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Home My WebLink About3415 LAVENDER LN - Building PermitsAop��cant to fill in all spaces ezeept those within heavY borCer linez antl sign all appropriate aeclarations. PERMIT NO. TRACT NO. LOT NO. UNIT NO. I�� C6TY oF COS7A MESa CONSTRUCI ION PERMIT � Z� � � + A.P. # Project Address � � '� �" v ��/1 ApplicanYs Mailing Address �T.�fJ ozlQ, A� ry "(fi 2Z Owner's Name ��. ��5.'�P�A K//✓P -P 6ne��/Y� i Address 3�'�� ' ✓�// �L�'�'Q Arch/Eng /��[7 License No. Addres; / Contractor's Name u.AnP�j/ linf%��. �a//• .LAc o�yg i3 Addresslmailing) 00,/JIk�Z�,.�I/++�.�'�/�'9 ��GZz Ciry License No. LICENSED CONTRACTOR DECLARATION I hereby atfi�m that I am licensetl untler p�ovi5ions ot Charter 9(commencinq with section ]000) of Division 3 ot the Business antl Professions Cotle, antl my Iicense is in (ull force antl eltecL ,� / �icense Class — l.icense o � Date� Signature �HKERS' COMPENSATION DECLARATION � reby affirm that I have a rertificate of consent to self-insure or a certificate � Workers' Compensation Insurance, or a certi`fletl copy thereot (S ction 3800, lab. C.j`�33� 9� .i��P ��%JS� Policy No. � Company �� Cer[ifietl copy is M1e�eby fumishetl. Cer[ifietl copy is filetl witM1 tne city Builtlinq Diyision,�K / y` Date �%�/ APPlicant%��A-�--��-//nf/ ! /// EXEMPTION FROM WORKERS' COMPENSRTION DECLARATION (This section neetl not be completetl if [he permi[ is for one huntlred ($100) or iess). ftzrtify that in the performance of the work for wnich this permk is issuetl, I shall not employ any person in any manne( so a to become s ibject to t Worker ��Cq p n�tion Laws o� California. Date � Signature � NOTIGE: If, after making this tleclaration, you shoultl come � ject to e Workers' Compensation Orovisions of the Labor Cod , you must fortl Ith tomply wiih such p�ovi5ion5 or tltis pe�mit shall bE tleemetl �evoketl. CONSTRUCTION LENDING AGENCV 1 hereby affirm Ihat tnere is a construction lentling agency �or t rforman of the work for which thi5 permit is issued (Secti n 7 Lentler's Name �entler's Adtlress OWNER BUILDER DECLARATION I hereby aHirm Lhat I am exempt from the Contractor'S L n f M1e fo�lowing ��eaaun (Section ]031.5 Business antl Professional . Any ci or munty which requires a pe�mit �o construct, alter, imptove, olish o� repair any slructure, prior to its issuance, also require5 [he applicant tor such p¢rmit/ file a signeG statement thai he/she is IicenSetl putsuant to the p�ovisions Ot Contractor's License law (Chapter 9(commencing with Section �000) ot iision 3 of [he Business antl Profesvons Cotle) or that he/she is exempt ,.r4refrom antl the basis for the allegeG exempilon. Any violatlon of Section ]031.5 by any applicant for a permit subjects the applicant to a civil not more than five huntlretl Gollars ($500). wner of the p�oper[y or my employees with wages a5 thei� sole .ion, will tlo the work, antl ttle SGucture i5 not intentletl o� off¢retl Section 7044, Business antl Protessional Cotle: The Contractor's .w tloes not apply to an owner Ot a pwperty wno builtl5 or improves ntl who tloes such work bimzelf/M1erself or tM1rough his or her own employees, provitled [hat such Impwvements are nof intentletl or otteretl for sale. H, however, the builtling or improvement is soltl within one year of com- pletioq the owner wi11 have the burtlen of provin9 he/she tlitl not buila or im- prove for the purpose af sale). ❑ I, as owner of [he property, am ezclusively contracting with licensetl con- tractorsto canstruct the project (Section 7044, Business antl Profe55ion5 COtle: i The Contractor's Litense law dces not apply to an owner ot property who �' builtls or imProves theteon. antl who conVacts fo� su[h oroiects witn a r.on- t�aclor(s} license pur5uant to [ne ConVactor's License Law). I am awar¢ tha[ proof of thei� Wo�ker'S Compensation insurance Shoultl be provitletl [o me. ❑ I am exempt untler Section B. & P. C. for this reason Date Owner I hereby certify tnat I have reatl this aoPlication antl state that the above information is correct. I a9ree to compty with all city antl wun[y ortlinance5 dntl State laws relating to builtling con5truction, antl he�eby authoriie repre- 5¢ntatives of lhi5 ti[y to enter upOn the above-mentionetl pwperty to� inspection purposes. Signature Date Drivers' License or 55 � TVPE OFCONSTRUCTION lJ NEW�ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH OTHER DESCRIPTION OF WORK/USE OF BLOG. A�� ^�.�L��'� TYPEOFPERMIT GRADING FOUNDATION STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ^ � ❑�OTHER / // n PROJECT DESCRIPTION Sa.FT. ,r . pCr.ucarvr.v _` . CONSTRUCTIONTVPE vN VAWATIONS I��OuS ZONE GRADINGCU.VDS. ACRES Remarks: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs S Fas�viee� Outlets Interceptors Kitchen Sink � Lavatories Trap of Drains 1 Reinspection Pee $15 Boiler ust System ❑ Multiple ❑ irepl/Fact. elt. iC80 # Heating System & Ducting ❑0-100,000 BTU � 100,000 BT Reinspection Fee I $15 OBfi5�4fi, rev. 5/88 Wnite - Bui�tling: Canary - Appiicant; Pink - Accoun[inq; Goltlenrotl - Assessor PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collecmrs Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closex I�ter Heater Lau or TYPeI ❑ y Type I I ❑ Refrigeretion System ❑0-100,OOOBTU ❑100,OOOBTU System Fepair/AI[eretion Fire Dampers Registers Issue Fee FEES $ 3 FEES $ 3 S Main Building: TFront 2 rj � ARear 'Z� / � i 1 C Ri9ht 12� (�'� K � g . Left � Ping. ftef. # Planning Notes: . �j Automatic Washer Construciion PoleSi Cooking Unit Dishwasher Dryers ❑Gas ❑EI Fan F.A.U. Fixtures Device Baxes Outlets Switches Garbage Disposal Generator �0.5 KW ) ( Zone � Accessory Building: Z O N I N G R Parking Req./Provided E � S Q 5 M T S. ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over100amps Sub Panel Motors OO-1 HP O i%- 8 Ina Solar �9-15 HP 016-15+ Microwave Pole Light Range Standing Sections 5-15 KW Trash Compactor I Reinspection Fee �$15 I I Issue Fee DEVELOPMENTSERVICESRE�UIREMENTS: 2oning Approved By Building Approved By Appliotion luued Bv FEES $ 3 SUMMARV OF ES BUILDINGPERMIT $ �Bn�SMIP $ �_ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAI $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTA� FEE $ PLAN CHECK 25% $ q00078 , ?� CONSTRUCTION AND PLANNING �� P 8i' APPROVALS Permit# Date Inspector p�ppROVALS Pern c Date Inspector h . � �1. Temporary Electrical Service or Poli� ;� ' 52. Pool & Equipment Lo 2. Soil Pipe-Undrgrnd. � " � 53. Steel Reinforcement � 3. 'Electrical Conduit Utility-Undrg �d. 54. Forms 4. �Elecfrical Condui{=Undrgrnd. ,` 55. Electrical Bonding 5.'�Steel Reinforcement 56. Rough Plumbing & Pressure Test 6.' Electrical UFER Gmd. � 57. APPROVAL TO COVER-GUNITE 7. Footings, � j '' i� 58. Electrical Conduit-Undrgrnd. 8.' Foundation , , �/ , � � 59. Gas Pipe, O Undrgrnd., Test 9. ,Water Pipe-Undrg'rnd. � ! '� 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System •% "' 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - . �. 62. ,6a�ck��6'a h& ReceptorFinal . ,,, 12.'Sewer Cap ' ' �! ''` �` , -' � �� 634 Heate #& Vent-Final 13. Roof-Drains ' r ��'�� j 64. %��lum6ing System - Final 0 14. Rou h Plumbin �!:- r'�1 9 9' � � ,� 65e�E1�ctrical-Final �! ft �I 15. Rough Electrical-Conduit b6. 6olar Syst� f,,;inal� J7� � -�, 16. Rough Electric Wiring �B'7,�° Fe cing &?Acce�s Apptoval j ��'y�-: 17. Rough Wiring Sign ��88. APPROVED`FQ6,PLASTERING�s� .r' 18. Rough Electrical-T Bar Ceiling ' a,69. POOUSPA SYST�F�S FINAL � A � u�' 19. Rough Heating & Air Conditioning �� FIRE D�PS.