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Home My WebLink About3408 LAVENDER LN - Building Permits2� Zs �2�z�"� ��oz Tv�riniaq Laboratories �f ��E_,� ea�'�foin�, �,�. � 33:0 4vaor. Way ; nnadiny aonress P.O eo. a� / �ong Beacn. GA 9080� / 12�31 4263355 / f213� 636-2386 / 1�1a� 828-6432 TESTIN6 avar,er�p=ri�_ �gia-oNonoSusanSiieei � 5aniaAna.cn92�03 i O�<�ssa�25a5 July 20, 1988 Examination: SC88-6666 COMPRESSION TESTS ON GUNITE CYLINDERS Richard L. Hubba^d 17�22 Yellowstone Avenue Yorba Linda, California 92686 PROJECT SWIMMING POOL & SPA (MIRA) aD�RESS 3408 Lavender Lane, Costa Mesa ARCHITECT CONTR4CTOR - - Blue Haven Pools ENGINEER SUBCONTRNCTOR B.C. Adams SMI & Sons SAMP�E FROM Spa wall and deep end wall SPECIFIED MIX �+•�-1 STRENGTH DATE CAST 7-8-88 SLUMP —— SIZE DATETESTED %-18-88 7-18—H8 SPECIMEN NO. 1 2 COMPRESSION 10—Da�� 10—Day TOTALLOAD.LBS. �2�700 70,000 POUNOSPERSQ.IN. 2,820 - 3,400 10=�DAY AVERAGE. PSI 3� 110 COMPLIANCE 10-Day tests comply with specified strength. SPECIMENS DISTPIBUTION: Richard L. Hubbard - 3 _Ceai.e Mesa Bldg. D=pt. MP.DE BY �ELNERED BV Lope2 Hubbard 2,000 pSi 1: 4.90" a 11.30" 2: S.OS" x 12.78" 3,4,7 b 6 "HELD IN FIELD" RECEIVED ON 7-15-88 LYby��i�l/� ,: �,��,�,.,...� , �,. . .. ,,,,;, ._ ., . .... . ... , v. i� n�. ... .. � . , , . . :. . _ . , _-.. .. �. „ . .., _..�,,.... .,. . . i.;., .. �o�: n� o��:. � � r.�::. ,� ,.: ��, ., o: ;- ,. i,_:.�.,_:., . _.._.,,,_.,::. .- ::.. . �. _. .-. ... _ , _.. � . ... . � . . . .��.�. -.. ..- __ � . , ,.cPCr.T Or :i;SPFCTiOP! Ui`! 91LL TO Address ;,VNER: ?ROJECT: �W tMMl1�C, � ?�ddress: Archi[ect: Address: Engineer: �ddress: Inspector: Mix Used: �iUlli i,2 l i i'�clSOfli^/ � Concrete ( ) � �OSL-I�IlSi0112d '✓Jl1Cf��2 =ireproofing R2inforcing Steel fiepor[ No. (� p I v �j 3/ � U I�.�R1V�1V.(�� i Permi [ No. QE,P 7 � Q'3 Con[�actor: ��„VE, �� tJ 1 �O� Address: S��\A )JI�q ��,1 ��jV�� Subcontractor: ��a. SO'�;J (Gunite) R �ip�.y� pv nasonry or C� aa6b �� Concrete) Address: Slump, inches: Admixture: Designed Strength, PSI: �� C The Followin9 inspection was performed in acc�rdance Nith the approved draNings: Cu.Yds. No. of DATES Plated CYIs• Remarks � � � 1a1�� aw S T � -Mf �. �Ac� �� Fc�S ��1�\ S , - � ___ _ . __ _._�.. ..— —:.—:�-,f__.-_ Cooies of .Reports�[o:'(IndicaYe which 8'1`d9:'Depc G furnish address of any nst• ;isred`) �- " Applicant to fill in a11 spaces exceo� those within heavy GorCer Iines and sign a11 approDriate aeclarations. CITY C�� COST �` CONSTRUCTION PERMIT P RMIT NO. �{y TRACT NO. LOT N. UNIT NO. � ..�Pro`jectAddress��0 LA✓ENbEFj /_.!)�11C. ��v �� I '� �� Appiicant's Mailin-g �A%d,dr2s5 3�OS �-�'/{-v/'L N��P� L�}N� TVPE OF CONSTRUCTION NEW AOD ALTERATION REPAIR Owner's Name ' /'nM�S " • [_,� � � PhOne �� CONVERSION ❑ DEMOLISH ❑ OTHER q,p, # _ _ Zane ' Address �ZU�� LALF�'�2 �/T�"2 DESCRIPTION OF WO(iK/USE OF BLDG. S Main Building: Accessory Building: Arch/Eng. License No. TVPE OF PERMIT GaaoiNG FouivDA7loN S7RUG7uRa� T Frontf � � p Addre55 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL 6 R¢dr 'f � � N ❑ OTHER A I Contractor's NamP Phone C Right ' � � N PROJECT DESCRIPTION 59.k'. OCCUaArvCv K G Addre551mailing) . CONSTRUCTIONTYPE VALUATIONS Z�ZIi S Left O� City Li[ens¢ NO. ZONE GRADING CV.YOS. HCRES R LICENSED CONTRACTOR DECLARATION Ping. Ref. # Parking�Req.IProvided E I h¢r¢by affirm tha[ I am licensetl untle� O�oyi5lOn5 of Cha�te� 9(commencing Remarks:. (�� S �- Planning Notes: / M witb section ]000) ot DivisiOn 3 ot the BUsine55 antl PrOte55ionz Gotla, antl , T my license is in Iull torce antl e/iect. I w' License Class License No. . S Date Signature PLUMBING FEES WORKERS' COMPENSATION DECLARATION 62� Sink ShOw¢�5 ELECTRICAL FEES I hereby aHi�m thal I have a ce�tllicate o( COqSent to 5eH-Insure o� a certifltate of Workers' Compensation Inzurance, or a�¢rlHietl copy Ihereof ($ection BdCkflOwPr¢v¢n[Cr S¢rViCeSink 3800, �ab. CJ Automatic Washer Transformer ❑ 15-50 KW . 7olicy No. Compaqy Backflow Irrigation - Sewer Cap Construction PoleSub. ❑ 50+KW 8 Certifietl copy is he�eby fu�niihetl. Certifietl copy is flletl with the dty Builtling Dlvislon. BaLhtubS Sewer COnnCctiOn COOking Unit Meter ❑up t0 100 ampi Date Applicant - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Cl2�iFi¢�5 SOId� COIICCLOfS Di5hwa5hBf M¢tE� �Ov¢� 100drrlp5 ♦ (TM1izseciion nee0 not be cOmpletetl If the permit I5 to� One huntl�etl (S100) or less). Dishwasher Solar Piping Dryers ❑Gas ❑Eleciric . Su6 Panel I certify that in [he pertormance ot tbe work fOr wltich thls pe�m�t Is i55uetl 1 shall not employ any person in any er so as lo become subject to tf�e Drinkin9 Fountains Solar Tank Fan Motors �0-1 FIP �1'h- 8 Wo�kets' Compensa �on Lyq s of Cali . Date y�6-Q� � Si9natur c1 �i. i i PA.+ �Q. / Floor Drains Swimming Pool w/Spa F.A.U. Inc. Solar �9-15 HP �16-15+ NOTICE: If, after making this tleClara[ion, ypu Shoultl become subject to Ihe - Workerz' Compensation provisions of [he �ybor Cotle, you must forthwith FI00� SinkS U�indl FixLu�BS Microwave � Comply witM1 such provisions or IhiS permit shall be deemetl revoketl. CONSTRUCTION LENDING AGENCV GasService �ULI2t5 WaterC105¢t DCvic2B0%¢5 1 hereby atfl�m lhat lM1e�e is a construGtiOn Ierytling agency for the perlo�mance POI¢ Liyht Of the work /Or which (hI5 permit is issuetl (SeC[ion 3097 Clv. C.) I�t2�cept0�5 WaterHeater Outlets �Ran¢ Lentler's Nama 9 Lentler's FEtlress Kitchen Sink Water Service Switches Sign OWNER BUILDEH bECLARATION I he�eby affirm thaY I.am exempt irom the Conlractor'S License Law for the Lavatories AutO-Wdsh Garba 2 Di5 0531 followin9 reason (Section ]031.5 Business antl Professional Cotle: Any dty or 9 P . Standing Sections county wbicb requires a permit to construtt, alter, Improve, tlemolish or repair P-Trap LaundryTrays any sVucturq prbr_to-its issuance, also reqUires the applicani for such permit Genera[Or OQ5 KW QS-75 KW TraSh Compactor to /iie a signetl stalement that ne/she is IicP�setl pursuant to lhe provisions af Roof Drains lhe Con[raclor's UCens¢ Law (Chapter 9(commencing wl(h Section 7000) ot "� Division 3 of ihe 6usiness antl Profesvon: Cotle) or lhat he/she Is exempt , there�rom antl the basiz for the allegetl exemp[lon. Any violation of Section 7 1. by any applicant tor a Oermit subjects lho applicant to a civil en of not more tban tive hundretl tlollars ($500). I, as owner of the property M-w�Y-�ae�y �_ '��^ Reinspection Fee $15 Issue Fee $ 3 wrte}erteeliew, will tlo the work, antl lhe structure is not Intentletl or offeretl Reinspection Fee $75 luue Fee $ 3 for sale (Section 7044, Business antl Professional Cotle: The Contractor's MECHANICAL FEES License Lzw tloes not appry to an owner of a Oroperty who builtls or imOroves ihereon, antl who tloes such work himself/herselt or through his or her own goiler Hood or T e I � DEVELOPMENT SERVICES REQUIREMENTS: employees, provitletl that zucM1 improvemenrz are not intantletl or oHoroC for VP Q sdle. It, however, tne builtling or improvempnt Is soltl wlthin one year o1 com- Cdnopy Type II ❑ Zoning Approved 8y � Date �' �� O , pletlon, tne owner will nave lhe burtlen of proving he/she tlitl not builtl or im- Dutt - Unde� G�Ou�d BUilding App/OVed By D2te p�ove tor the purpose of sale). �p ❑ I, as owner oi the property, am exclusively contracting with Ilcansetl con- Duct -Structural Refrigeration Sys[em Applitdtion luued By Date �e /CTU tracto/sto consFucl Ihe Oroject ($ecUOn 7044, guziness antl Profesiions Cotle: The ConvactoYs License Law does nol appry to an owner of property wno Duct - Ventilating ❑4100,000 BTU ❑700,000 BTU SUMMqpV OP FEES ,.a builtls or improv¢5 thereon, antl who coniracts to� suGh projects with a con- �—_ tractor(s) i¢ense pursuant to tne ConVactor's Ucense Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alt¢ration BUILDING PERMIT 5 i� SMIP 3 oroot of their Worker's Compensation inspran<e shoultl be provitletl to me. PLAN CHECK 5 ��O PERMIT ❑ I am exemvt untler Seccion B. 3 P. C. for tnis reason Firepl/Fact. BIL ICBO �I`- Fite Dampers p�UMBING 5 ISSUANCE $ �ace - � owner • • Heating System & Ductin9 Registers p�qN CHECK 25% S ENERGV P.C. S hereby certi�y that i have rwd tnis appiication antl state that tne above ❑0.100,OOOBTU �100,0006T ELECTRICAL $ GRADING $ tormation is cortecL I agree to comply with all tlty antl county ortlinances tl state laws relating to builtling wnstruCtion, antl hereby authorize repre- PLAN CHECK 5096 $ MICROFILM $ sentatives o this ily to en[er upOn [M1¢ above-mentionetl properiy for inspection o s.^`� / 'M /- 3 3 �� MECHANICAL S TOTAL FEE $ �� O Si9nature t / ��__k�- � �� Reinspettion Fee S15 laue Fee S 3 PLAN CHECK 25% $ CMF 08fi5-46, rev. 10/84 Wnite - Builtlin9: Cdnary - qppllcanp Pink - Accounting; Goltlenrotl - Assessor UL Ut7UUJ /-ODUU]�(4 1 $`y,�IJ �� "� CONSTRUCTION AND�PLANNING POOL&SPA APPROVALS , P.ermii #�� Date Inspector qppROVALS Permit # Date Inspectoi ._ � 1 i ETemporary Elec[rical'Service or Pole 52. Pool & Equipment Location . � � i . �. 2. Soil Pipe-Undrgrnd. �� '' 53. Steel Reinforcement •� 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding - 5. Steel Reinforcement �y ap � 56. Rough Plumbing & Pressure Test - 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�,GUNITE := 7. Footings �., .. ' 58. Electrical Conduit-Undrgrnd. 8. Foundation�, i� 59. Gas"Pipe, � Undrgrnd., Test i� � ,a 9. Water Pipe�Undrgrnd'. �, 60. Backwash Lines, P-Trap, 0 Undrgrnd. ' 10. Structural Floor System � 61. APPROVAL TO DECK ' , . 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final , 12. Sewer Cap 63. Heater & Vent-Final � 13. Roof Dreins 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. Undergraund Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush '�� 24. Roof Freming 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing � , 74, pverhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ' - 27. Frame and Flashing 76. Dry Standpipe � j , 28. Lathing & Siding 77. FIXED SYSTEM FINAL": . i 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 �SSUED �t: 33. Final Electric Notes: D U`r � !�' 34. Final Heating & Air Conditioning �! i . 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 Irripation SYstem � 45. Sound Attenuation 46. Handicap Regulations � � 47. FINALSTRUCTURE&BUILDING 6 ' 48. Special Requirements Completed , � 49."Electric Release to Edison 1 50. Gas Release to Southern California Gas Co •. Si:_^ERTIFICATE OF OCCUPANCY ) No. � �� Date - , 7,1.a0 N��` b'-1 'a'uQ.�'�'lq/1'YI'�j ��"1 � �% 1N3W1atld3G 9�:I�INtlId 3Hl A8 43AOaddtl 39 lltlHS SN011�3aa0� L+0 'SN0113130 'SNOIlI00tl 314i� "—pa►NlrY io � � •�.�vc —�--�---xf � 'Wi •ilip •flQ19 Ol L7lffM '1d30 °JNINNVId vS3W tl1S0� O � � '�Q�dd� � � W c � r c�'�+'�� - - - . �o�� iI �:';�:",�,-;,,. = , �+ �-1 �: . F � c s �,' '�.'t_: ICify of Costa Mesa Builcing uep'r. � BY �^ _CATE�co 1S �,�- � THESE PLANS A1USi BE ON 106 Ai ALL iIMES MAKE i NO CHANGES VJITHOUT PRIOR qFPP,OVnI OF DEPI�. ' �� %`ts TNE�ISSUANCE OF GRANiIP:v Oi A PF2;dii O; qPp�70VA1 OF � PLANSMDSPEfIF{CATICNSSH.iL:NO!BEtON3i2UE�T09EA iPcRlN7 FOG, OP q,Y AN?RCYAI. pF, AN1' ViCIP.TiC;� OF ANY OF THE PROVISlONS 0.'- T:115 C0^C NO F:dMIT "rkESUMING TO GIVE AUTHORItt TO VIC:4iE pR CAf3CE! THE �F,OV�SI�NS OF 74!5 ICODF. SHqfL BE VA! IC, EXCEP7 1N SO FAF. !S iH_ WOgK OR L5E WHICH li FUiHORIZES I$ Lh�NfUL. THE ISSUANCE OF A P;R1d1T 6ASED U�'O;: PlANS AND SFECIFICATIONS SHALi NpT pg_ryc�•;; 7NE BtlIIDfNG OFFIbA! fF0/t THEREnFTEP. REOl11RINC; iNE E�J2@ECTtpN O"r Fd2pP,$ IN S.IU FiAN:'. k:JD SFC:C(FKAit6N5 �.7 FRQI+I p9EVFpIjIMG BUIIDING O?ERATION58Err4�^- URftiF� 47<FHEkEt,�HppR WH"eN IN VIOIAFfON OF THIS C^v9F OR O� !