectlon aaoo, �e.�� 141 ' Home Policy No. Company � Cfe�rtjifietl c(Qo/�PY i5 tiletlbwith,thehc �[Y I1.f i �IRI Da�tU/��`�-* AOPllcant ��•• �I"��Q - EXEMGTION FROM WORKERS' COMPENSATION DECLARATION (TM1i55eCtion neetl mt ba complatetl if the permit is for one huntlretl ($100) or less). I cer[ify that in th¢ performance of [ne wo�k for which this perm�t i5 i55ueQ I Shall not ¢mplOy any person In any manner So as to �ecOme subjeGt to lhe Workerz' Compensation Laws of California. , Date Signature NOTICE: If, afle� making thi5 tl¢tlaration, you shoultl become subjeGt to [he Workers' COmp¢nsation provi5ion5 0l [he Labor Cotle, you mu5t fOrthwith comply with such provisions or lhls permit shall be tleemea revoketl. CONSTRUCTION LENDING AGENCV I hereby ai9rm that there Is a construction lentling agency for tne pertormance of the work tor whlch this permit iz issuetl (Section 309� Civ. C.) Lentler's Nam¢ t_entler's AGtlress ' OWNER BUILDER DECIARATION�- ' I hereby affi�m lhat 1 am ezempl frOm the ConVactOr's License Law Tor Ihe tollowing reason (Section 7031.5 Buslness antl Professional Cotle: Any tlty or county whlch requires a vermit to construct, alter, improve, tlemolish or repair any structure, prior to Its issuance, alm requires the applicant (or su<h permit to file a Si9netl SlatGment that h¢/She Is licensetl pursuant to [he prOvisions of rnn c��r.acrn.�a i irenw I aw tCnaoter 9 Immmencina with Section 70001 of' 'a`herefrom and the Dasis for the allegetl exemp[ion. Any violation of Section `7W3.5 by any ap0licanl 10� a permit subjects the applicant to a Civil �enalry of not more than tive nuntlretl tlollars (5500�. , LJ I, as owner ot the property or my employees with wages as their'sole compen5atio0, will Go the work, and the Structu�e I5 not intentletl or ofteretl tor sale (Section 7044, Business antl Protessional Cotle: The Contractor's License Law tloes not apply to dn owner oi a property who builtls or improves thereon, antl who tloes such wo�k himself/hetselt or through his or her own employaos, provitleC thal such improvements are not in[endetl or ofteretl for sale. If, however, the builtling cr improvement is soltl witnin one year of com- Oletion, the owner wlll have lhe bu�tlen Of proving he/she tlitl not builtl or im- � �ove for [he.purpose of Sale). LI I, as owner of the prooerty, am exclusivety mntractin9 witn licensetl con- Lldt[Of5I0 COf15lfUCi lhC pIOj2Cl ($EC[IOfI %044. BOSI0055 dlld PfOfC5510lIT COtlC: The Contractor's License Law tloes not apply to an owner ot property wno builtls or improves thereon, antl who contracts tor such projects wrth a con- tractor(sl license pureuant'to�tne�Cantracto}'s License Law). I am aware that proof of their WOrker'S Compensatlon insurance shoultl be provitletl to me. ❑ I am ¢xempt untler $ection B. & P. C. fo� Ihis reason Date tnat 1 have ea�hls application antl state that Ihe above rect. I a9re [o c mply wilh all city antl county ortlinantas ating to b iltlin constructlon, antl hereby author�ze repre- City f0 ente� upon the dbov¢-mentionetl ptoperty fat TYPE OF CONSTRUCTION XECJ NEW LJ ADD LJ ALTERATION LI REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TVPE OF PERMIT LJ GRADING[ �LJ FOUNDATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL q(�(PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION $Q. FT. OCCVPANCV— CONSTRUCTIONTYPE '� VAWATION$ ZONE GRADING CU. VDS. ACRES_ Remarks: Bar Sink Backflow Preven[er Backflow Irrigation � Bathtulis (�.IdflflQfS Dishwdsher Drinking Founlains Floor Drains Floor Sinks Gas Service Fi Outlets Kitchen Sink Lavatories P–Trap Roo( Drains Reinspection Fea � $15 Boiler Duct-UnderGround Duct - Sauctural Duct - Ventilating Exhaust System ❑ Multiple ❑ firepl/Fact. BI[. ICBO # Heating System & Ducting ❑0.100,000 BTU 0100,000BT Signature � Date L�I�T/ a7 Drivers' License or SS � – – Reinspec[ion fee $15 CMF 0865-46, rev. 4/84 White - Builtling: Canary - ApO��wn[: Pink - Accounting: GOltlenroU - Astessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee Hood or Type I ❑ Canopy. Typell ❑ Refrigeration System ❑0-100,000 BTU 0100,000 BTU System Repair/Alteration Issue Fee FEES 2 A.P. # S Main Buildi E T Front B Rear A C Right K Left S Ping. Ref. # Planning Notes: OI7B 10/12/84 2one Accessory Building: Parking Req./Provided ELECTRICAL � Auromatic Washer . __ Transformer ❑ 15-50 KW Consvuction Pole Sub. ❑ 50 + KW Cookin9 Unit Dishwasher Dryers ❑Gas �Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator �0.5 KW �5-15 KW Me[er ❑up to 100 amps Meter ❑over 100 amps Sub Fanel Motors O0.1 HP O1 h- 8 Inc.Solar 09-15 HP �16�15+ Microwave Pole light Range Sign Standing Sections Trash Compactor $ 3 Reinspactian Fee $15 luue Fea FEES DEVELOPMENTSERVICESREQUIREMENTS: 2oning Approvad By Building Approved By � Appliratian Issued By �� – $ 3 5.50 TL z O N I N G R E Q M T S. , ._, . $ 3 SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ . �7 A 7�D ��UANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING 5 P�AN CHECK 50% $ MICFiOFILM $ MECHANICAL $ TOTAL FEE $ . 5�� PLAN CHECK 25% $ CONSTRUCTION AND PLANNING FO�_ & SPA APPROVALS Permit# Date Inspector p�ppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location � 2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical�Bonding �1+ . 5. Steel Reinforcement. � �� - 56. Rough Plumbing & Pressure Test� _ j: � 6. Electrical UFER Grnd. � 57. APPROVAL TO COVER-GUNITE � 7. Footings - �.� 58. Electrical Conduit-Undrgrnd. ''.' 8. Foundation 59. Gas Pipe, O Undrgrnd., Test � � 9. Water. Pipe-Undrgrnd. /'� � 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System ' . . 61. APPROVAL TO DECK � 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final - 12. Sewer Cap 63. Heater & Vent-Final �� 13. Roof Drains . - � 64. Plumbing System � Final 14. Rough Plumbing 65. Electrical-Final !' 15. Rough Electrical-Conduit 66. Solar System-Final � i 6. Rough Electric Wiring - 67. Fencing & Access Approval - 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL 19: Rough Heating & Air Conditioning ; ' � FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating � 71. Product Piping O Gas ❑ Oil � 23. Gas Pipe-Rough & Test ' - 72. Underground Flush 24. Roof Framing _- 73. Undergrnd.StorageTank �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��cz � 36. Hood or Canopy . 37. Final Factory Fireplace � 38. Final Plumbing ' . � 39. Water Service-Final 40. Gas Service�Final 41. Solar pomestio-Final _ _ � . .� 42. Backflow Preventer . � 43. Backflow Irrigation . ^� 44. Landscape Irrigation System � 45. Sound Attenuation . � , 46. Handicap Regulations � ' 47. 