�yREQUIREMENT. �t� w 47 � �� 20. Rough Factory Fireplace � , �� APPROVALS �t!`�Permit # ! i% ^ 21. Ducts, in Structure . G;r�� 70. Underground�tiydro � .�� 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Qjl�,",�;� 23. Gas Pipe-Rough & Test �� f;� 72. Under'ground Flush 24. Roof Framing " - � 73. U�.,.,n.derg�d.StorageTa k �'.GT��OiI 25.'Fioof Sheathing ' . � 74. Ove �d Hydro "• �'�',. 26. T-Bar�Ceiling (StructuraQ & Monocoat 75. Dry Chemical `y'�+� �� 27. Frame,and Flashing _ ' 76. Dry Standpipe ,�� __ 28. Lathing & Siding � 77. FIXED SYSTEMsF�I,N�AL Y 29. Insulation ', 78. FIRE PREVy'FIPlAL� 30. Drywall Nailing -- � , H,xA�L�}IjDEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSP;ECTION 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 � 3S. Final Plumbing , . 39. Water Service-Final r 40. Gas Service-Final ' � 41. Solar pomestic-Final • 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape.lrriqation System � 45. Sound Attenuation� 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co � 51. CERTIFICATE OF OCCUPANCY No. Date � ApP��ant to till in all ipaees exceD� Ihose wit�in �eavy Dortle� lin¢s anG si9n all aOD�aVriale tleela�ations. . CITY�OF COSTA MESA � PLAN 4 El ev . A ` COIVSTRIlCTION PERMIT LOT # 30 Project Address � OS 1 ApplicanYsMailingAddress 1565 W..MacArthur Blvd. C.f4�. owne�•stvame CTAN�ARD-PACIFIC CORP ano�e 546-1161 Address 1FhF W Ma�Arthur Blvd � Arch/Eng. A(ia�15.�St.reeter �i�e�seNo. 25083 �4tldress 179R1 Sko Park Circle Irvine Contractor's Nam< iPP nWIIPP ' Phone Address (mailing) _ City�Licanse No. �� G�G LICENSED CONTRACTOR DECIARATION - I hereby atfirm that I am licensetl unde� p�ovislons of Charte� 9(commencing with section ]000) of Division 3 of the BuSiness antl Professions Cotle, antl my license is in fu i ce antl effect. ZQHO4Z License Class � � �' se oate 1 9_1 ri-Ri 5lynature � �IORKERS COMPENSATION DECLARATION hereby attirm that I have a certificate of consent to selt-insure or a certificate � of Workers' Compensation InSurance,� Or a certifietl Copy theieof (Sectlon - aaoo, �b. l�'� Fremont Indemnit ,o,;�v No. `l�P-84-225-856 ComPanY• Y eCertitietl capy is hereby fumishetl. �!+ ' � , . Certi�iG,tl_�ppy ��j1etl with the city eµilFld 9 91v1'y"Pac i f i c Date L I h S APPlicant JZ fldd U EXEMPT'ION FROM WORKERS' COMPENSATION DECLARATION (Thissection neetl not be completEtl if the�permlt is fo� One huntlretl (§100) o� less). ' .:?�"/- • . I certify that in Ihe per(ormance ot the worK�"or which this perm�t is Issuetl, I shall.not employ any person in any manner�so as to Cecome subject to the . Workers' Compensatlon Laws ot California. �. � � Date Si9nature � NOTICE: It, afte� making [his tleclara[IOn,�you shoultl become subject to the Wo�ke�s' Comp¢nsation provlsions of the Labot Cotle, you must to�thwith comply with such provlsions,or this permit shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV 1 hereby a(fl�m that there is a mnstructlon lentling agency for ihe performance of the work for whlch this permit is issuetl (SecHon 3097 Civ. C.) Lentler's Name Lentler's AtlOress OWNER BUILOER �ECIARATION ' I hereby atfirm that I am exempt from the C6ntractor's Uc¢nse Law for the following reason.(SectionJ031.5'eusinessand Professlonal Code: Any city or county which requires a p¢rinit to [onstruct, alter, impwve, tl¢molish o� repai� �any structure, prlor to its issuance, also requires the applicant tor such permit :5;',� file a signetl statement that he/she is licensetl pursuant to the provisions ot ";' e ContractorY License �aw (Chapter 9(commencing with Section ]000) of y':-y;9vision 3 of the Business antl Professions Cotle) or that he/she is exempt ^^".nerefrom anG the basis forSbe allegetl exemption. Any violation oi Section 7031'.5 by any applicant for a permif subjects the ap0��ant to �a ctvll �enalty of not more than five huntlretl tlollars ($500). U I,.as owne� oi tM1e property or'my�employees with wage5 as th¢ir sole mmpensation, will tlo the work, antl ihe sVucture is not intentletl or offeretl for sale (Section 7044, Busine5s antl Professional Cotle: The Contractor's LicenSe Law tloes not apply to an owne� of a prope�ty who bulltls or improves thereon, antl who tloes such work himzelt/hersel( or through his ar her own employees, provltletl that suth Improv¢ments are not Intentletl o� offeretl fOr sale. If, however, the builtling or Imp�ovement is�soltl within one yea� ot com- pletion, tM1e own¢r will have the burtlen Of proving he/she tlitl not builtl or Im- �rove fortne purpose oisale). 1, as owne� of the property, am exclusively conhacting with licensetl con- tractorsto construct the project (Section ]044, Business antl Professions Cotle: The Contractor's License Law tloes not apply So.an owner ot property who - builtls or improves thereon, antl who cantrac[s !or such projects with a wn- [ractof(5) IicenSe pur5uant to the Contrdctor's License Ldw). ❑ I am exempt untler Section B. & P. C. for [his reason , Oate Owner 1 hereby certify that I have reaa this application antl state that tne above InPormation is correct. 1 agree to comply with all city antl county ortlinances antl state laws relating to building construction, antl hereby authorize repre- sentatives of this� e er� upon the above-mentionetl pr perty for inzpection Signatur Date Ll Drivers' �icense or 55 � � _ tGs7a aai TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR — ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q.p. # / � DESCRIPTION OF WORK S Main Building: TVPE OF PERMIT GRAOING �❑ FOUNDATION ❑ STRUCTURAL � T Front a5� ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear a � PROECT DESCRIPTION SQ. Fr: � oGGVvarvcv C Right � 7� � CONSTRUCTIONTVPE VALUATION$ �2�.864 g Left � ZONE GRADINGCU.YDS. ACRES PIng.Ref.#�—� Remarks: —�. - Parking Req./Provided ' . Use of Building: PLUMBING � FEES P�anning Notes: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Claritiers � Dishwasher ' Drinking fountains Floor Drains Floor Sinks Gas Service Outlets <itchen Sink Lavatories �=Trap : Roof Drains ReinspeMion�Fee $Z5 Duc[- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Muitiple 0. Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ai oo,000 aTu O i oo,000 eri Reinspection Fee � $p5 CMF 0865-46 rev. ]/B3 White - Builtling: Canary - Applicant; Pink - Accounting; Goltlenrod - AsseSsor Showers . Service Sink Sewer'Cap _ .- Sewer Connection Solar�Collecmrs�� Solar Pipin9 �) Solar Tank � Swimming Pool vw. Urinal Wa[er Closet Wa[er Heater Water Service Issue Fee Hoodor Typel ❑ � Canopy TYPe I I ❑ Refrigeration Sys[em ❑aioo,000aru ❑ioo,000 System Repair/Alteration Issue Fee Automatic Washer Construction Pole 'Cooking Unit Dishwasher Dryers ❑Gas' ❑ Fan P.A.U. Fixtures D"evice Boxes OUtlets 5163 3/01/84 "" Zone Accessory Building: �- "r-/�/�/ Park.Fees $�/�f ELECTRICAL �^.'{ Trensformer ❑ 15-50-KW � Sub. � � 50�+:KW - Meter ❑up to 100 amps Meter ❑over 100 amps Electric Sub Panel � - Momrs �0.1 HP � 1 X- 8 �Inc.Solar �9-15 HP �1�6-15+ �Microwave � Pole Li9ht Range Sign Gartiage Disposal Standing Sections � ' ' Generator 065 KW 05-15 KW Trash Compactor $�� Reinspection Fee FEES �� PUBLIC SERVICES REd Zoning Approved By_ Applicatian Approved By � Application Issued 6y— $ 3 $25 � luue Fee � SUMMARYOF BUILDING PERMIT s 4£35.50 PLAN CHECK $ 7R RQ � � PLUMBING 5 � PLAN CHECK $ _ . ELECTRICAL $ � PLAN CHECK $ � ' MECHANICAL $ PLAN CHECK $ 572.85 T� Z O N � N G R E Q U I R E M E N T S FEES $ 3 SMIP g 8.46 PERMIT ISSUANCE $ , ENERGV P.C. $ GRADING $ MICROFILM ' $ TOTALFEE $ 572.85 f CONSTRUCTION AND P�ANNING��' PC & SPA APPROVALS Permit# � Date ' Inspector APPROVA�S Permit# Date Inspector 1._ Temporary Electrical Service or Pole � 52. Pool & Equipment Location ' r � 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ." � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � , +'� 4. Elecirical Conduit-Undrgind. � 55. Electrical Bonding �•� .