•.N! OiNFR pRt7,NplV�E OF THE CITY, � TYPICAL 6�� CONCRETE BLOCK Cement Coping Optional --� Channel Btock With 1-3/8� Horizontal Top ot all Fences For Fenees 5' or Less Ven. 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 Reinforeing Steel Shall Conform to Sec�A-15-39 A.S.T.M. AllSteelto be Lapped 24" Of to Code NATUpALGRADE TWO 3/8"� BARS �—+ CONY�NUOUSTOP � & eOTTOM .HOQfLSTEEL MU5T BE TIED IN V.LACE AT TIME OF THENCH INSPECTION. FENCE an � F-� W IDTH p" SEE CHG 9 BELOW D.I"e FOOTING REQUIREMENTS CHART �ENERAL- NOTES MORTAR: p�e part Plasfic Cement, and Three Paris Sand �ROUT: Orie Port Cement Three and One Half Parts S�and COPING: . One Parf Cement, Three Parfs Sand C�NCRETE: Weil Mixed 1:2-I/2:3-I/2 Mox. of 7- I/2 Gallons ot Woter Per Sack of Cement GROUT MAY BE POURED FROM THE TOP OF THE FENCE IN CELLS WMERE STEEL OCCURS. CELLS AND AREAS OF HORI20NTAL REIN- f-0RCEMENT SHALL BE CLEAR, CLEAN & FREE Oi ALL MORTAR DEBH15, ETC. 'H OF EARTHTCOTH V3 THE HEIGTH Of FENCE �OW �80TTOM OF FOGTING. SCALE: I/2��= I' ....-- -�---�— - — . . .. WIDTH . . . . . . . . . . . . . . .14'� 14�� . . . . . . . . . . 12��. 12°.: �._ . ___. , THICKNESS . . . . . . 10'�. . . . . . . . . . . .10" . . . . . : . .". . . g". . '. . . . . 8 ". DEPTH Of EARTHTOOTH . . . 24° . . . . 20�� . . . . . . . . . . . 16" . . �. . . . ' 12�� SPACING OF EARTHTOOTH. . 12' . . . . . . . . . . .14' . . . . . . . . . . . 16'. .'. . . .'. . . . . 16� City of Costa Mesa, California Building Department i-v e � .._:•n_��•:� jLEV�5Ep NpK82. .� _.. .. ..... e ! OWNERS NAME: _ _ _ _ _ _ _ _ _ _ _ _ �_ _ JOB ADDRESS: ._ _ _ _ _ ,_ _ _ _ �_ �__ �_ _ _ FERMIT NUMBER;_ _ _ _ _ _ _ _ _ _ _ _ _ � SIGNATURE. _ _ _ _ _ ^ _ _ _ _ __ _ _ _ 0 � •� r• � r• �a �a �iIS AC�2EEM�S]'P, made atd entered .inm this a day of ' Tfzo�.�s �' . /y��.9 �f V N t= , 1988, by arrl beh+een hereinafter referred � as "LAND R�ft". and .ST�UE S/o�n/n✓/�/, hereinafter referred tv as "ALITACIITr PRCPERTY �1NIIt". It is hereby agreed that a party vrall will be constructed on the praperty line beriaeen �`�08 �A�eiic�e2 L-�`t w ��i0 % / �tiaacess c�i nu�+uiicy rc�zrcaes� (r"e�¢ YI � U i11 in the City of Costa Mesa, Co�ty of Orange, State of CaliSornia, as per map reconied in Book �, Page= of Miscellaneous lSaps, in the office of the Co�mty Recorder of said Cointy. 'lY�e party wall shall be permitted tn encroad� IN WI�SS FF�RE,'OF, the parties have entered into this Agreement the day a� year first above written. i :. � •,iu : �4. .�-��. `� ( Signatise ) Th ��-s � - /� �� a or rr�ntea� 3 �� GAve�Ja�e-z G» caa��s> C�J� �tesa. ( • ADJACE�TS PRC7PEKIY QaNER I , ,�'Y�°.-'Yi.�:t.� _ ��,.�o—,l•-�,e��J (Signatise) . / �'�'ve �To�" our��' N�ne ( or Prin ed) _�`%� ��Lil 7i [ UM l_ d.S fR /tl�'S<I (.4daress ) . y �• . C' 71] 1} �iIS AC�tEEt�Np, made and entered into this � day of � ` -J (InJ � . 19�, by ard behaeen %�i OmA-.� %� . /�l /� hereinafter referred to as "I.AND OFi�tt", and l�A-tJr /7 L� Ui hereinafter referred to as "ALI7ACF2JP PRC�ER'i7t C:ddER". It is hereby agreed that a party wall will be oortistructed on the praQerty line beri+een 3�(9� LA-veilo��°,� .Ln) `d- �j�/� / C�� L"� ( dress o Adjouung Properties) L{�; in the City of Costa Mesa, Co�mty of Orange, State of CaliSornia, as per map recotded in Bodc ; Page_ of lSiscellaneous Maps, in the office of the Coimty Recorder of said Co�ty. �he party �rall shall be pernutted tn encroad� IN WIZNFSS i+F�REOF, the parties have entered into this Agreement the day and year first above written. . •.iu : � �� (Sigttature) � o m/�S- K . Y-� (i�f) Name ('Iyped or Printed) � �o� Lr� ve��en- �,✓ tnaar�s)�S� MesQ G� ; ! • �a � a;..,• �:. • �� ^ �,� � �� _ (Ss�at e) %�r�'l/ t � 'g U� . Nart�e (1�pe� or Printed) � �-ri La-�e,zd e�- �,J (Address) � s��i- n1 ESC� � ( �:—Please�B�e'r�v�Yse sfde=&3r=notazp's--statei+eat) ' ApD��cant to fill in all spaees except tnose within heavy porGer Ilnes ane sign al1 aDDrovriate tleclarations. PERMIT NO. T CT NO L T UNI7 NO. I CITY OF COSTA M SA CONSTRUCTION PERMIT n.P. # zona .�40F3 LAv�,vddl Lt/ ,8E - 35��0.3 � Project Address . S Main Building: Accessory Building: ° AppliCant's Maili�ng��)J dre 5 / TYPE OF CONSTRUCTION NEW ' ADD ALTERATION REPAI R E Front Z � Owner'SName �`"��T� ��H Phnn�.�7� �� CONVERSION ❑ DEMOLISH ❑�OTHER I B N �DESCRIPM7IONOFWORK SEOF-BLDG. A Rear � Addr2ss /"`"'0L- � S�� C Ri ht N Arch�/Eng. � Licenu o.� TYPE OF ERMIT�-�� RAD�Nc�� FOVNDaTio�rv �❑ STRUCTURA� � K 9 G � ❑ TENANT I�ELECTRICAL 1dVLVMBING Ltl'M1AECHANICAL ', g� Left Address � ❑,OTHER , Ping. Ref. # . Parking Req./Provided E Canvactor's Nam E Phon ' Q PROJECT DESCRIPTION SQ. FT. OCCUPANC /iddress Imailing) �• � s � Planning Notes: ' ' M r O3f �i �. CONSTRUCTIONTVPE VALUATION$ , . T �ityLicenseNo. ZONE GRAOINGCU.VDS.- ACRES $, :.ICENSED CONTRACTOR DECLARATION . - I hereby affirm that I am licensetl untler provislons o! Charter 9(commencing Remarks: C%` �, with seclion �000) of DiviSion 3 oT the BuSiness antl Professions Gotle, antl my license is in full t ce a ect. S ELECTRICAL FEES License lass Lic nse No Date� 5iqnature PLUMBING FEES P,utomatic Washer Transformer ❑ 15�50 KW WORKERS'COMPENSATIONDECLARATION . ConStructionPoleSub. �50+KW � I hereby af�irm that I have a certificate of consent to selt-insure or a certificate Bar Sink ShowC�i of Workers' Compensation Insurance, or a certitieqqq copy thereof (Sectlon Cooking Unit Meter ❑up [0 100 amps _ n_ 3800, �ab. c.]��, �7'/ �� J Backflow Preventer Service Sink •� Policy No. �.L(L�/ j"� Company �� Backflow Irrigation Sewer Cap Dishwasher Meter ❑over 100 amps �❑ Certifietl mpy is hereby furnishetl. Dryers ❑Gas ❑Electric Sub Panel t�.Certifir,tllqgy if-J�M,tl with me city Bui ing 'sion. Bathtubs Sewer Connection Date � d a�f Applitant Fan MotorsO41HP01h-8 � � Clarifiers Solar Collecmrs EXEMGTION FROM WORKERS' COMPENSATION DECLARATIO � (Thissection neetl not be complet¢tl if the permi[ is for one huntlreG 5100) or F.A.U. � less). Dishwasher Solar Piping Inc. So1ar 09-15 HP 016-15+ I cerlify tM1at in the performance ot o�k fOr which this �t is issuetl, I PixtU�¢5 Oshall not employ any person in a ann come subject to the Drinking Fountains Solar Tank ' Microwave Worke�s' Compensation Laws o( � Date ' ure � Floor Drains Swimmin9 Pool w/Spa 6 p Device Boxes Pole Light NOTI[E: If, after g this tleclarat� ou shoultl become subject to the Outlets Range Workers' Co sation provisions of the Labor Cotle, you must forthwith FIOo� Sinks U�inal comply � suth provisions or this pE�mit shall be tleemetl r¢vOketl. CON UCTION IENDING AGENCV Gas$erviCe Outlets WaterClo52t Switches $ign I hereby aHirm that there is a wnstruc[ion lending agency for the pertormance � of the work fo� which this pe�mit is is uetl (Section 3097 Civ. C.) ��t¢�CCptOlS WdtCf HCet¢f Gd�bag¢ Di5pO5dl Standing Sections � Lentler's Name Lentler's Atltlress Kitchen Sink Water Service Generator DO-5 KW �5-15 KW Trash Compactor OWNER BUILDER DECLARATION ' I hereGy aftirm Lhat I am exempt from the ConVacto�'s Liwnse Law for the LdVdtO�i¢5 AuLO�WeSh � . IQdL � 00 following reason (Section 7031.5 Business antl Protessional Cotle: Any tlry or county which requires a vermit to construct, alter, improve, tlemolish or re0air p—Trap Laundry Trays . any structure, prior to its issuance, also requires the applicant for sucn permit to (ile a signetl statement that he/she is licensetl pursuant to the provisions of Roof Drains tM1e Contractor's LicenSe Law (Chapter 9(commendng with Section 7000) o( Division 3 of the Busine55 antl Professions Cotle) or that he/5he is exempt peinspection Fee $15 Issue Fae $� theretrom antl the basis (or the allegetl exemption. Any violation of Sectlon 7031.5 by any applican[ for a pe�mit subjects th applicant t0 a civil penalty ot not more than five huntlrea Aollars (5500 . 3 DEVELOPMENT SERVICES REQUIREMENT . �� ❑ I, as owner of the property or my em oy s witn wage heir sole Reinspection Fee $15 Issue Fee $ Zoning Approved By Dat compensalion, will tlo Ihe work, and the st c �e is not tletl o� o/f¢re0 `� �/� tor sale (Seccion �044, eusiness antl Pr ona e: The Convactor's MECHANICAL FEES Building Approved By Date � License Law tloes nol applY to an owner a p tY who builtls or improves tbereon, antl wno tloes such work him rself or tbrough his or her own gOiIC� Hood or Type I ❑ APP��t�on Issued By Dat 6' employees, provitletl [hat such impro ents ar¢ no intentletl O� otteretl fo� . sale. If, however, the builtlin9 or i r vement Is so within one year of com- Canopy Type II ❑ SU RV OF FEES pletion, the owner will have t urtlen of provin e he tlitl not builtl or im- Duct - Unde� Ground p prove tor tne purpose ot sai . BUILDING PERMIT $ 4� SMIP $ �• /8 ❑ I, as owner ot the p erty, am exclusively co ractin9 with licensetl con- Duct -Structurel Refrigeretion System P�.qN CHECK $, 9•�� pERMIT tractors [o const�uct e Oroject (Section ]044, Buzine55 antl Protessions Cotle: The Contractor's cense Law tloes not apply to an owner of property who Duct - Ventilating ❑0.100,000 BTU ❑100,000 BT PLUMBING $ �0 ISSUANCE $ builtls or impr 5 thereon. antl who contracts fo� such oroiects wrth d�om � - iractor�sl hc se pursuanc ro me ConVa<mrs Licenu Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration P�N CHECK 25% $ � SO ENERGY P.C. $ proof of eir Worker's CompensaYion insurance shoum be providetl to me. ELECTRICAL $ '�fs.00 GRADING $ ❑ 1 am xempt untler Section�' - B..& P. C. for this reason Firepl/Fact. Blt. ICBO # Fire Dampers (r p0 MICROFILM $ .i �- - PLAN CHECK 50% $ I.t r; �at ' Owner � " " — � Heatin9 System & Ducting Registers MECHANICAL $ + I nereby cer[ify that I have reatl tnis applicatiOn antl state that the above ❑0.100,000 BTU �100,0006T TOTAL FEE $ ��. 93 Intormation is mrrect. I agree to comply with•all city antl county ortlinances PLAN CHECK 25% $ j antl state laws relatinq to builtling construction, antl hereby authorize repre- �,�C. sentatives of this city erit upon t :above-mentionetl p=o erty�r.-- - �: K InsDection pur ses. fY Signature Dat � "O , --- � Drivers' License or 55 � Reinspection Fee $�5 laue Fee $ 3 Oa DCtp115732—ti0aflti7�s) .TCal` 32�.43 0865-46, rev. 5/88 Whlt¢ - BUIItliOg{ CaOdly - HppllCdht; PIlIk - ACCOl1OLf1g; t301a¢f110O - H552550� �.!2 - �b`'v -\ - d\' . . s � ' CONSTRUCTIOfV�AND`PLANNING '� ' ' ' ,,.� POOL & SPA ' �'� � �� Date Inspector �'1,Date.= Inspector .,� APPROVi4CS'f Permit# � APPROVALS Permit# , %. 7. Temporary � ctrical Service or Pol�e �� :�52. Pool & Equipment Location � (o: 2- 6 2. Soil Pipe�Undrgrnd. q? �� ' ;� 53. Steel Reinforcement `"" � .l N I. 4` 3:1 Elecfrical'Conduit�Utility-UndCy�nd. �f�� ;� 1 54. Forms � � /f I I . 14 Y' I� 4� Ele Lrical.Cpndu t;U�nd`grnd. N ��' , �� 55. �Electrical Bonding � �� , t • . bl r ;. � � . `' i� 5�i �te�Rei_nf,br,cCXent ,�- /t � 56. R'�ugh Plumbing & Pressure Test. � � � EIeY}ical�UF�ER2Grnd� :' .' 57. A;�ROVALTO COVER�GUNfTE (� i9 �P8- L` ^' L1fi�I; G IG Zj Fdotings /j� � ,y '� `� 58. E ectr,ical Conduit-Undrgrnd�t ..�p � ' .. i. i (�!, /1 /� � % 1�.' �. "� W .A,� '• a' �U ':%i" % '�� 59. GasPi e.O Undr rnd!�Cest ' 1, 8 L��?