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 AOO��ant to fill in all spaces exceD� tMose wilhin heavY �ortler lines antl zi9n all approoriate aeclarations. CITV OF GOSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LO7 NO. UNIT NO. Projecc Address 3'� o`� �flti e^��er Applicant's Mailing Addnress Owner'sName �"r'? Phone Address Arch/Eng. License No. Address Contractor's Nam a�i phone Address (mailin9) City Licenu No. LICENSED CONTRACT00. DECLNRATION I her¢by affirm that I am licensptl untler provi5ions of Cnart¢r 9(commencin9 with section ]000) of Divisbn 3 oi the Business ana Protessions Cotle, antl my Ilcenie is in tull torce antl eitect. License Clasz License No. Date Si9nature WORKERS• COMPENSATION 4ECLARATION 1 hmeby affirm Ihat I have a ce�lificate of mnsent to self-insure or a cmtiflcate oi Worke�s' Compensition Ins�ranco, or a certitietl copy tnereoi (Settion 3800, lab. C.) Policy No. Company BCertltietl coOY is hereby fumi5hetl. Certitietl copy is filetl with the city Builtling Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION OECLARATION (This se<tion nee0 not be complptetl ii the permit iz tor one huntlretl (E300) or less): 1 certify that in lM1e perto�mance o/ Ihe work tOr which tnis pe�mi( is issuetl, I Shall no[ employ any per5on i� any mann¢r so as to become Subjec[ t0 the workers' Comven5ation Ldws o� Califomia. Da[e Si9ndture NOTICE: If, after making this tleclaration, you shoultl become subjett to fhe Workers' Compensation provisions of the Labor Cotle, You musl iorthwi[h comply with such provisions or this permit shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV I nereby aHlrm that there is a construction lentling agency for the pertormance oi the work for whicb tnis permit is Issuetl �(Section.3097 Civ. C.) Lentler'S Name Lentler's AOtlress OWNER BUILDER DECI.ARATION� I he�eby dtfirm that 1 am exert�pt trom the Contracto�'S UCenSe Law fOr Ihe . tollowing reason (Section 7031.5 Business antl Professional Cotle: Any clty or coun[y whiclt requires a permil IO con5[ruct, alter, improve, tlemolizh o� repair any struclure, prlor to its issua��e, also requires the applicant (or sucb permit to tile a sign¢tl sta[ement [hat he/She I5 IicenSetl pu�suant to th¢ P�oviS�Ons of the Contrac[or's License Law (Chap[er 9(commencing with Sectlon ]000) of DiviSion 3 of lh¢ Buziness antl Protessions Cotle) or that he/She it ¢xempt therelrom antl the basis for (he allagetl ex¢mption. Any violation ol $ection 7031.5 by any applicant for a permit subjects the applican[ to a civil �¢nalty of not mo�e than five huntl�etl t1011a�s (E500). U I, as owner of the proper[y or my employees witn wages as thelr sole compensation, will tla the wo�k, antl the structure is nol intentletl ov of}e�ed i0! SdIC ($ECIIOl1 �O4A� BU51lIQ55 dOd PlO1Q5510l1d1 Cotle: The Conlractor's LicenSe Ldw tloes not apply to en owner o/ a property who builas or Improve3` thereOn, antl who tloes suc� Work hlmself/he�self or throu9h his or her own employees, provitletl tM1a[ sucM1 Improvemen[s a�e not In[entletl or otfa�etl for sale. Ii, nowever, the builtling pr Improvement is soltl wlthin one year of com- pletlon, the owner will have tne burtlen of proving he/she tlitl not bulltl O� im- ��ova 10r Ihe purpo5e ot sale). I, a5 Owne� of [he property, am exclu5ively Contracting with IlcenSetl con- trd<tors to cons[ruct ihe project ($ectiDn 7044, Business antl Protessions Cotle: The Contratlor's License law does not apPly to an owner of proPerty who builtls o� im0�ove5 thereon, a�tl who mnt�acl5 for such project5 �+Itb d con- tractor(sl license pursuant �ro the Contractor'S Llcense Law�. 