-5. Steel Reinforcement ; � � 56. Rough Plumbing & Pressure Tesi �. - 6. Electrical UFER Grnd.'� _ � � � 57. APPROVAL TO COVER-GUNITE �: 7. Footings � �, 58. Electrical Conduit-Undrgrnd. �; 8. Foundation ' ' 59. Gas Pipe, � Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. "� - 60. Backwash Lines, P-Trap, O Undrgrnd. � 10. Structurai FloocSystem ^ 61. APPROVALTO DECK ' 71. Property Sewer Line & Hquse 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 Electric Wiring 67. Fencing & Access Approval i7. Rough Wiring Sign 68. APPROVED FOR PLASTERING � 18. Rough Electrical�T Bar Ceiling � 69.� POOL/SPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT -� 20. Rough Factory Fireplace � � � APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydra 22. Ducts, Ventilating - 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test � 72, Underground Flush . � 24. Roof Framing - 73. Undergrnd. Storage Tank C7 Gas ❑ Oil 25. Roof Sheathing ' ' 6��g(,�' 8� 7q, 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 � g �� 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 O 35. Final Gas Pipe-Test , 0�� .��_ 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&'I�UILDING `d G� � ✓(,/ 48. Special Requirements�Completed ' . 49. Electric Release to Edison . � , ' 50. Gas Release to Southern California Gas Co � � � 51. CERTIFICATE OF OCCUPANCY � _ . � � No. ' Date � . � Applicant to fill in ail spaces exee0� lhose witnin heavY �oraer lines ana slgn all apProoriate tleclaratians. GT�Y.OFCOSTA`MESA .��A-j� y Per�nnil ry,0��o ' TRACTNO. LO�� a�o . . , 30(11 6/27L84 86.^5, TI - CO(VSTP.;JCTION PERMIT C_ � PfojeCt AddfC55 TYPE OF CONSTRUCTION NEW ADD A�.TERATION REPAIR AppliCant'S Mailing Addreis � - ❑ CONVERSION ❑ DEMOLISN ❑ OTHER q,p, # � Zp�g DESCRIPTION OF WORK Owner's Nam`e � �/y�, Phone S Main Building: Accessory Building: Z AddIe55 /J/1��L/� �� Iv'�' /�rhuli' TVPEOFPERMIT GRADING FOUNDATION ❑STRUCTURAL T Fron[ ' �7 ' Arch/Eng. `-QS7 /� PS/� License NO. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B . � . . . A Rear . N AddYesS ❑ �OTHER — f C _pho ��7 PAOJECT DESCRIPTION 5Q. FT. occuvaNCv C Right G COntractor's Na/rp - K � � p Addres5�(rrroilirfyl CONSTRUCTIONTVPE VALUATION$ S Lef[ E ZONE G{3ADING CU. VOS. ACRES Ping. Ref. # Park.Fees $ ' � Q City License No. LICENSED CONTRACTOR DECLARATION Remarks: -Jl- 7D Parking Req./Provided � �� 1 hereby affirm that 1 am licensetl untler provisions of Charter 9(commencin9 R v'uith section 7000) oi Division 3 ot the Business antl Professions Cotlg, an U5¢ of Building: E my license is in full f e an e ect. 3�` p'; �/ M Liwnse,Class _ ` 'pen;,�jvo.� PLUMBING FEES Planning Notes: Da[e � Sg t � ��5�• - E . Bar Sink ' Showers N WORKERS'COMPENSATION DECLARATIO 7 I he�eby affirm that I have a certificate of consent [0 5eI6lnsure or a certificate Backflow Preventer $2NiC¢ $IOk ' $ of Workers' Compenza[ion Insurance, or a certifietl copy thereof'(Section 3800, Lab. C eackflow Irrigation Sewer Cap ELECTRICAL � FEES Policy No. -�7�� Company �� yyI C�ertifiea copy is nereey tumisnea. .� eathtubs Sewer Connection � Automatic Washer Transformer ❑ 15-50 KW IffTertiti tl[ p is fileA with Ihe city Bu" i ' n ' r ❑ 50+ KW �ate Applicant Clarifiers Solar Collectors Construction Pole5u6. EXEMPTI N FROM WORKERS' COM ATION DECLA ATION DIShvPdShC� Solar Piping COOking U�i[ - M2IC� p p (This section neetl not be completetl it the permit is for One huntl�etl (§300) o� ❑u t0 100 BRI 5 less). <Drinkin Fountains • I certlry tnat in the performance of the work for which this perm�t is issuetl, I 9 Solar Tank Dishwasher / Meter �wer 100 amps 5ha11 not employ any person In any manner 50 as to become 5u0ject to the Workers' Compensatlon Laws of California. Floor Drains Swimming Pool w/$pa Dryers ❑Gas ❑Eleclric Sub Panel Date $i9nature — NOTICE: If, after making this tlecla�atlOn, you shoultl become subject to the PIOOf Si0k5 U�ipol Fan� �. Motors O0.1 HP LZJ4'fe - 8 � Workers' Compensation provfsions of the Labor Cotle, you must forthwith comply with such provisbns or thi5 permit shall be Oeemetl revOketl. G25S¢NiC2 OuL12t5 W2tefC105¢t F.A.U. Inc.Solar �J-1$ HP 016-15+ CONSTRUCTION LENDING AGENCV ' � 1 hereby atfirm that tM1ere is a con5fruction lentling agency tor the perfarmance Int2/c¢pt0�5 W2t¢� Heat¢Y FixtU�¢5 ' �/ � MicrowdV2 � � ot the work tor which this permit is issuetl (SecHon 3097 Civ. CJ , Lentler's Name Kitchen Sink Water Service � Device Boxes Pole Light � Lentler's Atltlress Lavatories OWNER BUILOER DECLARATION ' � ' Outlets / Range �'� 1 hereby affirm that I am ezempt trom the Contractor'S License law tor the p_Tra tollowinq reason (Sectfon 7031.5 Business antl Professional Cotle: Any city or P Switches Sign covnty wnicb requires a permit to construct, al[er, im0�ove, aemolish o� repair . any st�uctur¢, prior t0 its issuance, also �equi�es the applicant for SUGh pe�mit ROOf DIdi�S Garbage Disposal St3nding S¢CtIOnS / Q to tile a signetl statemen[ tM1at he/she is licensetl pursuant to the provisions ot . � �Ihe Contracror's License Law (Chapter 9(commencing witn Section 7000) ot ' Generator 00.5 KW �5-15 KW Trash Com actor Division 3 of tne Business antl Professions Cotle) or that ne/she is exempt P therefrom ane tne basis for the allegeG exemption. Any viola[ion of Section . 7031.5 by any applicant for a permiLsubjects-tne applicant to a civil � 3 �enatty ot not more tnan five huntlretl tlollars (g500). Reinspection Fee $25 . Issue Fee- $ LJ I, as owner ot tne propecty or_ my employees with wa9es as their sole ' MECHANICAL Reinspection Fee $25 laue Fee $ 3 mmpensation, will tlo the work, antl the structure is not intentletl or offeretl FEES for saie (Section 7044, Business antl Professionai Cotle: The Contractor's . PUBLICSERVICESRE�UIREMENTS: License Law tloes not apply to an owner ot a property who builtls or improves Boi12� Hood or Type I ❑ tM1ereon, antl who tlocs such work M1lmselt/herselt or through his or hef own Zoning AppfOV¢d By Date employees, provitletl tM1at such improvements are not intentletl or offeretl for Canopy TYPe II ❑ Duct- Under Ground sale. It, however, the builtlin9 or improvement is soltl within one year ot com- Appliwtion Approved By Date pletlon, the owner wlll have the burtlen of proving he/she tlitl m[ builtl or Im- , Z �rove for the purpose ot sale). ' Duct - Structural Refrigeration Sys[em Appliration Issued By Dat 1, as owner ot the property, am exclusively contractin9 with licensetl con- Iractorsto construct the prqect (Sect�on �044, eusiness antl Professions Cotle: Duct - Ventilating ❑0.700,000 BTU ❑100,000 BTU SUMMARV OF FEES The Contracror's LirenSe Law does no[ apply to an owner of. property who . . buiitls or improves tnereon, antl wno contracts for such orojects with a con- Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT � ❑ bam exempt untler Sectlon B. & P. C. tor this reason Firepl/Fact. Blt. ICBO # PLUMBING $ ��UANCE '$ Date Owner ' Heating System & Duc[ing PLAN CHECK $ ��—p7 ENERGV P.C. $ i hereby certify that i have read this aOPliwtion and state that the above ❑0-700,OOOBTU �t00,000BT � ELECTRICAL $ .9 Ai 7'�_ GRADING $ � Information is correct. I agree to comply with all city antl county ortlinances' ' antl s[ate laws relating t b'tling constr ctio antl hereby authorize repre- $� MICROFILM $ sentatives ot this city o t on e ove-mentione prop rty for� PLAN CHECK in5pection purposes. �.,/�_ 01L ' MECHANICAL $ � � 5�9nature Date 0 7 , TOTAL FEE $ Drivers' License or 55 � Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ CMF 0865-46 rev. 7/B3 White - euiltlin9; Canary - Applicant; Pink - Accountin9; Goltlenrotl - Assessor . CONSTRUCTION AND PLANNING 7 POOL & SPA Date Inspector Date Inspector ` �,`�-%�PPROVALS Permit # APPROVALS Permit # , 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd! � 53. Steel Reinforcement .3.,Electrical Cond�iVUtili[y-Undrgrnd; 54. Forms 4.