�'j1) ' B�,Fou j ation � �� . � � p g �., Wate'r Pipe-U jdrgr;i��. -� � `�, � 60. Backwash Lines, P-Tlap,,�,Undrg'�nd, rs;? �l �_ . v , . ., ; � . - � . � � 10-Structural F�o6r Sys,{em' � � i� f 61. APPROVAL70 DECK / L�� I ' 11! Property�Sew�r Line'& House Con�ection i/ � 62. Backwash & Receptor�inal ` � n. ./ i ti%' . n '�J 1. y; 12. Se �e� Ca �i'I �� . �� G % 63. Heater & Vent-Final � r � 13.� Roo,f�jDra�s �,.6� � e� 64,' Plumbing System - Final ��tl 14. Ro gh Plumbing�'; r� • � 65. Electrical-Final � - � 15. Rough Electrical-Conduit 66. Solar System-Final �7.��. Rough Electric Wiring 67. Fencing & Access Approval -��7.�` Rough Wiring Sign 68. APPROVED FOR PLASTERING $� � '18. Rough�El'ectrical-TBarCeiling 69. POOUSPASYSTEMSFINAL � � `/' 0,�. � Y�1�9, Rough �veating & Air Cond�ioning FIRE DEPT. REQUIREMEIVT �. � 20. Rough FactoiY Fireplace (�' APPROVALS Permit # 21�. Ducts,in�Structure -� 70.�UndergroundHYdro � . . -- - 22: Ducts, Ventilating ^ .,� . � 71. Product Piping OGas ❑Oil �; , 23. Gas Pipe Rou�qh &4Test �+, . . ' 72. Underground Flush 24�. Roof F�emirrg �� .� r 73. Undergrnd.-Storage Tank O Gas ❑ Oil � 25. Roof Sheathin9 �� ,�� 74. Overhead Hydro 26. T-Bar Ceiling (Structural) &!Monocoat 75. Dry Chemical : �2�.`Frame and FI shing � 76. Dry Standpipe i � 28� Lathing & Siding 77. FIXED SYSTEM FINAL . � 29. Insulation 78. FIRE PREV. FINAL ' � 30. Drywall Nailin9 �� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � • 79. FINAL INSPECTION . , � 32. Electrical PoWer Mete�r-Final id 80. FOOD CERTIFICATE ISSUED ' 33. Final Electric � Notes: ' 34. Final.Heating & Air Conditioning - � � � 35. Final Gas Pipe-Test 36. Hood or CanoPY 37. Final iactory,�Fireplace ' ` 38. F;nal,Plumbing �'�'�•� .. 39. Water Service��inal �.1 � � 40. Gas Service-Final ;:� 41. Solar pomestic-Final.� . �.. . 42. Backflow Preventer � � �,'. �� . - . 43. Backflow Irrigation , . � ' ' .. '� _ • i 44. Landscape Irrigation System � ti � . ,-, 45. Sound Attenuation � 46. Handicap Regulations i . 47. FINALSTRUCTURE&BUILDING � � �� 48. Special Requirements Completed _ . h. 49. Electric Release to Edison �� „ � 1 ;� �50. Gas Release co Southern CaliforniaGasCo �Vv,• _� � '� , � _.y �� -�� _ >-'. 51.-'CERTIFICATE OF OCCUPANCY � � . � - � u -� ri ' • ��i,a ` � No. - Date ' , -.'p � ' � � . o -�-�= � � B L U E- �-� AV E N PO O LS �-'`� �.. .: �� /ur,�c ��-v� 1--� ��- L� C�< f� %1��sa. 7s'� ��o� � 23 HUYEN/OWNEN/S ADDHESS �� _ � /�� %/_ / PE� HO�' � ��Y ACT OATE 5 s MAP BOOK PAGE LEGAL DESCflIPTION • LOT TRACT JOB PHONE Owner and Contracror acknowlad9e j` --._ . _ _. .. __. . r.T.r�'"'_"_' �-_.7._..-'�'__,.- T i .-rr i . ' i ' i i �`�� , �- tha[ [hdY era rasponsible for the . . � . . � . . � � • { ^�� ^ f ) I I � • . � i � i � . .: { -i . � � . I ' I -t . � . _� . . f j - . tollowlnB: r � i . � . .� � � I '� � j 1 r '�-�' � � t I i � .. ... ' �. ... ; I 1 + 4 .. � . I . i ,- T V -,'.��I .. I _ f _ , r _1 . � , ,._ ,_ , ..� � 1 I_ �. t {j I � Yi � �_S t � __�I _' � } .' I I , -{ �-, _ � � � � �. � '• a-� �-i fenc� Ramoval by Concrac�or Owner i . . .- . . _: _. I . t._' � + � _( t � .......� � {I� -;-�t �".. I i � . � .�_. i...y � .� ' l .I -_ I i .. � + I � � I '�p } i ' _ - Fence Re0lacemen� bV -- -.- ... � ,.., , . � i ... i _ .{._ I ! � . i J .i-_I I �._.. i � � �. � � I .i -1-. I I_... . � i : i , ,_".'i '_ TreeHaulin bY .. . . . . �-� I�fl_) I � ��V I � �'i� i _ 1't � !-,' :-' I. j I "_I'� I ; . � � , � i i I I I_ I i Tree R �rta/al D `-' : � � � .i � I y �l`�� N� � � � I I �t IT� I -��~I I _.�-....�'-++ i '- � �t�i'� y._' I Deckin b� Y Y i v_(� .�I.��__. I- : i�_N'_ w 1.., ��--. r_.. _. tj � .i I I !_ d�.�..._� I_,. l.._� !� i- i I i�� E.oans on Joints b Y 1-1�,1-'��-. {_I. .-_I.. in�!_\. �..--�-. �. _ f t_' �Q-:_ I_i' __�� __i �� i-_ .. i`a�l_�-i1 �-I I_..�� I .. i.......�' �...�_� f_..J.� G as L i ne & Pe rmrts b N `1 `�, `` 4 I ' Heater Ventina bv ,_':�V'_' �"`�_j �__'_ �--- '_tV�- �--u+-�� _ �i�'T_�'j--�-(� � I-i__'� i � I ��` -:`_i__� ``i°; U�`` r � I . � . , 1� I I I � 7� I I I H 1 I �� I �_ , i u � � i �ni � __ _ _•__ _ , _ booxup oy � -->t SALESMAN �� b!!�.T_�_.l. �� MUST INDICATE LOCATION ON YMIS OI- �'' !=.`� � � SCALE DNAWING OF ALL ITEMSO i`V� -� � LISTED BELOW AND THE FOLLOW�NG r1 �,' _(� MUST BE ACNNOWLEDGED BY ��-.. ' - ��-. \ OWNEN'S INITIA�S. '__`.��_� � Shepe of Pool � �+---� 1__l �. LenO�h of Pool '-�-;'�14 � � Dep[h of Puol i'-." �� i Fil[ar Location F- r' �-j i-- T Board Locacion � �� i - + ��_ �-!�'_r._I-'-. . _ L�Bht Location __ _ _ .� � _ � � --- r�� — , • -'--i IOCATE THE FOLLOWING ON I--! DRAWING: �Pool Shave & �imensions .-. 'Access .w.... .. L. ''�_i ered Patio -,� �. i I' �� I' � ; %' vic eox � . - } --'-- Meter � t -... .._�""'� ' _�'_i'.,_-i...., _. Dis[ance Pool from. -'j"�'+-�-^-' �-�-i--r House & Prop. Lines � � i i I ; i � Ovarhead Utiliry Line i �� i � r �-,--I�_�_i' _ `��_ PuClic U�ility Easements I ly,�� I� i' Exi5lin0Structureor I � , i '�-'�-?�"j-';- �",._..__ . Proposed Sirucmre on PwO. ��_ %- T' �-� i , i ACCESSDAMAGEORUNDERGROUND -'-' " � -- �j '_'' I i � � ....: DBSTFUCTIONS: ��--.-�-'--;--I��` i ` CONTRACTOP cannot assJme 1 1� i resDo�siOility for damape [o culbs, � }' '�-� � ___� �- � �idewelks.Eriveways.cementslabs, I-�-I �i �I 'I"' -'i'� I �"- sawors, lawns. Vees, /ences, re� L' � .' . I..i_ caininp walls, s0�inklers, telephone ' �' j' lines, contluits, gas linas or shrv05. � � � � � � -� � j Nhen accass is made Nrouph a ' � ' ' . ; !" --�-� -!--! ieiBhboYs O�operry it is u�erstPod r'- • „""' -:_ "_'I_''.. :hat you, the owneq have Nat neioh- 1,� j ' �oYs {__._t.. ;.'�_ I_.___ Dermission an0 assume /ull I � 'esoonsibiliry. _.. I _: 1. � I _ F . .. _ 4 �_I lUVEP APPqOVES PLAN ANU SPECb � �� 'ICATIONS AS OUTLINED HERE��`1. j i GND HAS fl CEIVEO A COPY OF � -r:� j, � T-' � fH13 LAN. -�-�'� "i _' �__ "�_ �_, ,- ��,��r�.:.. � , �r �_.-=�_.,: _ �-,--. , ��a�1 f- >,r�c� : ,_. _, � � , ____�_. � ;caie t/8" �— � i � _._:--4-.-; jT I � � � I � _:_...._,_r -r-i--� i i ialesman � i ' i '�., _ � "I _' _' _A' ` • _.- � � "' j—f- � -j � , � � H �--r �_f �~�_ _.if_'� _�� i _� I. PU�1P FILTER HEATER � i `-'-� � �� ❑ � r__ L'�l.y_ t' I_-�_�.'_'r � I r '--- -�-; j- ; -; t- �I � GAS EIEC. � I '�-"I-"-i"i�"-f-I METER METER -1-"-�� -- - . ' �� ..! ._ � ' ..t/ ' � _�. �� o � \ ` - :_', � ', � � ,� _r NEAREST N - � � HOSE BIB ELEV. PT. � ' � i � _�' _�i�i _' -i .a �� .o. _ _,:,:�- ` � ,� � SNIMMER �ADDEF UGHT .f... � r � . y _ f'_"... . ,. � f DivinpBoartlS ��( .r.L r y _, _4 �__ G' BoarE I' Over W.L. -^-- -- . ' 8'�Board 1' Over W.�, 10' eoard 2' Over W.L �.�_ . i__�.. � I.�_i_ (,_i__i 72' Board 3' Over W.L. STDi FORM NO. T3309 �- --= L� i_ I_L�-I_L n �� E ' � � ADP��ant to fill in all s0a s xcept ose witnin neavy boraer lines ana sign all aoo�opriata tleclantians. CITY OF COSTA MESA �CONSTRUCTIOf� PERMIT P MIT O. . TRACT NO. LOT NO. UNIT N6. Project Address 3� F1' �l+i G�P4�/G-i ��'Yfi¢ �°�f�-� �- /a�0// �� 4308 I 2/ I 9/3p L+oe: T.. Applicant'S Mailing Address � L` yj�lu TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR /f is/6'•!c% Tk.r ., Owner'SName � �� '� Phone � CONVERSION ❑ �EMOl.ISH ❑ OTNE� q,p,�6 1_ 3�O Zone — � DESCRIPTION OF WORK/USE OF BLOG. r� 0 S 2 Address �u0 L9dn,.� s'.J' ��1t2 �b(R'i ��i[.64 S MainBuilding: �d Accessory8uildin9: $/Y/� Arch/Eng. � License No. TVPE OF PERMIT ❑ GRADiNG FOUrvDATiorv �STRUCTURa� T Front (,L , G[.�T, p Address ❑ TENANT ❑ ELECTRICAL ❑ PLUM6ING ❑ MECHANICAL gn Redf P� / r/ �5 / N CoMraCtor's Name � A � ❑�OTHER O to h�oJeJ•30-20f'P C Ri9ht L.F� � 5� N `� CC1lU. T �k, �I�� PpaECT DESCRIPTION 5a. FT. ocCUPAN� S M_/ K Addreulm�'��gl ��`3� C' //�S CONSTRUCTIONTVPE VALUATIONS L.d� g Left 5� �'�L City LicenSe No. �O ZONE GRA�ING CLL VDS. ACR 5 E LICENSED CONTRACTOR DECLARATION Ping. R¢f. # Parking R¢q./PrOvided Q 1 hereby a/firm that I am licensetl untler provislons of Charter 9(commencing Remarks: PldnOiOg NOL¢5: ry� wi[h section ]000) ot Division 3 ot the Business ana Professlons Cotle, antl my license is in tull t rc antl effect. .0 • � S S License Clazs �� 7 'c se N��Z3 • Date � Si9nature � • _ PLUMBING FEES WORKERS'-,/�SATION DECIARATI Bd� $ink ShOw¢fs 1 nereby a(firm that I have a certificate of consent to sal(-insure or a<ertitiwte ELECTRICAL FEES ot workers' Compensation Insurance, or a certHletl cooY thereoi (SecUon BackflowPreventer ServiceSink 3800, Lab. �0 y��nz. - �� F o AutOma[ic Washer Transformer ❑ 15-SO KW Pcy7cy rvo. Company 4��` Backflow Irrigation Sewer Ca ❑ 50+ KW P Construction Pole Sub. Certifietl copy is hereby iumisnetl. �/ // Certifietl c�with tne citY i Q^ I° /fCm(l.'f�� Bathtubs Sewer ConnecUon Cooking Unit Meter ❑uP to 100 amPs Date Applicant - E%EMPTIOf�I OM WORKEF25' COMPENSAT N DECLARATION Cld�ifi¢�5 $OId� C011¢Ct0�5 DiShwdSh¢� M2t¢� ❑Ov¢� 1��drt1p5 (TOis se�tion neetl not be completetl it the permit 15 tor one huntlretl ($300) or - less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the perlormance of the work (or which tnis oerm�t is issuetl, I zha11 not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors �0-1 HP 01'h- 8 Workers' Compensatlon Laws of Calitomia. . Date Si9nature Floor Drains Swimmin Pool w/S a 'NOTICE: If, after making this tleclaration, you snoultl become subject ro lhe 9 P F�A�U� InaSolar 09�75 HP �16-75+ Workers' Compensation provisions ot Ihe Labor Cotle, you must forthwith FI00! SinkS U�indl Fixtu�¢5 comply with such prOvisions or thi5 p¢rmi[ Shall be tleemetl revoketl. Mic�Owdv¢ CONSTRUCTION LENDING AGENCV GaSService OuUets WaterCloSet DeviceBoxeS 1 hereby aHirm tha[ there Is a construction len�ing agency for the per(ormance Pole Light of the work for wbiclL [�is Pe/mi[ is 65uetl ($ection 309] Civ. CJ Interceptors Water Hearer DuLIEtS Ran9e Lentler's Name ��'�� L Lentler's Atlaress Kitchen Sink Water Service OWNER BUILDER OECIARATION Switch¢s Si9n I hereby atfirm fhat I am exempt trom the Conlractor's License Law for the Lavatories Auto-Wash tollowing reason (Section 7031.5 Buslness antl Professional Cotle: Any city or Garbage Disposal ; Standing Sections county which requires a permit to construct, alter, improve, aemolish or repalr P—Trap Laundr Tra s any structure, prior �o I\s issuance, also �equlres lhe appllcanl for SucM1 pe�mit Y Y Generator �0-5 KW �5�15 KW T�25h COrYlpdCtO� to file a slgnetl statemenl lhat he/she is IlcenSetl pursuant to IhC Orovisions of ROOf D�ainS the ConVac[or's Licenie Law (ChaO�e� 9,(tommencing wlth Soc[ion ]000) of Division 3 of Ihe Busine55 antl Proles5�On5 COUe) or (ha[ ne�sne is exempt therefrom antl the ba5i5 f0/ ttte allegetl exemption. Any violation of Section � ]031.5 by any applicant for a pe�mlt Subjec[s tM1e appliGant [o a civil eenalty of mt more tM1an five huntlretl tlollars (E500). , LJ I, as owner ot the property or my employees witn wage5 as thel� sole RBinSpeMiOn Fee $15 ISSue F¢¢ $ 3 compensation, will tlo Ihe wotk, antl the structu�e I5 not intentletl o� o/fer¢tl RBi�Spection F¢B $15 ISSUe Fee $ 3 tor sale �Section 7044, Business antl Professional Cotle: The Contracror's MECHANICAL FEES License Law tloes nol apply to an owner ot a 0/o0erty wito bui1C5 or improve5 - thereon, antl �who aoes such work himself/nerselt or throu9h itls or her own , DEVELOPMENT SERVICE$ RfcQUIREM% TS: emplovees, provitled that sucn improvements ara not intentletl or offeretl for Boiler ' Hood or Type I ❑• Zonin A roved B DKC �ifi{�/ �� Data �Z �9 sale. If, however, the builtling or improvemen[ is wltl witM1in ona year ot com- Canopy Type I I ❑ g PP Y f pletion, Ihe owner will nave [he burtlen ot proving h¢/she tlltl not builtl or Im- DuCt - Und¢��(�i�0und Building App�ovBd By __DOte prove tor the purpose of sale). ., ❑ I, as owner of tne property, am excluslvely contractin9 with Ilcensetl con- Duct - Structural ' Refrigeration System AppliUtion luued By Dat [IdCIOR f0 COlISLYUCt lhC plOj2CI (SCCLI00 JO44. BUSIIIC55 dOG PlOfQ5510lIS COtl¢: Tne Contracror's Li<ense Law �Ioes not appry to an owner ot prooerty wno Duct - Ventiiating ❑0.100,000 BTU ❑100,000 BTU S ARV OF FEES builtls or improves Ihereon, antl who conVactS lor sucn prolects wi[h a con- ' tractar(s1 license pursuant ro the.Contracior's �icense Law). I am aware tnat Exhaust $ystem ❑ MWtiple ❑ Sys[em Repair/Alteration � BUILDING PERMIT $ O $MIP '$ �•SD proof o( cheir Worker's Compensation Insurance shoum be provitletl m me. PLAN CHECK $ �7• ZZ pERM1T , ❑ 1 am exempt untler Section B. & P. 0.