1 am awar¢ �hat pro0/ O( Iheir WorkeYs Compensalion insurance Shoultl be provitletl fo me. ❑ 1 am exempt untler Section B. & P. C. tor tnis reason Date Owqer certity that 1 have reatl this appliwtion an0 state that tne above in is correcL I a9ree to compry with all city antl counry ortlinances laws relatin9, to builtling constructlo tl hereby authorize repre- of lhisielt,y �o Ynter u0M the � ve-mentionetl property for �/� ��r 9�-� I I I� a�l I I TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WOFK/USE OF BLDG. TVPE OF PERMIT IJ GRAOING LJ FOUNDATION LJ STRUCTV RAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION Sp.FT. OCCUPANCV_ CONSTRUCTION TVPE VALUATION $ ZONE GRADING CU. VDS. ACRES_ Remarks: Bar Sink eackflow Preventer Backflow Irrigation Baihtubs rinking Fountains loor Drains loor Sinks ' as Service Outlets Kitchen Sink Lavatories Roof Drains Showers Service Sink Sewer Cap Sewer Connection $018f C.OI�2Ct0l5 Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Reinspection�Fee � $15�/�� IssueFee I $ 3 I MECHANICAI FEES Boiler ' Duct - Under Ground Duct - Structural Duct � Ventilating Exhaust System ❑ Mul[iple ❑ Firepl/FacL Blt. ICBO # Heating System & Ducting ❑ a100,000 BTU O 100,000 BT inspecuon purp — ��/�� Si9nature Date peinspeciion Fee Driver5' li Se or 55 � CMF OB -46, rev. 4/64 White - Builtling: Canary - Applitant; Pink - Atcounting; Goltlenrotl - ASsessor $15 Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System �0�100,OOOBTU ❑100,000 System Repair/Alteration Issue Fee � $ 3 A.P. ,ie S Main Building: E T Front B Rear A C Right K left S Ping. Ref. # Planning Notes: Aummatic Washer Constructior Pole Su6. Cooking Unit Dishwasher Dryers ❑Gas ❑Elec Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generaror �0.5 KW � � ZonB Accessory Builtling: ELECTRICAL . Transformer ❑ 15-SOKW '- ❑ 50+KW Meter ❑up to 100 amps Meter ❑over100amps Sub Panel Motors O0.1 HP O 1 X- 8 � Inc.Solar 09-15 HP �16�15+ Microwave ' Po1e Light � Range { KW Standing Sections Trash Compactor FEES Z O N I N G R E Q M T S. I Reinspection Fee I$15 I I �ssue Fee I $ 3 I DEVELOPMENTSERVICESRE�UIREMENTS: Zoning Approved By Date Building Approved By C�� Date I� Appliption IssuBd By Data SUMMARV OF FEES BUILDING PERMIT $ SMIP S PLAN CHECK 3 PERMIT PLUMBWG $ �S•OO ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM 5 MECHANICAL $ TOTA�FEE $ _�-Q� PLAN CHECK 25% $ _ CONSTRUCTION AND PLANNING - POO� a SPA . . APPROVALS Permit # Date Inspector qppROVALS Permit # � Date Inspector ��. Temporary Electrical Service or Pole 52., Pool & Equipment Location , _2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement `� 3. Electrical Conduit Utility-Undrgrnd. - 54. Forms � 4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding 5. Steel Reinforcement 56. •Rough Plumbing & Pressure Test • 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, � Undrgrnd., Test '9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System 67. APPROVAL TO DECK 11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing SYstem - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final " 16. Rough Electric Wiring � � 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace - ' APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro � 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL . 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT . 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Elec[rical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: ' 34. Final Heating & Air Condifioning 35. Final Gas Pipe-Test , (U!(7��/ G�p . " 36. Hood or Canopy ' 37. Final Factory Fireplace 38. Final Plumbing �a/(y/gt� hl7 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final . 42. Backflow Preventer . 43. Backflow Jrrigation . 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 3 �-to LI LG v�,.c�2�-- �2OZ Applicant to fill In all s0aces except ihose wlthin �cavy CorOer Iines CI7Y oF COSTk'MESA . CON�T.RUCTIQN PERMIT Project Address j �� 111� - �� 6��1i /^�%•r Applicant's Mailin9 Address ,��u � � " �� . Owner's Name % Phonay �2 �%tl0 ti Address �ild(/ �cS%✓/'wi�ifar �iD�.v.Y Arch/Eng. G��S � LicenseNo. �� - P.ddress �`1./e� e Contracror'sNam � Phone��'1�d� Address (mailing 6�% ` CityLicenseNo. - Z�[S�� LICENSED CONTRACTOR DECLARATION 1 hereby afflrm tM1at I am licensetl untler provislons of Charter 9(commencing with section ]000) of Divislon 3 of the Buslness antl Profe55ions Cotle, antl my Iicense is in /ull torce antl eftect.Cf � Datensc C ss ,� . Signahre ��/_/ �5e No' / p S� /OR E 5' COMPENSATION DEC AT ON . hereby affirm that I nave a certiflWte ot consent to selt-insure or a certiticate ot Wo�ker5' Compensation Insurance, o� a certifie copy the�eo� ($ection 3800. Lab. C`)�`P .J3'�%,,� '. A r . Polity No. _� Company;w /��-/c.lZ �Certifietl coOY is hereby furnishetl. �" Certifie co s filetl with tbe city Bwl •fdiv ion. Da[e_ APplicant T_ EXEM TIO FROM WORKERS' COM A ION DECLARATION �(Thissection neetl not be completetl it the permil i5 tor one huntl�etl (E100) o� less). I certity tha[ in the Periormance o( the work for which l�ls permR is issuetl, I Shall mt employ any pe�son in any manner so as to become subject lo lhe Wo�kers' Compensation LawS of Calitornia. Date Si9nature ' `NOTICE: If, after making this aeclaration, you snoultl bacome subject to the Workers' Compensation provisions of the Labor Cotle, you must torthwith mmply with SucM1 provisiOns or this permit zhall b¢ tl¢emetl revoketl. CONSTRUCTION LENDING AGENCV - 1 hereby ai(irm thac there is a constructlon lentlin9 agency for the performance of Ihe work for whicb [M1is Oermit is issuetl. (Section 309] Civ. C.) LenOer's Name � Lenaer's Atltlress B/y/� OWNER BUILDER �ECLARATION I hereby affirm tnat I am ¢xempt from the Contrdctor's l.icense Law for the tollowing reason (Section 7031.5 Husiness antl Professional Cotle: Any city or counry which requires a vermit to construct, alter, Improve, tlemolish.or repair any"sGucture, prlor to it5 i55uance; also reqWres the applicant for such parmit to file a signetl slatement that he/she IS licensetl pursuant to the-prOvlsions of the Contractor's License Law (Chapfer 9(commencing with Section 7000) oi Division 3 of tM1e Business antl Professions Cotle) or that he/she is exem0� therefrom and tM1e basis for the alleged exemption. Any violatlon of Section 7033.5 by any applicant for a permi[ subjec[s Ibe appllcant t0 a clvil �nd�ty o! not more than fiv¢ huntlretl t1011a�s (5500). I, as owner ot the oroperty or my employees with wagos as their sole compensation, wlll tlo the work, antl the structure is no[ IntenCetl or offeretl tor sale ($ection ]044, Businesz antl Pro/essional Cotle: The Contractor'S License Law tloes not apply to an owner of a property who builtls or imp�oves lhereon, antl who tloe5 SucM1 