�'Electrical Conduit-Undrgrnd. • 55. Electrical Bonding 5. Steel Reinforcement. , ' 56. Rough Plumbing & Pressure Test � 6.. Electrical UFER Grnd. ' 57. APPROVALTO COVER-GUNITE `�,�� 7. Footings . 58. Electrical Conduit-Undrgrnd. . � 8. Foundation - � 59. Gas Pipe, O Undrgrnd., Test /l,,� 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. � 70. Structu�al Floor System �� 61. APPRONAL TO DECK 11. Property Sewer Line & House Connection � ' 62. Backwash & Receptor-Final � I / „72. Sewer Cap � ' 1 63. Heater & Vent-Final . 13. Roof Drains : 64. Plumbing System - Final � 14. Rough Plumbing� � 65. Electrica6Final . 15. Rough Electrical-Conduit 66. Solar System-Final - - 16. Rough Electric Wiring 1(( �� _ 67. Fencing & Access Approval 17. Rough Wiring Sign • 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGaS ❑Oil 23. Gas Pipe-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 2S. 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 f. � j;. � �' � 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 � � 57. CERTIFICATE OF OCCUPANCY • ' _ ' No. Date ' .- ., ' . , . . ��//��l� y� ADP�itant to till in all s0aces except those within �eavY Dortler tines anE si9n all app�oDriate tleclarations. r:�Tv oF �osr�� c��c�N P�� Project Address , 9 Ap�licant's M dre _ Owner's Nariie�� /y ��y� P iQn �� Addtes�� _c/ ii[{o / Arch/Eng. License No. Address �{ Contracto ' N �� Ph�° '� C� Address Im� i'��I ��/�+i�� I/ /✓ / /Y� �G�..J City License No. J�� I LICENSED CONTRACTOR DEC�ARATION 1 hereby at(i�m tM1at I am lic¢nsetl untl¢r provislons of CM1arter 9(mmmencing with sec�ion 7000) of Division 3 of the Business antl P�ofesslons Cotle, antl my license is in tull f an f ct. LIC¢0 Id55 ' � License N Date Signature WO ERS' CO PENSATION OECLARATION � 1 hereby affirm that 1 have a certificate of consent ta s If-insure or a certificate of Worke�s'.Compensifion Insurance, or a c itie copy thereoT (SeCtion 3800, Lab�� ,�/ j Policy No. Company Certi(ietl opy's hereby furnisned. /�/' ' er ' co i �I with the city�i�l�fn i�� Date APPlicant � EXEMP ION FRO WORKERS' COMPENSATION DECIARATI N (Thissection need not be completetl if the permit is for one huntlred ($300) or ' less). 1 ce�tify that in [he Oerto�mance of Ih2 work fOr which this perm�t is issuetl, 1 shall not employ any person in any manner so as to become subject to the Workers' ComOensation Laws of California. Date Signature NOTICE: If, atter makin9 this tleclaration, you shoultl become subject to the Warkero' Comp¢nsation provisions of the Labor Cotle, you must fortnwith comply with such provision5 or this permit shall be deemetl revoketl. CONSTRUCTION LENDING AGENCV - ' 1 nereby affirm that there is a construction lentlin9 agency tor Ihe performance a( the wo�k for which this pe�mit is issued (Section 3097 Civ. CJ Lentler's Name �' Lentler's Atltlress � I OWNER BUILDER DECLARATION ' I hereby afflrm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business antl Prafessional Cotle: Any city or munty which requires a permit [o const�uct, alter, improve, tlemolish o� repair any stru<ture, ptiot to i[5 issuance, also requites the applicant for suth permit to file a si9netl statement tM1at he/she is licensetl pursuaM lo the provisions of . the Contractor's License Law (Cnapter 9(rommencing with Section 7000) of Division 3 of the Business antl Professions Cotle) or that he/5M1e is ezempt theretrom antl the basis tor the allegetl exemption. Any violation oi Section 703L5 by any applicant fo� a permit subjects Ihe applican[ t0 a civil �nalty of not more than five huntlretl tlollars ($500). LJ I, as owner of the property or my employees with wage5 as [heir sole mmpenzation, will tlo the work, antl the structure is not intentletl or otferetl tor sale (Section 7044, Business antl Pwfessional Cotle: The ConGactor's License Law does not appty to nn owner of a property who builtls or improves [hereon, antl who tloes sucb work himself/M1erself nr through his or M1er own employ¢es, provitletl that su[h improvements are not intentletl or offeretl fOr sale. It, howeve�, the builtlin9 cr imp�ovement is soltl within One yEar of com- pletion, tne owner wili M1ave the bu�tlen ot provinq he/she ditl not builtl or im- prove for the purpose of sale). ❑ I, as owner of the oroperty, am exclusively conGactin9 with licensetl con- tractors to mnstruct the project (Section 7044, Business antl Protessions Cotle: The ConVactor's License Law tloes not apply to an owner of property who builtls or improves lhereon, antl who contracts tor sucn projects with a con- ' tractor(s1 license pursuant to tne ConVactor's License Law). 1 am aware that proot ol their Worker's Compensation insurance should be provitletl to me. ❑ I am exempt untler Section B. & P. C. for this reason Oate I nereby certity that information is wrrect antl state laws re atin sentatives of hi cit in5pectian pur Signafure � D�ive�s' License or 55 Owner Itave �eatl this a lF] �that tne above unty ortlinances autborize repre- tl oLODPltY_for TYPE OF CONSTRUCTION jL1�NEW LJ ADO LJ ALTEf3ATION LI REPAIR ❑ CONVERSION ❑ DE�!OLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. _ ' TVPEOFPERMIT ❑ GRADING FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAI PIUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION 5a. F7. OccVaarvCV �CONSTRUCTION TVPE 'VALUATION $ ZONE GRADIIVGCU.VDS. ACRES Remarks: ' ' Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers rinking Fountains loor Drains loor Sinks as Service Outlets Kitchen Sink Lavatories P—Trap Roof Dreins ReinspectionrFee ' � $15 Boiler Duct- UnderG�ound Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ FirepVFacL Blt. ICBO # Heating System & Ducting ❑6100,000 BTU 0100,OOOBT Reinspection Fee � $75 CMF 0865-46, rev. 4/84 Wpite - Builtlin9; Canary - Applicant; Pink -Acmun[ing; Goltlenrotl -Assessor Showers Service Sink . Sewer Cap Sewer Connection Solar Collectors ' Solar Piping Solar Tank Swimming Pool w/Spa U�inal Water Closet Water Heater Water Service Issue Fee Hood or Typel ❑ Canopy Type I I ❑ ❑0-700,OOOBTU ❑100,000 System Repair/Alteration Issue Fee FEES $ 3 FEES $ 3 A.P. �f`- S Main Buildi E T Front B Rear A C Ri9ht K �eft S Ping. Ref. # Planning Notes: Automatic Washer. Construction PoleSub. Cooking Unit ,� Dishwasher Dryers ❑Gas �Elec Fan F.A.U. Fiztures Device Boxes Outlets Switches Garbage Dispoul Generator �0-5 KW � Fee Zone Parking Req./Provided ELECTRICAL ' Transformer � 0 15�50 KW ❑ 50+KW 5KW T $15 Meter ❑up to 100 amps Meter ❑overi00amps Sub Panel Morors �0-1 HP �1`/: �8 Inc.Solar 09-15 HP 076-15+ Microwave � Pole Light Range Sign - Standing Sections Trash Compactor luue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By ___,��T FEES $ 3 2 O N I N G R E Q � M , T SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMB G� (�7 .