(or this reason Fiiepl/Fact. BIL ICBO # Fire Dampers pLUM6 WG $ ISSUANCE $ � Date Owner Heating System & Ducting Registers p�qN CHECK 25% $ � ENERGV P.C. $ 1 hereby certify that I have reatl this applicaclon�antl state tnat the above ❑0.700,000 BTU �t00,0006T - - GRADING $ intormation iz mrrecL I agree to comply with all dly any county ortlinances ELECTRICAL $ ana state laws relatin9 to buildin9 constr ction, antl e 0by authorize repre- . � PLAN CHECK 50°.6 $ MICROFILM $ sentative5 of this,cily to t P e ove- tionetl property for /' insoectionqwp�s�y G�J MECHANICAL $ � "��.2Z Signatur¢ �J� Date �2 �' a r , TOTAL FEE $ Drivers' License or 55 � Rainspee[ion Fae $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46, rev. 10/84 White - Builtlin9; Canary - Applicant; Pink - Ac<ounting; Goltl¢nrotl - Azsezsor CONSTRUCTION AND PLANNING ; � POOL & S°A . ' APPROVALS Permit# �Date Inspector AppROVALS Permit# -Date InspPr.tor I �1. Temporary Electrical Service or Pole - � 52. Pool & Equipment Location � 2. Soil Pipe-Undrgrncl. � � 53. Steei Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4'.'Eleciiical Conduit;Undcgrnd. � 55. Electrical Bonding � , 5.�'Steel Reinforcement .� ,- 56. Rough Plumbing & Pressure Tesi , 6. Electrical UFER Grnd. 57. ,4PPROVALTO COVER-GUNITE 7. Footings � 3�.� �� 58. Electrical�Conduit-Undrgrnd. • S.�Foundation ��' ' 59. Gas Pipe, O Undrgrnd., Test .��'� 9..Water Pi e•Undr� rnd. ' • � ' �i' P 9. ��, 60. Backwash Lines, P-Trap, O Undrgrnd. � 10. Structural Floor'System ' 61. APPROVAL TO DECK 11. Property Sewer Line_ & House Connection � � 62. Backwash�& ReceptorFinal �12. Sewer Cap , � !' 63. Heater & Vent-Final . � . a 13; Roof Drains �� 't 64. Plumbing SYstem - Final � 14. ,Rough Plumbing'. 65-. Electrical-Final y 15.'Rough Electrical-Conduit � 66. Solar System�Final � 16 � Rough Electric Wiring • 67. Fencing & Access Approvaf 17� Rough Wiring Sign - 68. APPROVED FOR PLASTERING . i 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL . , t1191 Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT _: � ' j20. Rough Factory Fireplace , APPROVALS Permit # � � �+21. Ducts, in S[ructure .�_� 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas C70i1 i 23� Gas Pipe-ROugh & Test 72. Underground Flush 24. Roof Framing 7� �,; � , 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing � . 74. Overh2ad Hydro 26. T-Bar Ceiling (Svuctural) & 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. Electrrcal Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric � Nntes: 34. Final Heating & Air Conditioning - 35. Final Gas Pipe-Test ' � 36. Hood or Canopy 37. Final FactorY Fireplace 38. Final P,lumbing � � � � � � 39. Water Se}vice-Final 4�. Gas Service-Fi�at , . � 41. Solar pomestic-Final , . " ,;�{ . 42. Backflow Preventer ' ' '� � f%�: 43. Backflow Irrigation � � � � ' - , ?"� 44. Landscape Irrigation System . 45. Sound Attenuation ' , _ . 46. Handicap Regulations'� � 47. FINALSTRUCTURE&BUILDING � �r' � � , . 48. Special Requirements Completed - � � � • 49. Elec[ric'Relaase to Edison - � - - - 50. Gas Rel'ease to Southern California Gas Co ' • ' �, �' 51. CERTIFICATE OF OCCUPANCY ' . - . ' ' , � � �o. Date � ' , . . ' . ' � Applicant to fill in ail soaces exeoo� tnose within heavy bortler Iinas antl si9� all apo/opriate Ceclarations. ` � PLAN 3 Elev. C Cll Y UF COS�TA MESA PERMI NO. TRACT NO. LOT NO. BLD . . � � � -CONS��UCTIONPERMIT LOT 18 � �ZQ 5160 3/0�/84 „4'.2E;' t Proj¢ct Address ,�Q I��,von�i�^ ��[�a TYPE OP CONSTRUCTION NEW /�.DD ALTERATION REPAIR Applicant'sMailingAddress �❑ CONVERSION ❑ DEMOLISH ❑ OTHER p,p,;y, .��Z, Zone Owner's Name 5+�...I��rl O�ri fir !'nrn Phone��}�� DESCRIPTION OF WOaK , S Main Building: �+cceuory Building: Z E O Address C� h ' �dx� TVPEOFPERMIT GRADING FOUNDATION STRUCTURAL T Front Zv �. N Arch/Eng. ��m��rfe�ex� Licenie No. ��ag� ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL 6 Reaf � Address �� -�r��'��r�}-��•i ., ❑,OTHER ' ' C Ri ht , G ~Phone� PROJECT DESCRIPTION S�.FT. � oCCUPANcv 9 S Contractor's Nam �ee�� —=6$�— 9!l K Left � R AddrCss�mailingl N� ' CONSTRUCTIONTYPE VALUATION$ 144_5�JV_ S S � . " E //�/ p� . ZorvE GRADINGCU.vDS. ACRES ping,Ref.# y3�ro 2��1 Park.Fees$ �s 5�� n CityLicenseNo. L✓ U LICENSED [ONTRACTOR DECLARATION , Remarks: � Parking Req./Provided y � 1 hereDy afiirm lhat 1 am Iicensetl untler pwvisions of Charter 9(commencing . � . _ q with SeC[ion 7000) ot Oivislon 3 ot lhe BuSin¢55 antl PrOfe55lons COtl¢, antl • � USC Of BUildlflJ: n � ' E my Iicense is in tull forc antl e(fect. ' . License Class - LI se . PLUMBING FEES P�anning Notes: ' M E oa�e ��_�T�.�� siv��m�e Bar Sink showers HOLb FOft SPECIAL RE UIRa"sMENTS N W00.KEH5' COMPENSATION DECLARATION 7 I her¢by affirm that I have a certititat¢ ot consent t0 self-Insure o� a ce�tlflcate Backflow Preventer . Service Sink ' S ot-Workers' Compensation Insurance, or a certifietl copY thereof (Section 3800, Lab. c.) � Backflowlrrigation SewerCap " � ELECTRICAL - FEES vor�Y No.WP-R4-225-856 comaa�v Fremont Indemnitv .`� � �� BCertifietl copy is hereby fumishetl. Bathtub's � Sewer Connectioh i_ • Automatic Washer Transformer ❑ 75-50 KW' Certifietl co y is tiled with the city Builtling Division. Date_.]�-��R3 ApplicanC Standard-Pacific Clarifiers � SolarCollec[ors ConstructionPoleSub. ❑50+KW � EXEMPTION P0.0M WORKERS'.COMPENSATION-DECLARATION Dishwasher - . Solar Piping ' Cooking Unit Meter DuP [O 1002Tp5 (This section neetl not be completetl i( the Dermit iz for one huntlretl (5100) or lecertify that in th¢ perfo�mance of�the wo�k (or whith th75 p¢�T�t is Issuetl, I D�inking FOufltdi�5 Solar Tank � � DiShwdSh¢� M¢t¢/ �OV¢� 100 drtlp5 shall not employ any person in any manner so as to �ecome subjec[ to lhe - . workers' Compensation Laws oi Califomia. Floor Drains Swimming Pool w/Spa . � Dryers OGas ❑Electric . Sub Panel " Date Si9nature . _ NOTI[E: If, after making this aeclaration, you shoultl become subjeCt to the � FlOor Sinks Urinal Fan� MotorS �0.1 HP �t h� 8 Workers' Comp¢nsa[ion provisions of.the Labor Cotle, y0u must forthwith , , - comply with such provisions or this permit snall be aeemed revoketl. GasService ' Outlets� Water Closet .� - F.A.U. InaSolar �9�15 HP �16-15+ CONSTRUCTION LENDING AGENCV • I hereby atfitm that there ii a Constructlon lentling agency tOl the pertormance Int¢!c¢ptO�i W8t¢f H¢dt¢� Fi%tuI¢5 � MiC�ON2v2 of [ne work for which this permil is issuetl (SecHon • 3097 Civ. C.) _ ' Lentler'z Name Kirchen Sink ' Water Service 'Device Boxes Pole Light Lentler's Aatlress Lavatories ' OWNER BUILDER DECLARATION � - OutleSs R2nge I hereby atfirm t�at I am exempt irom the Contractor'z Litense Law for the p_Tra following reason (Section ]031:5 BuSiness antl Professional Cotle: Any city or P Swilches Sign county which r¢quir¢5 a p¢rmrt to cOnst�ucq alter, ImO�ove, tlemolish or repdir 'any structure, prior to Its Issuance, also requires Ne applicant tor such permi[ Roof Dfains Garbage Di5po531 . Standing $¢ctions ' to file a'si9netl statement that he/she is licensetl pursuant to the Orovisions ot the Contractor's License Law (ChaOter 9(commencing with Section 7000) of . GCneratOt �0.5 KW �5-75 KW T�ash Com actOr �Oivision 3 of the Business antl Protessionz Cotle) or that he/she is exempt P therefrom antl [he basis for t�e allegetl exemp[IOn. Any vioiation of SectiOn . 7031:5 by any applicant tor a permit 5ubjecK the applitant to a c7vil - ce �5 IsSUB Fee $ 3 � enalty of not more than tive huntlretl aollars ($500). ' Reins ction Fee ' � I, as owner of the property or my employees with wages as thair sole MECHANICAL Reinspection Fee S25 Issue Fee � $ 3 compensation, will tlo the work, antl ih¢ structure is not Intentletl or ofteretl FEES tor zale (Section 7044, eusiness and Professional Cotle: The Contractor's . PUBLIC SERVICES RE�UIHE ENTS: LicenSe Law tloes not apply to an owner ot a property who builds or improves ' Boilef Hood or Type I ❑ ��(�L (� ,Z 27 thereon, antl wM1n eoes such wo�k himselt/her5elf o� th�oug h his ot he� own Zoning.App�aved By Date employees, pwvitletl tM1at SucM1.Improvement5 are not intenGntl o� otferetl for DuCt - Und¢f C�iroUnd ��Opy � Type I I ❑ 3 J�y � sale. 1f, however, the builtlin9 or imprOvemen[ Is soltl within one yedr Ot cOm- Application App�Oved By DatB 6 pletiOn, the owner will nave the burden ot proving ne/zhe tlitl nOt builtl or im- '. � �rove for tne purpose oi zale). Duct - Structurol Re(rigeration Sys[em Appliption Issued By � Dat �� g I, as owner of Ihe property, am exclusively contracting with lic¢n5¢tl con- tractors to construct ihe o�oiect (Section 7044, Business antl Protessions Cotle: � Duct � Ventilating �0-700,000 BTU ❑100,000 BTU SUMMARV OF FEES The Contractor's License Law tloes mt apply ta an owner o, P,oae.�Y who � . 545.50 �Q. � 2 builtls or improves tnereon, antl who contracts tor such projects with a con- ' Exhaust System ❑ Multiple ❑ System Repair/Alt¢ration BUILDING PERMIT $ SMIP $' tractor(s) license pursuant to the Contractor's License Law): 'PLAN CHECK $ 8Q+-�4 PERMIT ❑ I am ezemot untler Section B. & P. C. for this reason Firepl/Fact. BIL ICBO # PLUMBING $ ISSUANCE $ oate Owner Heating System & �ucting PLAN CHECK $ ENERGV P.C. $ I hereby certiry chat i have read tnis aoP��cation ana state mat the above ❑6100,OOOBTU �100,0008T ELECTRICAL GRADWG �$ information is correct. I agree to compty with all dty antl county ortlinantes ' - ' $ antl state lawz relating to builtling constructlon, ana hereby authorize repre- PLAN CHECK $ MICROFILM § sentativ¢s ot this city [y� ent upon the above-mentioneC pr erty tor inspectlon�vns� �� MECHANICAL $ TOTALfEE $ fida iF+ S�gnature%r� Oate�� painspection Fee $25 Issue Fee $ 3 PLAN CHECK $ Drivers' License or 55 � CMF086�-46/ev.)/83 Wh�te-BWItlin9;Canary-Appli�ant;Pink-ACCounLng;GolUenroO-As5e55o� � CONSTRUCTIOPI AND PLANNING - POOL & SPA " APPROVALS Permit# Date Inspector p�ppROVALS 'Permit# Date Inspector �'.;. Tem orar Electrical Service or Pole p Y 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 ,i', 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 Approvaf 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling �� ' 69. POOL/SPA SYSTEMS FINAL 19. Rough Heacing & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure � 70. Underground Hydro 22. Ducts, Ventilating ' 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test , 72. Underground Flush 24. Roof Framing - � � 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing a�sy � 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 �� /G 78. FIRE PREV. FINAL 30. Drywall Nailing ' �� If �� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric � Notes: �./ � Yr¢ . 