work himselt/he�self or through his o� he� own' employees, provitletl that suclt improvements are not Intentletl or oHered tor sale. It, however, tne builtlin9 or ImOrovemeni is soltl witnin one year of com- pletion, the owner will have tne burtlen of proving he/she tlitl not bulltl or Im- ptove tor the pu�pose ot sale). - ❑ I, as owner ot tM1e property, am exclu5ively cont�acting witn lic¢nsetl con- tractors to construct the project (Section ]044, Bu5Ine55 antl Professions Cotle: The Contractor's License l.aw tloes not apply to an owner oi properry wno builtls.or Improves thereon, antl who contracts for such projects with a con- tractor(s1 Ilcense pursuant'to the Contractor's License Law). I am aware tnat O�oof of their Worker's Compensation Insurance shoultl be provltletl to me. ❑ I am ex¢mpt untle� Sectlon �B. & P. C. tor thls reason� Date Owner I hereby certi/Y tha[ I ve reatl [his applicatlon antl state tnat lne above Intormation is correct. 9ree to comply with all clty antl county ortllnances' antl stat o building consiructlon, antl hereby autnorize repre- sent es of I5 to enter upon tna above�mentlonetl propert � for Si9nature CMF sign all appropriate Eeclara�ions. UNIT NO. TYPE OFCONSTRUCTION �NEW L.J ADD LJ ALTERATION LJ REPAIR .� ❑ CONVERSION ❑ OE OLISH ❑ OTHER A.P. # — DESCRIPTION OF WORK/USE OF BLDG. $ Main Buildin9: TVPEOF'PERMIT GRADING FOUNDATION STRUCTVRAL T Front � ❑ TENANT ❑ ELF�TjiICC� ❑ PLUMB}� ❑ MEGHANICAL B Rear, ❑ �OTHER �,L �w� Q� A PROJECT DESCRIPTION SQ. F7. oCCUPAN�V C Ri9ht CONSTRUCTIONTYPE VALUATIONS ��+C�O g Lefi ZONE GRADING CU. VDS.� � ACRES 71ng. ReL #' ( pemarks: Planning Notes: o1l�Malnlr " ccvc � �/ / Bar Sink Backilow Preventer Backflow Irrigation Bathtubs Claritiers Dishwasher Drinking POuntains Floor Orains ' Floor Sinks Gas Service Outlets Interceptors ' Kitchen Sink" ' Lavatories � ^ P—Trap ' Roof Drains Reinspection Fee � Under Ground $75 Duct - Structural Duct - Ventilating ' Exhaust System ❑ Multiple ❑ Firepl/Fact BIL ICBO # Heating System & Ducting, ❑0�100,000 BTU Ot00,000BT . r�55�f �= ' � � _�� — I I RainspectionFee I $15 ]0/84 White - BUIltling; Canary - Applicant Pink - Accounting; GoltlenrOtl - ASSesSOr Showers ' Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank, Swimming Pool w/Spa Urinal Water Closet . Water Heater Water Service Laundry Trays ' Issue Fee $ 3 IANICAL FEE Hood or Type I ❑ ' Canopy Type I I ❑ ' Refrigeration System Oo�ioo,000eTu ❑ioo,000 System Repair/Alteration Fire Dampers Registers Isue Fee Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers �Gas ❑Elec Fan F.A.U. Fixtures Device Boxes Outlets Switche5 Garbage Disposal Generator �0.5 KW C Fee DEVELOPMENTSEH Zoninp APProved BY � Building Appraved By 5�9� ��7/�'S' Zone �Accessory Building: Parking Req./Provided . ELECTRICAL , Transformer ❑ 15-50 KW ❑ 50? KW Meter ❑up to 100 amps Meter ❑over 100amps Sub Panel ' Mocors �0.1 HP � 1 X- 8 Inc.Solar �9�15 HP 076-75+ Microwave ' - ' Pole Light Range ; Standing Sections 5 KW Trash Compactor $15 laue Fee � BUILDING PERMIT $ -�� SU PLAN CHECK $ ZS•p3 i P�UMBING � $ � PI.AN CHECK 25% $ • ELECTRICAL $ � � PLAN CHECK 50% $ MECHANICAL $ $ 3 PLAN CHECK 25% $ $ 3 FEES SMIP $. •�5� PERMIT , ISSUANCE $. ENERGV P.C. $ GRADING $ ' MICROFILM $ TOTALFEE $. � � � CONSTRUCTION AND PLANNING � P�' `& SPA APPROVALS Permit # Date Inspector qpPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location a. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement � � ?3. Electrical Conduit.Utility-Undrgrnd. 54. Forms ' 4. Electrical�Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcem'ent. L �. ✓ 56. Rough Plumbing & Pressure Test �6.,Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings� � ' a` f� 58. Electrical Conduit-Undrgrnd. 6. Foundation 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe-Undrgrnd. �. . 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System, 61. APPROVAL TO DECK . . i t. Property Sewer �ine &^House Connection 62. Backwash & Receptor-Final 12. Sewerv Cap 63. Heater & Vent-Final , I. 13. Roof Drains �' . 64. Plumbing System - Final ' 14. Rough Plumbing 65. Electrical-Final 15..RoughElectrical-Conduit 66. SolarSystem-Final . 16. •Rough Electric Wiring 67. Fencing & Access Approval i.' 17� Rough Wiring Sign 68. APPROVED FOR PLASTERING . 18. Rough Electriral-T 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. Undergraund Hydro � 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. �Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Freming 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 a ��(� BLG � 34. Final� Heating & Air Conditioning 35. Final Gas Pipe-Test � . 36. Hood or CanopY ' , � � 37. Final �actory Fireplace , 38. Final lumbing �' . � 39. Water'Ser'vice-Final � � 40. Gas Service-F.inal � 41. Solar pomestic-Final ` � i 42. Backflow Preventer � �� 43. Backflow•Irrigationf-"' • 44. ,Landscape Irriga[ion System • � � 45. Sound Attenuation � . ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING • �d'f �- 48. Special Requirements Completed, , 49. Elec[ric Release to Edison � � , � � 50. Gas Release to $outhern California Gas Cv �51. CERTIFICATEOF;OCCUPANCY No - Date � 1iN1G11)Y G�9UE�/IE/�. L�� . � 133a1s or� ��N70117Y 10N101t7Y � �.r � " 77�.1. � � 7�M70t�7Y AP��'� CITY OF COSTA MESA � PLANNING DEPT. � fUUFC7 10 BLDG. DEF7. REO. �Y_.%L[-��DnrE.(�. �4�� pIRERoa or our+N�r+G Cement Coping Optional � Channel Bloek With O� �%8u� Noriiontal Top of HI � Fences - For Fences 5' or Less Vert. Bars 3/8'�. at 4' -0" O.C. For Fences Higher Than 5' — Vert. Bars 3/8'�� at 32" O.C. Fill Cells Solid With Grout — Where Steel Occurs Reinforcing Steei.Shall Conform to Sec.A-15-39 A.S.T.M. AIISteelto be Lapped 16"or to Code NATURALGRADE TWO 3/8" BAHS ' CONTINUOUS TOP & BOTTOM TYPICAL s 0 ¢ _ �� >w a= a >Z > - a i � wo u r � o V�-� � �L � WID7 � SEE C1 4 p BEIOW �� O 6�� CONCRE�"E BLOCK FENCE FOOTING REQUIREMENTS GENERAL- NOTES MORTAR: p�e Purt Plastic Cement, and Three Parts Sand GROUT: . One Parf Cement Three and One Half Parts S�and COPtN�: One Part Cemeni, Three Parts Sond CONCRETE: Well Mixed I: 2� : 3%2 Max. of 7%2 Gallons of YYater Per Sack of Cement GROUT MAV BE POURED FROM THE 70P OFTHE FENCE - CELLS AND AREAS OF HOHIZONTAL HEIN� FORCEMENT SHAIL BE CLEAR, CLEAN & FREE OF ALL MOiiTAR DEBRIS, ETC. BONDSSMALLBEPROVIDED BV LAVING BLOCKSIN STRETCHER COURSESSO THAT VERTICALJOINTSA�TERNATEIN EACH COURSE. fH OF EARTHTCOTH I/3 THE HEIGTH OF FENCE S��OW BOTTOM OF FOGTING. SCALE: I/2��= I' WALL HEIGHT 6� 5�. 4� 3� WIDTH �F F007'ING 14'� 14�� 12�� 12�� THICKNESS OFF'OOTINC, . �0�� 10�� g" 8" DEPTH OF EARTHTOOTN 24" 20" 16° 12" SPACING OF EARTHTOOTH 12� 14� 16� 16� OWNERS NAME: _ _ _ _ _ _ _ _ _ _ _ _ _ _ City of Costa Mesa, California JOe ADDRESS: _ _ _ _ _ _ _ _ _ _ _ _ _ _ Building Department _ �� 7-6-84