(��/,�� /� /�ISSUANCE $�T E��q1 15� If 1 .1 1� q ADINC�$ � � d��--~ MICROFILM $ PLAN CHECK 50% $ MECHANICAL $ TOTALFEE $ PLAN CHECK 25% $ CONSTRUCTION AND PLANNING � - POV �& SPA . APBROVALS Permit# Date Inspecto� AppROVALS Permit# Date Inspector 1. Temporary Electrical,Service or Pole ' 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' 3. Electrical�Conduit Utility-Undrgrnd. � 54. Forms 4. Electrical Conduit-Und�grnd. 55. Electrical Bonding , 5. Steel Reinforcement • 56. Rough Plumbing & Pressure Test �: � 6. Electrical UFER Grnd.- � 57. APPROVAL TO COVER-GUNITE " 7. Foo4ings: ; . �, -� ', 58. Electrical Conduit-Undryrnd. ' 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 1 t. Propeity �Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer�Cap ' 63. Heater & Vent-Final 13. Roof Drains � ' ' 64. Plumbing SVstem - Final � 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit . 66. Solar.System-Final 16. Rough Electric Wirin9 � 67. Fencing & Access Approval . 17..Rough Wiring Sign � 68. APPROVED FOR PLASTERING 18. Rough Elearical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro ' 22. Ducts, Ventilating ' ' 71. Product Piping OGas ❑Oil � 23. Gas Pipe-Rough & Test . . . ,72. Underground Flush 24. Roof Framing 73. Undergrnd.5torageTank �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 MeterFinal , 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 �O�(0��'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. FINAL STRUCTURE & BUILDING � 48. Special Requirementx Completed � 49. Electric Release to Edison' • � � -- 50. Gas Release to Southern California Gas Co � 51. CERTIFICATE OF OCCUPANCY No. �Date � � � � CITY OF COSTA.MESA CONS�RUCT_JQJN PERMIT 3�s .°.CP��ant to fill In ali spaces excepl thosa within heavy borCer lines anG sign all aoc�ac�iate tleelarations. . , Project Add�ess. � i � � �T�-��'�� ffa�� Applicant's Maili ess _ ' Owner's Namt� PhyPe Address � �� "'�—� ��-- Arch/Eng. License No� Address �� Contracto 's Name P'--r M1^^^ 547 S A'ddress (m '�' „�� • �� City License No. �—� `� � LICENSEO CONTRACTOR DECLARATION I hGr<Dy afflrm tnat I am Iicensetl untler proviS10n5 Ot Chart¢r 9(commencing with section 7000) ot Divislon 3 of tne Bu5ine55 antl Professlons Cotle, antl my Ilcense is in tull fo ce a tl eftec . ' O � License Class Llcens o. 7ate Signature ' NORKERS'COMPENSATION DECLARATION . I M1ereGy aftirm that I have a tertlflcate of consent to self-Insure or a certiticate o( Workers' Compensation Insurance, or a tertlfletl copy tKereof (Sectlon 3800, Lab C.) ' /� Policy No�.0 Q--Stb9470 Company ��+'� Certlfietl copy is nereby furnlshetl. Cartl tl cOP i 1 with the cltYAuiN`Qing�� lon. � ate Applltan��v Y EXEMPTION F OM WORKERS''COMPENSATION DECLARATION (This saction neetl not be mmpletetl it tha parmit Is tar one huntlretl ($100) or' iess). , � ' : � - I cerU}y that dmthe performance of the work for whlth this perm�t Is Issuetl I shall not employ any person In any manner so as to become'subject to t�e Workers' Companzatlon Laws of Californla. Date Si9natWe NOTICE: It,iafter making this tleclaration, you shoultl become sub)ect [o the Workers' Compensatlon provl5ion5 of [he Labor Cotle, you must forthwith comply with zuch pravislons or.this parmlt shall be�tleemetl revoketl. CONSTRUCTION LENDING AGENCV ' 1 M1ereby afflrm that there is a constructlon lentling agency for the pertormanca of the wovk Tor wM1lch thls permit is issuatl (Section 309� Civ. C.) Lentler'S Name _ , LenOar's Atltlress � � OWNERBUILDER DECLARATION � � 1 herebv afflrm that I am exemot from the Contractor's License Law tor the 7 Dat �ef/OT antl tne basls (O� the allegetl ex¢mptiOn. Any vlolatlOn Of Sec[IOn i1.5 by any appllcant for a permlt subjects the appll<ant to a civll alty ot not more tnan tive huntlretl tlollars ($500). � I, d5 Owne1 Of tlle plopelty oI my BrtIpI0y085 with wa9e5 a5 th¢II 5018 �pensation will tlo Ihe work, antl the structure is not Intentletl or otferetl SdIB ($Bc41on 7044, Bu51ne55 antl PrOtE5510f1d1 COtlO: Tha. ColltldctOr'S 3nse Law tloes not apply to an owner of a property who bulltls or improves ' raon, antl who tloes fuch work himselt/herself or throu9h hls or her own �loy eas, provitlatl that such Improvements are not intentletl or offeretl for If, however, tne Gulltling or improvement 15 soltl wlthln one year of com- ion, the owner wlll have the burtlen of proving he/she tlitl not build or Im- ve for the pufpose o1 sale). . � I, az owner of the property, am exclusively tontracting wlth Ilcensetl con- � :tors to tonstruct the proje<t (Sectlon 7044, Buslness antl Professlons Coae: i Con[ractor•5 Llcense Law does not apply to an owner o( proPerty who Itls or improvat thereon, antl who contract5 for such projects wlth a con- :tor(5) Ilcense pursuant to the Contractor•s License Law). 1 am exempt unCer Section B. & P. C. for this reason e Owner thi5 abova �� % %S TVPE OF CONSTRUCTION �. ❑ CONVERSION �� DI DESCRIPTION OF WORK TYPE OF PERMIT , LJ GRA�Iq� ❑ TENANT ❑ ELECTRICAL ❑ OTHER LJ ADD LJ ALTERATION LJ REPAIR 7 OTHER FOUNDATION STRUCTVRAL ' LUMBING ❑.MECHANICAL � PROJECT DESCRIPTION SQ.FT. oCCVParvCV CONSTRUCTIONTVPE� VALUATION$_ ZONE GRADINGCU.VDS. ACIiES— Remarks: Sink Irrigation Drinking Fountains Floor Drains Floor Sinks - Gas Service Outlets Interceptors Kimhen Sink Lavatories Roof Draini Reinspection Fee $25 Duct - Under Ground � Duct-Structural � Duct - Ventilating . � Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating'System & Duning '' �Q100,000 BTU 0100,0008T sentatives of [�is ci y to' ent�er upon tn above-mennonetl � qOgrt tor � Inipectlon puf0a5 . �—t/J /6 Slgnature / �' � e C Drlvers' Llcenu or 55 � Reinspection Fee CMF 0865-46 rev. 12/83 White - Bulltlin9: Cana�y - Appliwnt; Plnk - Accounting; Goltlenrotl - Assessor $25 Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank � Swimming Pool w/Spa Urinal ' Water Closet � Water Heater Water Service I� laue Fee FEES $ 3 X A.P. #_ S Main Building: , E T Front A Rear C Right g Left Ping. Ref. # Parking Req./Provided Use of Building: Planning Notes: Automatic Washer Construction Pole Su6. Cooking Unit Dishwasher � : 5752 "3/09/84 ^ 2ona- Accessory Building: Park.Fees ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Fan F.A.U. � Fixtures Device Boxes Outlets Switches Gar6age Disposal � Generator 065 KW �5-15 KW Meter LJ up to 100 amps � Meter �over 700 amps . Sub Panel Motors �0.1 HP 01'/:-8 Inc.Solar �9-15 HP �16-15+ Microwave � Pole Light Range Standing Sections Trash Compactor fleinspectian Fee $25 �ssue Fea IANICAL FEES PUBLIC SERVICES REQUIREMENTS: Hood or Typel ❑ ' . Canopy Type I I ❑ , Zoning Approved By Building Approved By Fiefrigeration System ❑0.100,000 BTU ❑ 100,000 BTU System Repair/Alteration � Issue Fea � . �� $ 3 3B.00 TL FEES $ 3 - � SUMMAHV OF FEES BUILDING PEFMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ e'1I^ ISSUANCE $ , PLAN CHECK 25% 5 �� ENERGY P.C. $ ELECTRICAL $ ' GRADING $ � PLANCHECK 50%�$ ' MICROFILM $ � �( MECHANICAL '$ . TOTALFEE $ �b'� . PLAN CHECK 25% $ � - • " O N 1 N G R E Q U I R E E N T x `� ��-CONSTRUCTION AND PLANNING . PG� _ & SPA - , _ - APPROVALS Permit # Date � Inspector AppROVALS Permit # � Date Inspector ' 1,TemporarY'Electric8l Serviceor Pole 52. Pool & Equipment'Location ��• � � � 2:' Soil Pipe-Undrgrnd.