34. Final Heating & Air Conditioning � 35. Final Gas Pipe-Test . ` �d �d 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. .Laridscape Irrigation System 45. Sound Attenuation �� 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING �/ . 48. Special Requirements Completed , p� � 49. Electric Release to Edison � - � � 50. Gas Release to Southem California Gas Co . , � 51. CERTIFICATE OF OCCUPANCY ' No. Date � /-� ��! ��. . Aov��ant to till in all soaees e� pCthdse Withln h2avy bo}�i��gn al1 avProoriate Oeclarationz. CiTY OF COSTA [E/$A STRU TION�j /��.,E�R.MeIT �ER NO. � TRACT NO. LOT NO. UNIT.NO. _ _ Project Address -�/D� /.+:�� /-�/Y�"'� AppliCdnt�s Mail d� TVPE OF CONSTRUCTION EW ADD ALTERATION REPAI R Owne�'S Nam��=� � �-��_�ho i '� � � �ONVERSION ❑ DEMOLISH ❑ OTHER p,p, # Zane J �j �%%�� DESCRIPTION OF WORK/USE OF BLDG. Addreuf �r��'�� `�'s"�" ��"� - ' S Main Building: Accessory Building: Arch/Eng. ' License No. TVPE OF PERMIT ❑ GRAOING��}. FourvDATiOrv ❑ STRVCTURAL T Front p Address' - ❑ TENANT ❑ ELECTRICAL �LUMBING � MECHANICAL A Rear ' � ' ' N ❑ OTHER Contractor's Narp , io ��-� C Right � N Address (ma'�"�9� %��yL �ift/ �� PROJECT DESCRIPTION 5�. FT. OCCUPANCV CONSTRUCTIONTVPE VALUATION$ g Left G City Lic¢nsP No '� � ZONE � GRADING CU. VDS. ACRES R LICEfJSED [ONTRACT00. DECLARATION Pln9. Ref. # Parking Req.IProvided E Q I hereby affi�m that I am licensetl untler provi5ions of Charte� 9(commencing Remarks: . Planning Notes: . M WI�II 5¢CIIOl1 %00�) O� DIVISIOfI 3 of the Business dfltl Pl0}Q551005 COdE� dlltl my license is in fu force effect. . T Licen��ss � � Lic¢n9e N� S' Date � 5'9 t i� PLUMBING FEES WORK RS' COI PENSATION DE LARATION � I hereby aftirm that I nave a certificate of mnsent to self-insure or a ceriiticate Bar Sink / Showers � � ELECTRICAL FEES of Wo�ke�s' Compensa[ion Insurance, o� a certifie copy.[hereof (Se[tion gackflowPreven[er ServiceSink . . Automatic Washer Tronsformer ❑ 15-50 KW 3800, Lab. C�rn�i�/y/ , � . ❑ 50+KW Policy No. �� Company Backflow Irrigation $ewer Cap . Constructior Pole Sub. Certifietl copy is M1e�eby tu�nishetl. CerC 'etl ooy i,fi tl with the ciSy�Q i�J� D i j+ / Bathtubs Sewer Connection Cookin Unit Meter ❑u to 100 am s Da[e J APPlicantZ(/•/•�� /� /w ! � 9 P P EXEM TION FROM WORKERS' COMPENSATION DECLARATION Cl2fifi2�5 $Ola� COII¢CtOfS Dishwash2� Meter ❑Ov2r 100 dmps (Thissection neetl not be completetl if the permi[ is for one huntlretl ($300) or � . less). Dishwasher Solar Pipin9 Dryers ❑Gas ❑Electnc Sub Panel 1 certify that in the pe�fo�mance of (he work fo��whlch this pe�mit is issuetl I shall' not employ any person in any manner so as to become subject to t�e Drinking Fountains Solar Tank Fan Motors �0-1 HP �1 %- 8 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa NOTICE:It,afte� mdking this tlecla�ation, you shoultl bemme subject to the F.A.U. IncS012� �9-75 HP Oj6-15+ Workers' Compensation provisions of the Labor Catle, you must forthwitb Floor Sinks Urinal Fixtures Microwave mmply wilh such p�ovisions or this permlt 5M1a11 be tleemetl revoketl. CONSTRUCTION LENDING AGENCV GasService � Outlets WaterCloset . DeviceBoxes I M1e�eby affirm that there is a mnstruction lentling agency for the perfarmance P012 Liyht ot the work for which this pe�mit is issuetl (Section 309] Civ. C.) Int¢�CBpto�S � Wdt2� H¢d[2/ Outl¢t5 Range lPnaer's Name Lentler's Atltlress . Kitchen Sink Water Service Switches gi9� OWNER BUILDER DECIARATION , 1 I hereby affrm Ihat I am exempt from the Contractor's License Law fo� the Ldvdto�i¢5 . . tollowing reason (Section ]03L5 Business antl Groiessional Cotle: Any city or Garbage DispoShc ' Standing Sections county which requires a permit to construct, alte�, improve, tlemolish or repair P—T�a 1 ' any structure, prior to its issuance, also requires the applicant for such permit P 1 Generator �0-5 KW 05-15 KW Trash Compacmr to file a si9netl statement that he/she is licensetl pursuant to the provisions of Roof Drains � - tbe Cont�actor'S License l.aw (Chapte� 9(commencing wi[h Section ]000) of � � DivisiOn 3 of the Business antl Professions Cotle) or that he/She is exempt - therefrom antl the basis for the allegetl exemption. Any violation of Section " �031.5 by any applicant for a permit subjects [he ap0licant to a civil [e�dlty of not more than five nuntlretl tlollars ($500). ' . LJ I, as owner of the property or my employees with wages as tneir sole ReinspeMion Fee $75 Issue Fee $ 3 compensalion, will tlo IM1e work, antl the SVucture is not intentled or o!f¢r¢tl RBins ¢ctiOn Fee $ 3 for sale (Section �044, eusiness antl Pmiessional Cotle: The ConVactor's MECHANICAL FEES P $�5 luue Fea License Law tloes not apply to an owner o( a pwperty who builds o� imprOves thereon, antl wno tloes su<h work himselt/herselt or throu9h his or her own goiler . Hood or T e I ❑ � DEVELOPMENT SERVICES REQUIREMENTS: employees, provitletl that sucn imp�ovements are not intendetl or otfereG for YP Zonin A mved B sale. It, however, the builtling cr improvement is soltl within one year ot com- � . Canopy Type 11 ❑ 9 PP Y Date pletion, tM1e owner wlll have tM1e burtlen ot proving he/she tlitl not builtl or im- Duct - UndB� G�Ound BUilding App�OVed By Date �rove for Ihe purpose of saleJ. Z I, as owner of tne property, am exclusively contracting with licensetl con- Duct - Structural Refrigeration System Appliratian Issued By Dat tractors to wnstruct the project �Settion ]044, Business antl Profession5 Cotle: a The Contractor's License Law tloes not appry to an owner ot property who Duct- Ventilating ❑61000006TU ❑700,000 BTU SUMMARV OF FEE$ builtls or improves thereon. an0 who mnVactS fot such projects'with a con- tractor�sl license pursuan't to tne Contractor's License Law). I am aware that ExhaustSystem ❑ MWtiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance zhoultl be provitletl to me. PLAN CHECK $�_ PERMIT ❑ I am exempt untler Se[tion B. & G. C. for this reason Firepl/FacL Blt. ICBO # � PLUMBIN ISSUANCE $ � Date Owner Heating System & Ducting p�,qN CK 25 a V P' $ I nereby certiry ihat I have reatl this application antl state that the above ❑0.100,OOOBTU �100,OOOBT ELEC RICA $ � IN � intormation is corr t. I a9ree to comO�Y wi[h all city antl county ortlinantes and state laws r la ng to builtlin9 constr ction, antl here y authorize repre- PLAN CH CK 0% $ IC OFILM $ sentatives of t 5 c' y to ente� up e a ve- enti netl property for Inspectionpurp s MECHANICAL $ TOTA�FEE $ Siqnature � Da[e Drivers' License or 55 � — Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ GMF 0865-46, rev. 4/84 White - Builtling; Canary - Applicanq Pink - Accounting; Goltlenrotl - Assessor .; ' CONSTRUCTION AND PLANNING ' POOL & SPA y APPROVALS� permit# Date Inspector p�ppROVALS Permit# Date Inspector �,� 1.iTemporary Electrical Service or Pole' _ 52. Pool & Equipment Location � 2. Soil Pipe-Undrgrnd. �' , 53. Steel Reinforcement _, 3. Electrical;Conduit Uti�iiy-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 ' ' i� � 58. Electrical Conduit-Undrgmd. _ 8. Foundation - -, 59. Gas Pipe, � Undrgrnd., Test � ' 9. Water Pipe-Undrgrnd. � � 60. 8ackwash.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 76. .Rough Eleciric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLAS7ERING 18-Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • 19.' Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in StructUre , ' 70. Underground Hydro 22. Ducts, Ventilating •- 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test • � . �' 72? Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 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 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 STRUC7URE & BUILD�ING ' _ 48. Special Requireinents Completed ' � 49. Electric Release to Edison � � � 50. Gas Release to Southem California Gas Co '- 51. CERTIFICATE OF OCCUPANCY No. Date 3�' Applieant to flll In all spaces except those within hoavY �ortler Ilnas antl sign all appropriate tleclarotions. .. CIFY�OFLOSTA MESA � 8 PERMIT NO. TRACT NO. - LOT NO. BLD . . . - 'CONSTRUCTION PERMIT 9� , 5768 3/09/84 4D..50 ��' �j¢ct AddreSs' TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR '� A�liCent'S Melling Add 55 . �4'—I'/ ❑ CONVERSION ❑ DE OLISH ❑ OTHER • ,q,p, �(6 '. � ' Zone� ' ' � � OWnEr'SNBmB one�� , DESCRIPTIONOFWORK �, - . . l� . E Main Building: Accessory Building: O Addreu , TVPE OF PEFMIT GRAOING FOUNDATION STauC7V RAL . T Front " �.J Alch/Eng. LiCBnu NO. ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL 8 � - A Rear N AddrB55 ❑ �OTHER - Contractor's Nam hone 41— PROJECT DESCRIPTION 5c;. FT OCCUaANCv C Right � G K Left R CONSTRUCTIONTVPE VALUATION$ $ Atldress (meiling) - E '� Q!'d(',� ZONE GRADING GU. VDS. ACRES p�ng. Ref. # Park,FeEs $ � City License No. � � LICENSED CONTRACTOR DECLARATION Remarks: Pe�king Req./Provided � I hereby affirm that I am Iicantetl untler provislons of C rtar 9(tommencing R wltn sectlon 7000) 01 Dlvltlon 3 of the Business antl feislons Cotle, antl Use of Building: E Ty IICBnSB IS in t II 10 B d tl BtfO f. � � PLUMBING FEES Planning Notes: M IJcense Class Licensa o. Date Slgnature E W00.KER5' COMiENSATION DECL/1RATION Be� Sink I ShoWers a � � N I heraby afflrm that I nave a certlficate of consent [o sel/-insure or a certifiwte Beckflow Preventer Service Sink S af Workers' Compenution Insurance, or a ce Ifle(qqq�� copy'�t)ryereof (Sectlon aeoo, �ae.�.� C5 �Oc141U �P�C�--� . Backflow Irrigation Sewer Cap ELECTRICAI FEES PollCy No. Company ' Certifletl copy Is hareby furnlsnea. ' h' � Bathtubs � Sewer Connection Automatic Washer Transformer ❑ 15-50 KW Cerj 11 tl o f letl with the clty Iltli I Ision. /f� � � ❑ 50 + KW ate��_ APplicant �,ah�[-A'/�t 7-�f� Clerifiers Solaf ColleCtors ConitruCtion Pole Sub. � EXEMPTION FROM WORKERS' COMPENSATION DECIARATION ' Diihwdsher ' 1Thlssectlon neetl not be com0leletl if tha permit I5 for ona huntlretl (5300) or Solar Piping Cooking Uni[ Mete� �up to 100 amps ress). � ' Drinkin Fountains ' I certlfy that In"the performance of tha work for wlilch this perm�t is Issuetl I 9 Solar Tank Dishwasher Meter �over 700 amps snall not amploy any person In any manner so as to become sub7ect to [{�e Workers' Compensatloro Laws of calnornla. Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel � Date Signature - . NOTICE:If,iafte� miking thli OeCla�atlOn, you snOultl beCOTe subject to the FI00�$iOkS U�inal ' F80 Motors OP1 HP OiX-8 Workert'� Compensatlon provlsions of the Labor Cotle, you musl forthwlth . Comply with suth proviilon5 or tnli petmit Shall be Eeemetl revoketl. GeSServiCe Outl2t5 .3 WaterClosEt F.A.U. InC.Solar09-15HP�16-75+ CONSTRUCTION.LENDING AGENCV ' I hareby atfirm that Ihere is a constructlon lentling agency for the Oarformance Interceptors I� Watei Heate� a Fixtures � Microwave ol the work tor which thls parmlt is 155uetl (Sectlon 3097 Civ. C.) unaer's Name I Kitchen Sink � �, Water Service � Device Boxes Pole Light � Lantler's Atltlress Levatories b OWNER BUILDER DECLARATION � � ' • � ' O OUtlets 'Range I haraby aftirm lhat I am exemp[ from the Con[ractor's Llcense Law for tM1e p_7ra following reason (Sectlon 7031.5 Buslness antl Professlonal Cotle: Any clty ar P Switches $ign county whith raqulras a Oermit to construct, alter, ImOrove, tlemolish or repalr any structure, prior to Its issuance, also requlres the applicant for such permit Roof DrainS '' �� Garbage Disposal Standing $ections ' to flle a slgnatl statement that he/5he Is Iitensetl purtuant to tha provislons ot the Contractor'S License Law (Chapter 9(commencing witn Section 7000) of DlNslon 3 ot the Buslness antl Protesslons Cotle) or that he/she Is exempt . Generetor 00.5 KW 05-15 KW Trash Compactor thare(rom ane tne basis for the allegatl axemption. Any violation of Section 7031.5 by any appllcant tor a permlt subjects the appli<ant ro a civll qein5pection Fee $25 - laue Fae $ 3 �enalty of not mora than five huntlretl tlollars ($500). I, as owner ot tne Oroparty or my employees wlth wages as tneir sole MECHANICAL 'Reinspection Fee $25 Isue Fee $ 3 compensatlon, wlll Eo tha work, antl t�e structure Is not intentletl or offeretl ' ' FEES for sale (Section 7044, Business antl arofezsional Cotle: 7ne Contractor's PUBIICSEHVICESREQUIREMENTS: Licensa l.aw tloes not apply to an owner of a DroOerty wha bulltls or Improve5 Boiler Hood Or Type I ❑ thereon, antl wFlo tlaes such wolk h1m581f/hetself of thrOug� h15 Or hBr Own - ZOtlillg ApplOvBd By DatB amployees, provltletl t�at such Improvements are not IntentleE or o/feretl for . ��opy Type II ❑ � sale. If however, t�e bulltlin or Im rovement I5 soltl wlthln one ear of com- Dut[ - Under Ground . 