� ��]��/ � fj� 53. Steel Reinforcement � : � '��3,� Electrical Conduit Utility-Undrgrnd�. � 54. Forms ' . . . 4. Electrical Conduit-Undigrnd. � 55. Electrical Bonding � �� 5. Steel Reinforcement ; - .� 56. Rough Plumbing & Preswre Test ` ' � � 6:' Electrical UFER Grndl '� , . 57._ APPROVAL TO COVER-GUNITE �.'' � 7. Foo[ings ` 58. Electrical Conduit-Undrgrnd. , • , 8. Foundation • -- � 59. Gas Pipe, O Undrgrnd., Test . - - '�! ' 9. Water Pipe-Undrgmd. 3 j(�yl� (�� 60. Backwash Lines, P-Trap, O Undrgmd. _ - , 10. Structural Floor System ' • ; . 61. APPROVAL TO DECK � � , � - � 11. Property Sewer Line & House Connection r 111'�Y _ L� � 62. Backwash & Receptor-Final ` � ti� ! 12. Sewer Cap � _ � � - 63. Heater & Ven[-Final � . ' . 13. Roof Drains ', ' "64. Plumbing System - Final _ . 14. Rough Plumbing 7��/ jkf L� 65. Electrical-Final ' � 15. Rough Eiectrical-Conduit - , i 66. Solar System-Pinal -'" - ' 16. Rough Electric Wiring � 67. Fencing & Access Approval - `= � '- ' 17. Rough Wiring Sign • � 68. APPROVED FOR PLASTERING � ' 18. Rough Electriral-T Bar Ceiling' . .' 69. POOUSPA SYSTEMS FINAL �' '' 19, fiough Heating & Air Conditioning FIRE DEPT. REQUIREMENT. ' � ru, � 20. Rough Factory Firepiace , • APPROVALS Permit # , � � - � � 21. Ducts, in Structure ; � 70. Underground Hydro _ �22. Ducts, Ventilating �� 71. Product Piping OGas .00iI ' 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 i 77,1 FIXED SYSTEM FINAC � � , i �, 29. Insulation �78.� FI�RE PREV. FINAL � 30. Drywall Nailing �• � HEALTH DEPT. REQUIREMENT 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'GasPipe-Test cr � (�Q � � , - �� 36. Hood or Canopy . 'i . i 37. Final Factory Fireplace � � ' � � � � � � � � 38. Final Plumbing � � �%t� L�J � � . � 39. Water Service-Final � � 40. Gas Service-Final � � -� ' ' 41. Solar pomestic-Fi�al � , 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 � ' � � ' . - � ' � i 50. Gas Release to Southern California Gas Co � �, 51. CERTI'FICATE OF OCCUPANCY � - , . � � , . No. � Date i . � Apvlicanl to fill in all sDatts exeeo< those within heary boraer lines ane sign all aooropriate eeclantions. CI7v OF caSTA Mes�I C NSTR TIOIy PERMIT Project Address �J � �� Applicant's Mailin ddre s Owner's Name � L Ph e Address ArchlEng. Licenu No. Address - Contracror's Nam� W �•Phone Address (mailing) Ciry Licenu No. LICENSED CONTRACTOR DECL RATION I hereby atfirm [hat'I am Iicensetl untler provisions ot Charter 9(commencing witn sectlon ]000) of DivlSion 3 of the Business antl Professlons C�e, dntl my licensf is in tul or[jantl effect /� G/ (�p LJcen�¢ �� I ep� �� Date � 5'9 t � W00.K RS' COMPENSATION DECLARATION� � ' hereby aifirm tnat I nave a certi(icate o( mnsent t self-in re or a certificate �f Workers' Compensatlon Insurance, or a cert't etl copy thereof (Sectlon 3800, Lab. ��/�� p p�/� � Golicy No. �'r��d��0`Y/ Company 8 Certif tl opy is hereby /umishetl. C '(W' filetl with the city BQ��Q/' I4'f' . l. Oate Applicant_�1 v EXEMPTION ROMWORKERS'COMPENSATIO DECLARATION (Tnis seclion neetl not �e completetl If the permit Is for one huntlretl (E100) or lezs). I ce�tlly that in the p¢r/Ormance ot the wo�k fo� wM1ich t�is pe�m�t Is issued, I snall not employ any person In any manner so as to become subjecl to the Workers' CompensaHon Laws of Calitornia. Date Signature NOTICE: H, atter making this tleclaratlon, you shoula become subject to the Workers' Compensation provisions ot [M1e Labor Cotle, you must forthwith comply with zuch p�ovislons o� lhis permit shall be tleem¢tl revoketl. CONSTRUCTION LENDING AGENCV . 1 he�eby aifirm tha[ thete ISp con5lruction lentling a9enq tor the p¢rformantt ot the wOrk for wnic,h/Qblp�P2rmit iz i5suetl (Section 3097 Civ. CJ LPnOer's Name /��"�� LCfltl¢!'S Atltll¢55 OWNER BUILDER DECILARATIOfi-� � I hereby affirm that I am exempt trom the Contractor's License Law tor the following reason (Section 7031.5 Business ana Protessional Cotle: Any city or counry wF11CM1 �¢qUi�eS a Oermil to construct, alter, improve, tlemolish or repair any structure, prior to ils issuance, also requires ihe aoPllcant for such permit to file a Si9ned statem¢nt Ihat he/sne i5 licensetl pursuant to the provisions of ehe Contractor's License Law (Chapter 9(commencing with SecHon 7000) oi liviziOn 3 of the Business antl ProfeSsionS Cotle) or tha[ he/sne is exempt ierefrom and th¢ Dasis tor (h¢ alleqetl exemption. Any violation of SectlOn /031.5 by dny appliCant fot a permit subjects [ne appllcant to a civil �enalty ot not more lhan five nuntlretl tlollare (5500). 1, as owner of thc property Or my employee5 with wa9es as theinsole comoensation, will tlo the work, antl the s[ructure is not intenaetl or otteretl for sale (Section 7044, Business antl Professional Cotle: The Contracror's License Ltw tloes no[ apply to an owne� of a property who builtls o� improv¢s thereon, antl wno tloes sucn wurk nimselt/ncrsolf or tnrougn nis or her own employees, provitletl that such Imp�ovements are mt intentletl o� offeretl fo� sale. If, however, the bulltling cr improvement is soltl within one year ot com- Olefion, the owner wlll have tbe burtlen of proving he/she tlitl not builtl or im- �rOv! fo� lhe pu�poie Of sale). 1, as owner of Ihe property, am exclusively contracting witn licensetl con- t�actor5 to con5truct Ihe Oroject (Section ]044, Business antl P�ofessions Cotle: The Cont�actor's Llcenie Ww tlOM nOt apply to an owner of Properly who Cuiltls or improves thereon, antl wno contracfs for such orojectz with a con- tractor(sl license Dunuanl�to th¢ Contractor'S LicenSe Law). I am aware [hat proot o1 their Worker'S Compensation Inmrance zhoultl be provltletl [o me. ❑ I am exempt untler SecHon 8. 8 P. C. for this reazon Date Owner _ I herebY certiry Ihat I have reatl lhis TYPE OF CONSTRUCTION � NEW IJ ADD LI ALTERATION I.J REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TVPE OF PERMIT LJ GRADING U FOVNDATION L�'STRUCTURAL ❑ TENANT ❑ ELECTRIGAL ❑ PLVMBING L�•�ECHANICAL ❑ OTHEf3 PROJEC7 DESCRIPTION 54. F7. oCCUPANCV— CONSTRUCTION TVPE VALUATION $ ZONE GRADINGCU.YDS. AC0.E5_ Remarks: � / /`�%/� rinkinq Fountains loor �rains loor Sinks as Service Outlets Kitchen Sink Lavatories P—Trap ROOf Orains Reinspection Fae � $15 Boiler Dutt - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting �100,000 BTU O 100,000 BT antl state iaws eiaung to owi g c nsUucvon, ana ner¢ny autnor ze repre- sentatives o bis city to en , r u on the above-mentionetl pr er[ for Insoection o o , � $igna[ure l Date � Drivers' License or 55 # � Rainspec[ion Fea CMF 0865-46, rev. 4/84 White - Builtling; Canary - Appliwnh Pink - Accounting: Goltlenrotl - Aszessar $15 PLUMBING Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee Hood or Type I ❑ Canopy Typell ❑ Refrigeration System ❑aioo,000eTu Oioo,aoo System Repair/Alteration Issue Fee FEES $ 3 $ 3 A.P. �i`- S Main Buildi E T Front B Rear A C Right K Left S Ping. Ref. # Planning Notes: Automatic Washer . Construction Pole Sub. Cooking Unit Dishwasher Dryers OGas ❑Elec Fan F.A.U. Fixtures Device eoxes Outlets Switches Garbage Disposal Generamr DO-5 KW � � 3618 7/06/84 Zone Accessory Building: Parking Req./Provided ELECTRICAL Trans(ormer ❑ 15-50 KW ❑ SO+KW Meter ❑up to 100amps Meter ❑over100amps Sub Panel Motors � 0-1 HP � 1 Yh - 8 Inc.Solar �9�15 HP �16-15+ Microwave Pole Light Range ' Standing Sections 5 KW Trash Compactor � Reinspection Fee �$75 I I Issue Fee DEVELOPMENT SERVICES�REQUIHEMENTS: 2oning Approved 8y Building Approved By Appliption Issued By l�^ � BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ PLAN CHECK 25% $ ELECTRICAL 5 PLAN CHECK 50% $ MECHANICAL �S� PLAN CHECK 25% $ B.QC Ti Z O N I N G R E � M T S. FEES $ 3 Y OF FEES — SMIP $ — PERMIT _ ISSUANCE $ ENERGV P.C. S GRADING $ � MICROFILM $ _p_,__ CL II/� TOTALFEE $ � � CONSTRUCTION ANDPLANNING PO� �SPA APPROYALS Permit# Date Inspector qppROVALS Permit# Date Inspector 7. 