9 P Y . Building Approved By Data pletlon, t�e owner wlll have the burtlen of proving ne/sne Cltl no[ bulld or Im- , i �rove for the purpose of saie). Duct - Strucmral Refrigeration System Appliption luued By- -� Dat - LJ 1, as owner of the property, am axclusively contraccinq wlth Ilcensetl con- tractorstd construct the prolact 5ection 7044, Businass antl Professlons cotla: Duct- Ventilating ' _. ❑0.100,000 BTU ❑700,000 BTU SUMMARV OF FEES Tha Contractor'S License Law �oes not apply to an owner of property w�o • ' bullds or improvas thereon, antl who contracts for such Oro7ects wlth a con- ExhaustSystem ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT �$ SMIP � . $ tractor(s) Iicense pursuant to tha Contractor's Llcense Law1. . PLAN CHECK $ PERMIT ❑ 1 am exempt untler Sectlon B. a P. C. far <his reason Firepl/Fact. Blt. ICBO # PLUMBING $ �SSUANCE �$ Date - owner• HeatingSystem & Ducting � pLqN CHECK 25% $� ENERGV P.C. $ I hereby certlfy that I hava reatl thls applicatlon antl 5tate that the above - ❑0-700,OOO.BTU �100,0008T � : ELECTRICAL $ GRADING $ informatlon Is correct. I agree to comply with all clty antl county ortllnances . antl �state laws relating to bulltling conitructlon, antl hereby authoriza repre- - MICROFI LM $ � sentatives of tnls clty to� enter uqon tha above-mentionetl pro er f r � PLAN CHECK 50% $ InSpBCtlon pu Ses. ��/� � � .,y . _ �. — Signature ✓`"�R'�y Date 3 MECHANICAL $ TOTAL FEE $� Drivers' License or 55 # Reinspec[ion Fee $25 . � issue Fee $ 3 � PLAN CHECK 25% $ CMF 0865-46 rev. 12/83 White - Builtlinq; Canary - APplicant; Pink • Accouncing; Goltlenrotl - Assessor � CO�STRUCTION AND PLANNING ' . - POOL & SPA � - : _ , . .. ; o� Date Inspector - -� Date Inspector i APPROVALS Permit # APPROVALS Permit # ` L� emporary Electrical Service or Pole ' 52. Pool & Equipment Location � . ,; . , � 2. Soil Ripe.Undrgmd. � 3//j�f�/ , � �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� -r 6. Electrical UFER Gmd: � 57. APPROVAL TO COVER-GUNITE � _�'-�� 7. Footings -, �� ' "58: ElectricalConduit-Undrgrnd. �' ' - �'� • � �. • 8. Foundation' � �� 59. Gas Pipe, � Undrgrnd., Test , ' � � � 9. Water Pipe-Undrgmd. • � j�/�h�I� L�Q 60. Backwash Lines, P-Trap, O Undrgrnd. ' 10. Structural Floor System � � ' 61. APPROVAL TO DECK �' 11. Property Sewer Line & House Connection 6%�K � L�� 62. Backwash & Receptor-Final - - ' � .. 12. Sewer Cap • �� 63. Heater & Vent-Final , � ' 13. Roof Drains . _ 64. Plumbing_SYstem - Final , � � � � - 14. Rough.Plumbing �' . -- 7��7(lJ�( (kO � 65. Electrical-Final � ' 15. Rough Electrical-Conduit : � -66. Solar System-Final -- - -" i6. 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 O Gas ❑ Oil � - � , 23. Gas Pipe-Rough & Test � _ � Z2; Underground Flush -. �, 24. Roof Framing � 73. Undergrnd. Storage Tank O Gas O Oil ' � 25. Roof Sheathing � 74'. Overhead HYdro �� • � 26. T-Bai 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 ' i � '31. Plaster Brown Coat ' 79. FINAL INSPECTION • '32. Electrical Power MeterFinal ;� . 80.� FOOD CERTIFICATE ISSUED ' � � � . � - 33. Final Electric Notes: � � � � 34. Final Heating & Air Conditioning � .." 35. Final"Gas Pipe-Test� q � �� , , � � � � - � � _ _ 36. Hood or Canopy . . � i' 37. Final Factory'Fireplace � - ' , • 38. Final Plumbing . � )��y �� _ - � � 39. Water Service-Final � 40. Gas Service-Final ' , ' ' � 41. Solar pomesticFinal - - � � ' 42. Backflow Preventer . �i. 43. Backflow Irrigation � . 44. Landscape Irrigation System ' 45. Sountl . Attenuation ' � � ' 46. Handicap Regulations ' � ' , � . , - 47. FINAL STRUCTURE & BUILDING - � 48. Special Requirements Completed. � ., " 49. Electric Release to Edison ' � ' - ' - " . . � 50. Gas Release to Southem California Gas Co � ' ' • 51. CERTIFICATE OF OCCUPANCY � - , i No. " Date . - . . ADo�icant to lill in all spaces except tnose witnin heavy �ortler lines ana si9� all aporooriate tleclarations. • CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. . 3 yo Fr L ve.=de� // � 92 � Z 0447 10/ 1 7/84 15�'u? TL Project Address %�" TVPE OF CONSTRUCTION NEW ADO ALTERATION REPAIR Applicant'S Mailing Address ❑ CONVERSION ❑ DEMO�ISH ❑ OTHER q,p, �6 Zone Owner's Name S� I- Phone DESCRIPTION OF WORK/USE OF BLDG. ` Address ' S Main Building: Accessory Building: E Z Arch/Eng. LicenseNo. TVPEOFPERMIT GRADIrvG FOUNDA710N STRVCTURAL T Fron[ p Add�255 ❑ TENANT ❑ ELECTRIGAL ❑ PLUMBING ❑ MECHANICAL A Rear � N ❑ OTHER Contractor's Nam Q�-' Phone C Right '' N PROJECT DESCRIP710N Sa. FT. oCCUCANCv K G Addres5lmailing) � CONSTRUCTIONTVPE VALVATION$ S Left ' R City License No. ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION Ping. R¢f. # Pa�king Req./PrOvided E I he�eby affirm lhat I am licansetl untllr provi5ion5 of Charte� 9(commencing Remarks: ' PldOning NOtES: M with section 7000) ot Division 3 of the Busin¢55 antl Professions Cotle, antl my li<ense is in (ull force antl eftect. T License Class License No. S' oate Signature PLUMBING FEES ' WORKERS' COMPENSATION DECLARATION Bd/ Sink ShOW¢�5 I hereby afiirm that 1 have a certificale o( consent to zelt-insure or a certificate ELECTRICAL FEES of Workers' Compansition Insuranco, or a certifietl. copy thereof (Se<tion Backflow Prevencer ServiceSink 3800, l.ao. e.) Automatic Washer Transformer � 15-50 KW Poiicyrva. Company Backflowlrrigation SewerCa ❑SO+KW BCertifietl m0Y is hereby fumishetl. P ' COnStruCtiOn P012 Sub. Certifietl copy is tiletl witn the city Builtling Olvision. Bathtuhs Sewer Connection Cooking Unit Meter ❑up to 100amps Oate APPlicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clarifiers 5018� COII¢CLO/5 Di5hwd5h2� M2l¢r ❑Ov2� 700 amps (Thiz seclion neetl not be wmpletCtl if the pe�mit Is fo� one huntl�etl (5100) or - less�. Dishwasher Solar Pipin9 Dryers ❑Gas ❑Electtic Sub Panel I certity [hat in the pe�formance of lh¢ work for whlch this pe�mit i5 issuetl, I shall not employ any person in any manner so as to become subjacl to the Drinking Fountains Solar Tank Fan Motors 061 HP �1'h - 8 Workere' CompenSation Laws of Calitomia. Date 5iqnature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar �9-15 HP �16-15+ NOTICE: Ii, aiter makin9 this aeclaration, you should become subject to the Wotkers' Compen5ation provision5 ot [he Labor Cotle, y0u must forthwith FI00! Si0k5 U�iOdl comply with suc� provisions or tnis pe�mit shall De.deemed revoketl. FixtU�¢5 MiC�owave CONSTRUCTION LENDING AGENCV G25S¢NiC¢ DULIClS Wat¢�CIOSf[ DeviceBoxes I hereby atfl�m lhat l�ere is a con5truction lentling agency for the p¢rlorman<¢ Po�e Li9ht ot [he work tor which Ihis Oermit iz issuatl (SeGlion 3097 Civ. CJ Ini¢lC2pt0/5 WB�¢� H¢d�¢� �uL12[5 lentler's Name Range Lender's nddress _ Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION 1 he�eby affirm [hat I am exempt from the Conlracto�'s License Law tOr the Lavatories following reason (Section ]031.5 Business antl Professlonal Cotle: Any city or Garbage Disposal - Standing Sections county which �equir¢5 a permit to con5truct, alte�, improve, tl¢molisn ot repalr p—Trap any structure, prbr to Its issuance, alm requires lhe applicant for such permit Generator �65 KW �5-15 KW Trash Compactor to lile a signetl ztatement lha[ he/she Is licensetl pursuan� to the provisions of ROOf Df2inS Ihe Conl�a<tor'S Ucense Law (Cnapler 9.(wmmencing with Settion 7000) of Division 3 ot lhe Busine55 and Profes5ions Gotle) o� that h¢/She I5 exempt [herefrom an0 l�e basis for the all¢getl exemo��o�. A�Y �iolation oi 5¢<[iOn ]031.5 by any applicant for a pe�mii SubjeClS the applicant t0 a civil �enalty ot nol more [han tive huntlred tlollars (E500). I, as owner ot tne prOpe/ty o� my employees with wages as thel� 5 e / ReinSpBCtiOn Fee , $15 IStUe FBe $ 3 mmoensation, will tlo the work, antl the struciure is not IntenaeC or ot(er tl Reinspection Fee $15 luue Fee $ 3 tor ule (Section �044, Businezs antl Professional Coae: The Contracto • NICAL FEES License Law aoes not apply to an own¢r of a pro0erty who builds o� improv¢ thereon, ana whn tloes such work himseli/herselt or tnrou9h his or ner own DEVELOPMENT SERVICES REQUIREMENTS: employees, provitletl tha[ suth improv¢ments are not intentletl or otfered for BOile� HOOd O� Typ¢ I ❑ sale. If, nowever, [he builtling cr improvemen[ is soltl wi[hin one year of com- Canopy Type I I ❑ Zoning Approved By Date pletion, the owne� will nave Ihe burtlen Of p/oving he/she tlitl not bulltl or im- Duct � Under Ground BUilding App�OVBd By Dete ��ov! for the pur0ose ot zale). I, as owner ot the properry, am exclusively contractln9 witn Iicensetl con- Ducl -Struaurel Re(rigeration Sys[em Appliption Issuad By �� at tractOrs to mn5truct the projecl (Section ]044, Business antl Profes5ion5 Cotla: � The Con[ractor's License Law does not apply to an owner of p�operty wM10 Duct - Ventilating ❑0�100,000 BTU ❑100,000 BTU SUMMARV OF FEES builtls o� improve5 [hereon, antl who con[racts fo� such projectz with a con- Vactor(sI license pursuant to tne contractor•s License l.aw). I am aware tnat Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of ineir Worker's Compensation insurance shoultl be provitletl m ma. PLAN CHECK $ PERMIT ❑ I am exempt untler Section B. L P. C. for this reason Firepl/Fact. BIt. ICBO � PLUMBING $ � S-� ISSUANCE $ Date Owner Heating System & Ducting PLAN CHECK 25% $ ENERGY P.C. $ I �ereby certify tnat I have reatl [his appli<ation antl state that t�e above ❑0.100,OOOBTU �100,OOOBT GRADING $ information is correct. I agree to comoly wilh all city antl countY ortlinances ELECTRICA� $ antl state laws relating to builtlin9 consiructio , antl hereEy authorize repre- PLAN CHECK 50% $ MICROFILM $ sen[atives ot t�is tp, ente� upOn th ove-mentionetl Orop¢rty for inspection Ourpo C/ / Siqnature �ate �' � / "�" MECHANICAL $ TOTAL FEE $ �S � �\ Drivers' L nse or SS � Reinspec[ion Fee $15 Isue Fee $ 3 PLAN CHECK 25% $ GMF 0865-46, rev.4/84 Whife - Builtling; Canary - Applicant; Pink - Accounting; Goltlenroa -Assessor - CONSTRUCTION AND PLANNING � � POOL & SPA }l 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 •5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test • 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System � 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 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 FIRE DEPT. REQUIREMENT 20.,Rough'FactoryFireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush - 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. pverhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical � 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning � 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing ` j�� Li�i 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. F�NAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CEFiTIFICATE OF OCCUPANCY No. Date r,/�/J �pPlicant to fill in all ipaces except those wit�in �eavy OorEer lines antl si9n all apOropriate Getla�ations. CITY OF COSTA [E/S�(� pCO STRUCTION PERMIT PERMIT NO. TRACT NO. LOT N� UNIT NO. '.ProjectAddress �'"Q �/��(�f� �1j,�J G 13i3 � � � Applicant's Mailing Address TVPE OF CONSTRUC710N NEW /aoo ALTERATION REVAI R 3009 6/27/84 83oFi5 TI ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p,�S 20n¢ Owner's Nam�e / "�rn� �/J �p1ho �e — DESCFIPTION OF WORK/USE OF BLDG. Address �'1L0�-� �%i // /�c� '�r�77� L�n ' ' S Main Building: Accessory euilding: Arch/Eng. �7� ��,f-t' ��C%�_License No. TVPE OF PERMIT GRaoiNG FOVNDATiON ❑ STRVcrURa� T Front p ❑ TENANT ❑ ELECTRICAL ❑ 7LUMBING ❑ MECHANICAL A Reef N Addr¢SS ' ❑ .p7HER Contractor's Nam t �� PhO PROJECT DESCRIP710N 5o. Fr, ocCUPArvCY K Riqht G Addre551mailing) ^^�7 CONSTRUCTION TVPE VALVATION $ g L¢ft Ci�y Licen�P No I�✓(�T ZONE GRADING CU.YDS. ACRES p UCENSED CONTRNCTOR OECLARATION Ping. ReL # Pd�kipy R2q./P�Ovid¢d E I hereby afiirm that I am licehsetl untler provisions of Charte� 9(coTmencin9 q�marks: ' .