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� �.�lectrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings . ,� 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P•Trap, O Undrgrnd. 10. Structural Floor System - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains ' 64. Plumbing SYstem - Final 14. Rough Plumbing 65. Electrical-Final " 15. Rough Electrical-Conduit - 66. Solar System-Final � 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 7�Y1�e.� L� FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace . APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil 25: Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (StructuraQ & 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. �lectrical Power Meter-Final � 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: - 34. Final Heating & Air Conditioning jn��i�y � 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. $olar pomestic-Final 42. Backflow Preventer " 43. Backflow Irrigation . . � , . 44. Landscape Irripation SYstem � 45. 5ound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. 5pecial Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co . 51. CERTIFICATE OF OCCUPANCY No. Date � ..•• Applicant to fill in all spaees exeeot lhosa witM1in �eavv �ortler Ilnes antl slgn all app�opriate Oeclarations. CiTv oF COS7A MESA CONSTRUCTION PERMIT Project Address ";41 F l.i V PIIfIPt^ I a na Applicant's Mailing Address Owner'sName $tdndard Pa�ifi[' fnrnPhone 546-1767 Address 15.6� W MdCArthur fpcta Maca 9�6�6 ArchlEng. License No. Address Contractor'sNam�jl�yy�1—R]yy�blRj - Phone 52R_114O Address (mailingl 71 fl� 'AI Fne Ana �Anaheim Ciry License No. Z�Q�1 LICENSE� CONTRACTOR DECLARATION I hereDy affirm [hat I am IlcenSetl untlar provi51on5 0( CM12r e� 9(commencin9 with section ]000) of Division 3 of the Business and Pr essions Cotle, antl my Iicense is in /ull to�ce�ge ettect. QZE� O9 License CIasS LI. n NO. Datel� 1 fl /�� RA_ 519�ature WORKERS'COMPENSATION OECLARATI ' hereby atfirm that I have a certiticata ot consent lo zelt-insure or a cerNficate �t Worker5' Compens5tion InSurance, or a cerHfietl copY tM1ereot (Se<tion 3eoo, uc. r��_��141 Home Policy No. Company �Certifiea copY �5 hereby lumishetl. � Ce�jij��Q Sppy �5 with [he cltY B,yIeWn9j.�lumqn' n Date I U I ll(js4 AOPlicant IV Y I D 9 EXEMPTION FROM WORKERS' COMVENSATION DECLARATION (This saction neetl no[ be completetl il (he perml[ I5 (or one huntlretl (5300) or less). I ce�tify that in lhe Oe�fo�mance of the wOrk for which this permit Is Issuetl, I snall not employ any person in any manner so as to become subject to the Workers' Compensallon LawS Of California. Date $I9nature NOTICE: If, afle� making fhis tleclaration, you shoultl becOme subject to tne Workers' Compensalion provislons of the Labor Cotle, you must forthwith mmply wilh Such provisions or thi5 Perml[ shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV I M1ereby affirm thal [here is a conztruction lending agency lor the performance of the work for whiGh Ihis perml[ is issuetl (SeCOon 3097 Civ. CJ Lentler's Name Lentler's AAtlress . OWNER 9UILDER DECLARATION� I hereby affirm that I am exempt irom Ihe Contracror'S License Law for the tollowing reason (Section 7031.5 BuSinesS antl Protessional Cotle: Any city or county which requires a p¢rmit [o conStruC[, al[e� improva, tlemolish or repair any structure, prlor to It5 Issuance, also requires t�e applicant tor SUCh permit to file a signetl Statement tltat he/She Is licensetl pursuant to Ihe provisions of the Contractor'S License Law (ChaO�er 9(commencing with Section 7000) of `ivision 3 of the Buslness antl Protessionz Coae) or that he/She is exempt ietelrom antl Ihe basis for the allegetl exemption. Any violation oi Section .031.5 by any applicant tor a permit subjects the applicant to a civil �enalty of not more than five nunaretl tlollars (5500). I, as owne� ot the Property o� my ¢mployees wiM wage5 az tnei� sole comoensation, will do tne work, antl the structure is not intentletl or ofteretl for sale (Sec[ion ]044, Businezs antl Protessional Cotle: The Contractor's License Law tloes not apply to an owner ot a property who builtls or imOroves tM1ereon, antl whn tloes such work himself/h¢rs¢It or tM1rOugh his o� her own emvloyees, provitletl that such improvements are not intendetl or orieretl for sale. If, however, tne bulltling cr imOrovement is soltl witnin one yea� of com- pletlon, the owner will nave the burtlen ot proving he/she tlitl not bulltl or im- �rov< tor the purpose of 5ale). I, as own¢r Ot Ihe pro0erty, am exclu5ively COn[racting with licensetl corv tractor5lo construc[[he proj¢ct (Section �OC4, Business antl Profezsions Cotle: The Contractor's License Law do<s not apply lo an own¢r ot property wno builtls or improves the�eon, antl wno contracls for such prolect5 with a con- Vactor(sl license pursuanl�lo th¢ Conlrac[or's License Law). I am aware tltat proof o( th¢ir Worker'S Compensation in5uranG¢ zhoul0 be provitletl to me. ❑ 1 am exempt untler Se<Non B. 3 P. C. for this reason Date I hereby certity tM1at iniormatlon is mrrect antl state laws ralatin sentatives o Wic—eN inspeCtlon Ou� Signalure Drivtrs' LicenSe Or 55 [lon antl all city a i, antl h� property TVPE OF CONSTRUCTION 1(J� NEW U ADD Ll ALTERATION fJ REPAIR ❑ CONVERSION ❑ �EMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TYPE OF PERMIT LJ GiiAOING LJ FOVN�ATION LJ STRVCTURAL O TENANT ❑ ELECTRICAL � PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIP710N 5c?. FT. oCCUPANCv_ C O N ST RUCTION T V PE V ALUATION $ ZONE GRAOIIVGCU.VDS. AC0.E5_ Remarks: Vi � ��%%1 � �� Sink Preventer Irrigation Dishwasher Drinking Fountains Floor Orains � Floor Sinks ' Gas Service bOutlets Interceptors Kitchen Sink lavatories P—Trap Roof �rains Showers Service Sink � Sewer Cap � Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater �Water Service FEES Reinspec[ion Fee � $15 I I Issue Fee I $ 3 MECHANICAL FEE Duct - Under Ground Duct-Structutal ' Duct - Ventilating ExhaustSystem ❑ Multiple❑ Firepl/Fact. BIt. ICBO �I`- Heating System & Ducting ❑ 0.1 �,000 BTU 0 700,000 BT Reinspection Fee � S75 CMF 0865-46, �e�. 4/84 White - Bulltling: Canary - ApO��h Pink - Accounting; Goltlenrotl - Assessor Hood or Type I ❑ Canopy - Type I I ❑ Refrigeration System ❑o�ioa,000sTu ❑ioo,000 System Repair/Alteratian laue Fee I $ 3 A.P. # S Main Buildi E T front B Fear A C Right K Left S Ping. Fef. # Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit 0183 10/12/84 2one Parking Req./Provided TELECTRICAL � � Transformer ❑ 15-50 KW ❑ 50+KW Dryers LJGas LJElecvic Fan F,A,U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator �0.5 KW �5-15 KW Merer Uup to 100 amps Meter ❑over 100 amps ;Sub Panel � Motors DO-1 HP � 1 X- 8 Inc.Solar 09�15 HP 016-15+ Microwave Pole Light Range Sign Standing Sections Trash Compacror Fee � 575 � � Issue Fee 5.50 FEES $ 3 2 O N 1 N G R E Q M T S. DEVELOPMEN7 SERVICES REQUIREMENTS: Zoning Approvad By Date Building Approved By Date� Appliption laued By Data_�w.