// � Planning Notes: M wiih section �000) of Divisiqn 3 ot the Business antl Professlons Cotle, antl T my Ilcense is in f1y�•. fo� tl pHect. ^ 2 O� $. �icen Cla V e � Oat ' — ignature PLUMBING FEES W00.KER5' COMPE SATION DE LARATION Bar Sink Showers ELECTRICAL FEES 1 h¢reby attirm that I have a c@rliticate of cOnsenl to sell-Insure or d certlficate of Workers' Campensation Insurance,. or a certi/iatl copy tnereoi (Section gackflow Preventer ' Servite Sink � 3a0o, Lab, c.) i/ L �� /— / /� Auromatic Washer Transformer ❑ 15-50 KW Policy No. �� J Company � U'�� Backflowlrrigation SewerCaP ConstructionPoleSub. ❑ 50+KW ❑ Cerlitietl co0 �5 hereb IUYnlshetl. � �'%rti ietl c� is f itn the city eu' in vts' � Ba[htubs Sewer Connection Cookin9 Unit Meter ❑up to 100 amps Date ^ — APPlicant � -EXEMPTION FROM W00.KER5' COMP NSATION EC ARHTION Cld�ifi¢�5 SOldr CAII¢Ct0�5 � / Dishwasher � Meter �av2r 100 dmp5 (This section neetl not be comblatetl it the pe�mit ii for On¢ huntlretl (5100) or iess). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel 1 Certity Lnal in Me P¢r/O�mance of tM1¢ work (o� which tN5 p¢rT�t is issuetl, 1 shall not employ any person in any manner so as to become sub]ect to )he Drinking Fountains - Solar Tank Fan � Momrs DO-1 HP QT:4 - 8 Workers' Compensation Laws o( �alifornia. . oate Siqnature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar �9-15 HP �16�15+ NOTICE: 1f, after making this tleclaration, you snoultl become subject to the Work¢rs' Compensation proYslons ot the L2bot CoCe, y0u must forthwith FIOOI$ink5 Utindl Fi%Iuf¢5 / Compry wiU suth provisioqs or,�tnis pe�mit Shall be tleemetl �evoketl. �9ic�Owdv¢ CONSTRUCTION LENDING AGENCV GasService �utl¢t5 Wat¢�CIOS¢t D¢viC¢BOx85 P I hereby affirm Ihat Ihe�e is a Conslructlon lentling a9ency 1or [�e pertormance �I2 Light of the work fo� which this pe�mit iz i55uetl ($ectlon 309] Civ. C.) Interce t0l5 Water Heater ' L¢ntler's Name P Outlets Range � �entlerY Adtlress � � Kitchen Sink Water Service _ Switches Sign � OWNER BUILDER DECLARATION I Flefeby atfirm Ihal I am ex0mpt trom Ne COntfactor'S Li<¢nse Law fOr Ihe LdvdtOli¢5 GafbO 2 Di5 OSdI following reason (Sec[ion 7031.5 Business antl Pro(essional Cotle: Any city or 9 P $tanding Sections county w�ich requires a permit to construct, alter, improve, tlemolish or repair P—Trep " any structure, prior to its iss�ance, also requires me applicanl for such permit Generalor DO-5 KW �5-15 KW Trash Compactor ' to file a signetl statement thdt he/zhe Is licensetl pursuant to the provisions of Roof Drains ' '[ne Cm[ractor's License Law (CnaO�er 9(commencin9 witn Section 7000) of Division 3 of the Business dntl P�otes5ions Cotle) or [hal he/sh¢ is exempt therefrom and the basis for Ihe allegetl exemplion. Any violation Of $ection 7031.5 by any apO�iCant ibr a permit subjects the applicant to a civil �enalty of not more than five huntlretl tlollars ($500). 3 1, as owner o( the oroperty or my employees with wa9es as Iheir sole ReinspBction Fee $15 ISSue Fee $ compensation, will tlo the wOrk, antl the st�ucture is not in[entletl o� ofteretl RBi05peCtion F¢e $15 ISSUe Fea $ 3 for sale (Section �044, Business an❑ Protessional Cotle: The Contractor's MECHANICAL FEES �icense l.aw does not apply to un owner of a property wno builtls or improves DEVELOPMENT SERVICES REQUIREMENTS: iheteon, antl wM10 tloe5 Such �york himself/herseH ot throu9 h his o� ner own BOile� HOod Or T e I ❑ em0loyee5, provitletl thal suCh improvement5 are not in[entletl or off¢retl 10� VP sdle. If, however, the builtling �r Improvement is soltl within one year of com- Canopy Type II ❑ Zoning Approved 8y Date pleHon, the owner will have the burtlen ot provinq Ite/she tlltl not b W IO or im- DuCt - UndC� GrouOd BUilding ApproVed By D2te �ove for the purpose of sale). , I, as owner ot the proper�y, am exclusively contractin9 with licensetl con- Duct - Structural Refrigeravon System Application laued By �� Dat ufl tractoro to conztruct ihe proj¢t[ (Section 7044, Business an0 Professions Cotle: � Tne Contractor's License La�y tloes not apply to an owner oi property who Duct - Ventilating ❑0-t00,0006TU ❑700,000 BTU SUMMARV OF FEES builtls o� improves thereon, antl who mnt�act5 for such projects wlth a con- tractor�sl license pursuan't ta the Contractor's License Law). I am aware that Exhaust System ❑ MW[iple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof o1 their Worker's Compensation insurance shoultl be prov�qetl ro me. PLAN CHECK $ PERMIT ❑ I am exempt un0er Seclion B. & P. C. for this reason Firepl/Fact. Blt. ICBO # PLUMBING $ ISSUANCE $ Date Own¢r Heating System & Ducting ENERGV P.C. $ PLAN CHECK 25% $ i nereby certity ehat i nave reatl this appiication and state mat the above ❑0-100,000 BTU �100,000BT ELECTRICAL $ �— i GRAOING $ information is mrrecL I aqren to comply with all clty antl county ortlinantes antl state laws rel in to builtling onstru ion, antl hereby authorize repre- PLAN CHECK 50% $ �MICROFILM $ Sentatives of tK ci ter on [ e above�mentionetl op¢rt f � ��--�y� inspection purp s. �/� � MECHANICAL $ TOTAL FEE $�" 5ignature Date peinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ Drivars' License or 55 � CMF 0865�46, rev. 4/84 Wtlite - Builtlin9; Canary - Applicanh Pink - Accountlng; Goltlenrotl - Assessor '- 'CONSTRUCTION AND PLANNING POOL & SPA •% APPROVALS Permit # Date Inspector qPPROVALS Permit # Date Inspector 1.�Temporary Electrical Service or Pole' 52. Pool & Equipmen[ Location � 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement �- 3. Electiical 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. t �� 6. �Foundation � , 59. Gas Pipe, O Undrgrnd., Test � 9. Water Pipe-Und�grnd. �. � 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 7Jo � 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 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. 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 , ��y �j 80. FOOD CERTIFICATE ISSUED 33. Final Electric � �B �j 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. FINAL STRUCTURE & BUILDING � 48. Special Requirements Completed � 49. Electrie Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date • Aoolicant to tiil in all spaces except enose within neavY �ortler lines antl sign all approoriate Oeclarations. CITY OF COSTA MES NSTRUCT O� N P_ERMIT PER,MMIT1N0._ �� TRACT NO LOTI�. UN1T NO. � Project Address J� LGU �� =i 3610 7/06/84 9.?5 Tl. Applicdnt�5 Mailin dress TYPE OF CONSTRUCTION NEW A�D ALTERATION REPAI R ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p, # ZOne Owner's Na e � DESCRIPTION OF WORK/USE OF BLDG. Address � ' S Main Building: Accessory Building: Arch/Eng. License No. TVPE OF PERMIT GRADING FOVNDATION ❑ STRUC7URAL T Front p Addre55 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING �MECHANICAL B Rear N T ❑ OTHER A � Contracror's Nam � �/ one C Right N PRQIECT DESCRIP710N SQ. Fr. oCCuvANCv K. G Address (mailing) CON54RUCTION TVPE VAI.UATION $ S Left R CityLicenseNo. � ZONE - GRA�WGGU.YUS. ACRES E LICENSED CONTRACTOR DECLARATION Ping. R¢f. # Parking Req.�PrOvided 1 hereby affirm tM1at I am licen5etl untler provi5ions ot CM1a�te� 9(commencing Remarks: �/� �� . Planning Notes: • M wilh seclion ]000) of Division 3 of Se Business an ofessions Cotl arW ' T my licens�s in I f� antl effect. A/. /�) �/,� �- � � A Li o L��G ��-` lL S. LJcense� • Date—� � 5'q t PLUMBING FEES � WORKE 5' OMB NSATION OE LARATION Bar Sink Showers I hereby affirm that 1 nave a certiticate of consent to selt-insure or a certificare ELECTRICAL FEES of Workerz' C mpen5ition Insurance, or a certi�ooY there f(Section gackflow Preventer Service Sink 3800, Lab. ' �C - Automatic Washer Transformer ❑ 75-50 KW . Policy No. Company � Backflow Irriga�ion Sewer Cap ' • . � Construction PoleSub. ' � 50+ KW eCerti letl o s hereby fumishetl. � , C i s filetl with the city B� ' Bathtubs �; Sewer Connection � Cooking Unit Meter ❑up to 700 amps Date APPlicant EXEMGT� FR MWORKERSCOMPENSATIONDECLARAT� Clafifier5 . Sola�ColleC[or5 Dishwasher Meter �over100amp5 (Thi55ection neetl not be�completetl if the permit is for one huntlre0 ($300)�or - - . less). . Dishwasher "' Solar Piping .� Dryers ❑Gas ❑Electric Sub Panel I certify thaf in the perto�mance of ihe wark for which thls pe�m�t is issuetl, I shall not employ any person in any manner so as to become subject to the Ofinking Fountains Solar T2nk � Fan Workers' Compensation Laws of Calitornia. MOLO�S �0-1 HP 01 X- B Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc. Solar �9-15 HP 016-75+ NOTICE: It, afte� making this tlecla�ation, you Shoultl become subject to the ' Workers' Compensation provisions ot the Labor Cotle, you must forthwith Floor Sinks ' Urinal Fixtures � comply with 5uth�provision5 or titis permit shall be deemetl rewketl. Mic�Owev¢ CONSTRUCTION LEN ING AGENCV GasService OutIEtS WaterCloset Devic¢BOx¢5 I he�eby atfirm that th�r�is a�_ construttion'lentling agen[yfo� the performance - POIe Light of the work for wN;��Ytr� �ermit is issuetl (Section 3o9� Civ. C.) Interceptors Water Heater Outlets Range Lentler's Name ' �entler's AGtlress - Kitchen $ink Water Service Switches Sign � OWNER BUILDER OECLARATIOIV- I nereby atfirm [hat I am exempt trom tM1e ContraC[orY License L.aw fo� [be L3vdtO�ies following reason (Section �031.5 Business antl Professional Cotle: Any city or Garbage Disposal ' Standing Sections county which requires a p¢rmit [o construct, alte�, imp�ove, tlemolish o� r¢pair P-T�y ' any structure, orior to its issuance, also requires the applicanf !or such permit - P Generator �0.5 KW �5-15 KW to file a signetl sfatement that he/She is licensetl'pursuant to the provisions ot T�dSh COTp2ct0� the Contractor'S License Law (Chapter 9(commencing witn Secfion ]000) o� ROOf DfainS Division 3 of the Business antl Professions Cotle) or that he/she is exempt , . tnerefrom antl the basis tor the allegetl exemption. Any violation ot Section . 7031.5 by any applicant for a permit subject5 Ihe applicant to a civil eenalty of not more than five huntlretl tlollars ($500). ' 3 �J I, as owner of the oroperty or my employees wilh wages as their sole RainspeCtion Fee $15 ISSue Fee $ compen5a[ion, will Oo [he work, antl the structure i5 not intendetl o1 offeretl ReiOSp¢CtiOn Fee $15 ISSu2 F¢8 $ 3 for sale (Section �044, Business antl Protessional Cotle: The Contractor's MECHANICAL ' FEES Li<enu Law does not apply to nn owner Of a property who builtls or improves mereon, antl who aoes such work himself/Oerzelt or.throu9h his or her own - Hood or T e I ❑ DEVELOPMENTSERVICES REQUIREMENTS: employees, provitletl that sucb improvements are no[ in[entletl or offeretl tor Boiler � yp sale. It, however, the buiming cr imowvement is soitl within one year oi com- ��oPY TyPe �� 2oning Approved By Date ple[ion, tM1e owner will have tne burtlen of proving he/she tlitl not builtl or im- Duct - U�d2� i�i�OUnd Building App�oved By Dat¢�_ p�Ove for the purpose of sale). �-�� ❑ I, as owner of the prooerty, am exclusiveiy contractin9 with licensetl mn- Duct -Structural Refrigeration System Application Issued By Date-1��p._ lractorsto construct the project (Section ]044, Business antl Profe55ion5 Code: The Contractor's License Law tloes not apply to an owner ot property who Duct - Ventilating ❑0-700,000 BTU ❑100,000 BTU SUMMARV OF FEES builtls or improves thereon, antl who contracts for such p�ojects with a con- tractor(s) license pursuan't to the eontracror's License Law). I am aware that BUILDING PERMIT $ SMIP $ proot ol thei� Worker's Compensation insurance shoultl be provitletl to me. E%h3Ust SySt¢T ❑ MWtipl¢ ❑ Syst¢m Rep2i�/AIt2�dtiOn PLAN CHECK $ PERMIT ❑ I am exempt untler Section B. & P. C. for this reason FirepVFact Blt. ICBO # PLUMBING $ ISSUANCE $ oate owner . I Heating System & Duct' PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have reatl tnis aoPlication antl state that the above � ❑0.100,OOOBTU OO,OOOBT GRADING $ intormation is orrect. I agree to plY with all city antl county ortlinan<es ELECTRICAL $ antl state law relatin9 to builejiig c nstruc on, antl hereby author` e r ore- PLAN CHECK 50% $ MICROFI LM $ —�� Sentatives f this city to en�i up n th above-mentionetl P�o ert o� y, �'-� inspection p r e � t.�� MECHANICAL $ TOTAL FEE $��/`� Signature � Reinspection Fee $15 luue Fee $ 3 PLAN CHECK 25% $ � Drivers' License or 55 � CMF 0665-46, �ev.4/bn White - Builtling; Canary - Applicant; PInH -Hccounung; t3oiaenroo -tassessai CONSTRUCTION AND PLANNING � POOL & 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. Elecvical Conduit UtilitY-Undrgrnd. � 54._Forms - "4.�Electrical Conduit-Undrgrnd. 55.�Electrical Bonding 5. S[eel Reinforcement 56. Rough Plumbing & Pressure Test • ' 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings . � 58. Electrical Conduit-Undrgrnd. 8. Foundation ' . � 59. Gas Pipe, O Undrgrnd., Test - 9. Water Pipe-Undrgrnd. � ' 60. Backwash Lines, P-Trap, O Undrgrnd. : 10. Structural Floor System 61. APPROVAL TO DECK ' , 11. Property Sewer Line & House Connection 62. Backwash & ReceptorFinal � 12. Sewer Cap . ' 63. Heater &�Vent-Final 13. Roof Drains , 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical�Final � 15. Rough Elecirical-Conduit ' 66. Solar System-Final 16. 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 79. Rough Heating & Air Conditioning 7��yl�y 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 OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Siructural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final � 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: - 34. Final Heating & Air Conditioning �� 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace ' � 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation , . � � 44. 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 i�iAoolicant to fill in all soaces exceot tnosa wit�in heavY �ortler lines an0 sign all a00ropriate tleclarations. CITV OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. (� ` TRACT NO. LOT NO. UNIT NO. OI BO I O/ I 2/a4 ' S• �O TL ProjectAddress �4�g �dVelldel' �a112 � " /��✓� Applicant'S Mailing Address TVPE OF CONSTHUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ �EMOLISH ❑ OTHER q,p,# Zone Owner'sName Stao��r� Parific �OY'R, vho�e546-1161 DESCRIPTIONOFWORK/USEOFBLDG. . Addreu ��+ W MarArfhiir fnct,7 MPc� 92626 � S MainBuilding: Accessoryeuiltling: Arch/Eng. Licenu No. TVPE OF PERMIT GRA�ING FOUrvDATIOrv S7RVCTURAL T Front p Add�E55 ' ❑ TENANT ❑ ELECTRICAL �PLUMBING ❑ MECHANICAL A Rear N ❑ OTHER Contractor'sNam � Phone�%R–��40 � C Right � ' , N Address (mailin 1 �1 f19 N Foo pna PROJECT DESCRIP710N 5c]. FT. oCCuaANcv , e Anaheim CONSTRUCTIONTVPE VALUATION$ g �eft p City License No. 3�$]� _ ZONE � GRADING CU. VDS. � ACRES p�pg, Ret. # Parking Req./Provided Q LICENSED CONTRACTOR DECLARATION � ' 1 nereby afiirm that 1 am lic¢nzetl untler proJ on5 t Charter 9(commencing Remarks: Z � Planning Notes: M with section 7000) ot Division 3 oi Ihe B iness ntl Professions Cotle, antl . T my Iicense is in (uu foj,ce�rytl erfe��. 426109 � � � � 56 � ( � 2� S. License Class �� 0 cense No. ' �ate 1 f1 /_,.o. 1 f1.� AQ Signature ' PLUMBING ' FEES � WORKERS' COMPENSATION bECLA TIO Bd�Sink ShOw¢�5 � � . ELECTRICAL FEES 1 he�eby a/tirm Ihat I have a ce�lifica[e of consent lo SBINnsure o� a certiticatE oi WOrkers' CompGnsation InsUrance, or a ce�Hfietl copy thereof (Settlon BdCkfIOwP�¢v¢nt2� - S¢rviC¢SIOk- - 3800, Lab. �ry1�I Automatic Washer Transformer ❑ 75-50 KW Polic No. r^C-177714� Compan Home Backflowlrri ation SewerCa � ❑ 50+KW Y Y 9 P Construction Pole Suh. �Certitietl copy Is hereby tumishetl. � � , ' . � C r rt' c is (iletl with the city e iltlin9j]f visiq n, Bathtubs Sewer Connection Cooking Unit � Meter ❑up to 100amps Oa[ef�,15$�� ApPlicant �eW f I UmD]�]� ' � , E%EMPTION FROM WORKERS' COMPENSATION DECLARATION '. ClarifiErs Solar ColleCtorS Dishwa5her MC[er ❑over 100amp5 (This section neetl no[ be complNtetl if Ihe pe�mit i5 tor One huntlretl (5300) or less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify.that in the performanc¢ ot the work for which this perm�t is issuetl, I shall not employ any person iri any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors DO-1 HP 07'h - B Workers' Compensation Laws oi California. Datc ' Si9nature Floor Drains Swimming Pool wlSpa F.A.U. NOTICE: It, attm making this tleclaration, you shoultl become subject t0 the InC. SOId� �9�15 HP �76-15+ Workefs' Compen5ation pfovisipns Of the Ldbof COtle, you must folthwith FIOOf SinkS - Ulin21 � Fixtuf¢5 MicfOWdvE comp�Y with suc� O�ovisionz or this permit shall be tleemetl revOkeU. "- � CONSTRUCTION LENDING AGENCV GasService •Outlets Wdt¢�CIOSCL DCviC¢BOx¢5 I hereby afflrm ihat there iz a mnstruction lentling agency for Ihe performance Pole Light of Ne wo�k 1or which this permit iz i55uetl (Settion 3097 Qv. C.) Int¢�CE tOR Wdt¢� H¢et2/ lantler's Name P Outlets Range L¢ntler's AGtlress Kitchen Sink Water Service Switches Sign OWNER BUILOER DECLARATION� - I Flefeby dfflrm [hat I am exert�pt from tM1e Conlractot'S License Law tor Ihe L3vdt0lies Gdfbdg¢ Di5p0531 '$t3nding $eCti0p5 following reason (5¢ction 7031.5 Business antl Professional CoOe: Any ci[y or county whicn requires a permit to construct, alter, improve, tlemolish or repair P–Trap . Generamr �0-5 KW �5�15 KW Trash Compactor � any struc[ure, prior to its issuance, also reqWres the apP�icant tor such permit to file a signetl statement that ne/she Is IicenS¢tl pursuant to the p�ovisions ot Roof Drains � • ihe Contractor's License Law (Chapter 9(commencing with Sec(ion ]000) of Dlvizion 3 01 lhe Business antl ProfeSsionS Cotle) o� that he/she i5 exem0� tM1erefrom and Ihe basis for lhy allegetl exemptlon: Any violation of Section - �7031.5 by any applicant for a permit subjects [Ite aOPlican[ to a civil �enalty of not more than five huntlretl dollars (§500). $ 3 I, ds owner of the prope��y or my em0loyee5 with wages as their sole ReinSpeMiOn Fee $75 ISSua F¢e compensation, will tlo the wor4, antl tne structure is not intentletl or offeretl Reinspectian Fee $15 luue Fee $ 3 for sale (Section 7044, Business antl P.rotessional Cotle: The Contractor's MECHANICAL FEES License Law tloes not apply ro an owner of a property who builtls or improves lnereon, antl wno tloes such Work nimselt/nerseH nr throug� his or ner own - DEVELOPMENT SERVICES REQUIREMENTS: em0�oyee5, provitletl that such improvementz are not Intentletl or oHeretl tor Boiler HOod or Type I ❑ sale. If, nowever, the builAing tr imorovement Is soltl within one year ot com- �nopy Type I I ❑ Zoning Approved By Date pletion, tne owner will have tne burtlen oi proving hc/she dia not builtl or im- Ducl - Under Ground Building ApproVed By Date �rOve tor thc purpose of sale). •� I, az owner o/ the prooerry, am exclusively contracting with licensetl com Duct - Structural Refrigeretion System Appliption Issued By Dat�—� tractors ro construc[ the project (Sectlon 7044, Business antl Protessions Cotle: . The Contractor•s License Law tloes mt apply m an owner oi property who Duct - Ventila[ing �0-100 000 BTU ❑100,000 BTU SUMMARV OF FEES builtl5 0� improves thereon, aqd who con[�acts fOr such projects with d con- tractor(sl license pursuant to the Contractor's License Law�. I am awar¢ that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation inmrance shoub be provitletl to me. pLAN CHECK $ �y� PERMIT ❑ I am exempt untler Section B. & P. C. tor this reason Firepl/Fact.811. ICBO # PLUMBING g �.✓�/ ISSUANCE $ Date Owner Heating System & Ducting pLAN CHECK 25% $ ENERGY P.C. $ I hereby certity Inat i have �ea his appiicatlon and state that the above ❑4100,000 BTU �100,000BT ELECTRICAL GRADING $ InPormation is wrrect. I agreB to c mo�v wlth all tlty and county ortlinances � antl state laws relating to b lilq{n construction, antl hereby authorize repre- MICROFILM $ sentatives o/ this city to ent upon the above-mentionetl p�operry tor PLAN CHECK 50°.6 $ inspection puTpo . � MECHANICAL Signature �� oate �6 �7 $ TOTAL FEE $ <<7. � Drivers' License o/ 55 Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF OBfiS-46, rev, v/ov wnrte - Bulltling; Canary - Appl¢anp vinu -.vccounung; �oioenroo - nssmwr CONSTRUCTION AND PLANNING POOL & SPA _ I� APPROVALS Permit# Date Inspector AppROVALS Permit# Date � Inspector 1. Temporary ElectricBl Service or Pole ' 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. . 53. Steel Reinfarcement 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. Footirigs • , 58. Electrical Conduit-Undrgrnd. '� 8. Foundation �' 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe-Undrgmd. ' -. 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. Foof Drains � , 64. Plumbing System - Final 14. Rough Plumbing � 65. Electrical-Final �o 15. Rough Electrical-Conduit ' 66. Solar System-Final i6. 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. Ducis. in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. 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 . 35. Final Gas Pipe-Test /p�/1{D'�{ � 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. Souncl Attenuation , , � � � � � 46. Handicap Regulations. - 47. FINAL STRUCTURE & BUILDING ' 48. Special Requirements Completed � � 49. Electric Release to Edison - -• 50. Gas Release to Southern California Gas Co � 51. CERTIFICATE OF OCCUPANCY �� ' � No. � Date . � � ,