�� Z H— SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK S PEPMIT PLUMBING $ J�' �SO ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ GRADING S PLANCHECK 50% $ MICROFILM 5 MECHANICAL $ TOTALFEE $ �rS� PLAN CHECK 25% $ - CONSTRUCTION AND PLANNING PO. . SPA APPROVALS Permit# Date Inspector AppROVALS Permit# � Date Inspector i. 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 Bbnding �' 5. S[eel Reinforcement - , 56. Rough Plumbing & Pressure Test / 6. Electrical UFER Grnd. � 57. APPROVAL TO COVER-GUNITE - ' f� 7. Footings ,, - 58. Electrical Conduit-Undrgrnd. . 8. Foundation ` 59. Gas Pipe, O Undrgrnd., Test � 9. Water Pipe-Undrgrnd. _/q 60. Backwash Lines, P-Trap, � Undrgrnd. ' 10. Structural Floor System `r ' � 61. APPROVAL TO DECK r 11. Property Sewer �ine & House Connection 62. Backwash & Receptor-Final ' 72. Sewer Cap 63. Heater & Vent-Final � 13. Roof Drains 64. Plumbing System - Final ' 14. Rough Plumbing 65. Electrical-Final ' 15. Rough Electrical�Conduit 66. Solar System-Final - 16. Rough Electric Wiring 67. Fencing & Access Approval - 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING � 18. Rough Electrical,T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � APPROVALS Permit # 21. Ducts, in Structure • 70. Underground Hydra 22. Ducts, Ventilating � 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test . 72. Underground Flush 24. Roof Framing , 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) �& Monocoat � 75. Dry Chemical � 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding � ' 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. DrYWall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Cqat 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 ��(�� L(�% 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 Irrigatibn System � 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUC7URE&BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release, to Southern Califomia Gas Co 51. CERTIFICATE OF OCCUPANCY ' No. Date rxaecTno+;s: gq1S LAVENDER LN OY1NEfl'S NRME: MR . & MRS , D ELATORR E aoo?�ss: �415 LAVEND'ER LN a q'OSTA PCESA ' �cA 92626 . pp`�RUGHESS: P`5500 W� �BOLSA AV , � PENMITTEE: FI . B . nooeess:MR. S MRS. DELATORRE . 3415 LAVENDER LN 7000) oi DiWsion 3 oi Ihe Business anG Profi CITY UC.� 5T11TE L1C.: (.6� '" uxir: Sz() I�C7� flEG.NO.: .� ' uxrt:130 CA 92649 (714)545-1467 NONE CA �92626 ler proNsions oi C�aOrer 9(commencing witA Section full tyce an0 eflect. . �ate: " — Signature: �OBNEHS' COMPENSRTION OECUIIATION: I here6y� aflirm that I have a certificate oi consent to self-insur r a certificata oi Workers' Tpen5ati0n Insurante, Or a t¢rtitietl copY Ihereof ($ection 3800, Lah. C). POLICY NO.: EXP. D1TE: - COMPqNY: - . . ❑ Certifietl copy is herehy fumishetl. ❑ Certified capy is /ileU wi[h t�e ciry Building Division. Date: FpD�icant: - E%EMPfION FflOM WOBNEBS' COMPENSRTION OECUHIITION:v I is s ction need not be complete0 ii Ihe permh is for one huMreA (5100) or less). I certity I�at in Ihe 0 Mormance � �Ae work for which �h' pe Fi '�sue (I all no[ mploy any erson in any anner so as �a Decome suGject to lhe Wo rs' Co�m,p s tion aws oi Calilo � G! /s � "c Date: _ Signature' NUTICE: , aRer maki tAis Declaration, you should' ecome suUl� to the Warkers' CamDensation pravi ans oi the Labor Cotle, you must fort�with com0ly wi[A such provisions or t�is permit s0all be tleemetl revoked. CONSTNUCTION LENOING AGFNCY: I Aere6y aifirm that ihere is a constmction IenOinA apency fo� ihe periormance of Ihe waM for which this Dermit is issueC �Section 3097, Civ. C). LENOEH: FOOHESS' ' " ' ' ' - - OWNEB BUILDEB OECLAMTION: I hereCy aflirm that I am exemD� ��om tAe Caniractors' State License Law for the followin0 reason (Setlion 7031.5 Business anC Pmiessional Cotle: My city oi counry which requires a permit to consimct, alfer, impmve, Oemolish, or reDair any sWcture, pnar to its issuance, also requires tAe apDlicaN tor such permit to /ile a signea statemem tlat he/she i5licenseA pursuant m the pmvisions oi the Contractors' State License law �Chapter 9(wmmencinA witA Section 7UW) of Oivision 3 of t�e Business antl Professions Code) or Ihat he/she is exempt therelrom an0 the basis for the allegea eeemp[ion. Any violation al Section 7031.5 6y ny apDlicant for a permit SUGlectS the apPlicant �o a civil penalty ot not more �han five �untlred dollars (E500). �� I, az owner oi t�e pmperry ar my emyloyees with wapes as iheir sole compensation, vnll tlo ihe work, anG ��e simcWre is not intenUeO ar ofleretl for sale (Secnon 7044, Business anA Pmfessional Cotle: T�e Cantracrors' Stata Licensa Law � Ooes not aOPly to an owner oi a DroDerty w�o builtls or impmves thereon, antl who Ooes sucA woB himseltlhersell or I�rouAh his ar her own employees, pmvitletl Ihat such impmvemenis are not inten0etl or otlereA Por sale. Ii, Aawever ihe buil0ing or impmvement is solG within ane year af completion, [he awner will have the EurAen ai pmvinp he/she Uitl nat bui10 or improve for ihe puryose af sale). ' . . �. I, as owner of the pmpeM� am exclusively coniractinq wit� licensed cont2ctors to constNci tAe pmlec[ (Section 7044, Busine55 � antl Pmfeuions Coee: TAe Contactors' State License Law tloes not apply to an owner of pmDerry w1m bwl0s or improves t�ereon anU w0o coniracis lor such D�olec�s vnih a coniroctor(s) license pursuant to the Contractors' State License Law). I am aware that pmof oi iheir Worker's ComOensation insurance shoul0 �e proviOeA,to maJ � , � I am exemp� unGer Section: B. 8 P. C. . for this reasan: � Oate: Owner. ' I do here6y certity that l am aware of an0 untlerstantl Ine requirements of California Health anU Safery Coae Sections 25505, 25533, anA ' 25534 and Ihat I or any fu[ure huil0ing acupant wilUwill not (circle one) neeA ro comply with saiU state codes an0 t�e requiremenis for a permit br cbnstrucfion ar mo0ilication irom tAe Air �ualiry Manaqement District. Fesitlential constmction applications are exempt from t�ese pmvisions. ' , Wte: Applicant: I hereby certiry lhat I �ave reaC t�is aD�lication and state that e bove information is correcl. I apree to compty vnt� all ciry anA counry ortlinancesanOs�a�elawsrelatinptobuilOinOcanswctionantl reb autA izerepreseniativeso�thisciryt en�erupont�eaGove-meniioned pmDeRY fo� �nspection Durposes. _ � �/) Date: � Signature: �' `�� urrver's License or Saiai Securiry x: ' \�,1601�48 W�ite—Builtling; Green—Cotle Enforceman�: Canary—ApplicenC Pink—Revenue; GOIEenrotl—Assassor ` � CITY OF CGSTA.MESA - 9UILDING PERMII' PERM NO:�D J 045004 PERMIT NG: B O4S004 , PLAN CI�ECR NO: 0133'1-09 S, GOVT:''N�SUP�Y: N CONSTRUCTION TYPE: V-N PERMI7' TYPE: STR • FORPOSE: ADD . JOB DESCRIPTION :;DEN ADD-ON '1.58,Sp FT : , SQ PT:� , 25ft CLAIM VALOE: ., CALC-VALUE: 17,46G.60 GROUP OCC: R-J / COMMENTS: ***��*�**�r��r***�***�+r�*x x*****+�**+�****�r****��*�+��r*x*��r�x�*��r��*x�+�*******�*�.* . Z O N I N G R E Q U I R E M E N T S , S E T B A C K S ----=-=j---- MAIN BUILDING -- ------ -- ------ ACCESSORY BUILDING ---------- FRNT:•". FT IN RF.AR: 21 FT 6 IN FRNT: FT ZN REAR: FT IN LEFT�:'„'b FT ' IN AGHT: 12 FT 6 IN LEFT: FT IN RGHT: FT IN ='.�. . . . � , , PARRING REQ• PROV; PARCEL: 41237401 ZNE: R1 REF NO: PLANNING NdTES> ADDITION ATTACI3ED TO THE RIGHT SIDE OF AN EXISTING HOUSE.. >_. NEW ROOM TO BE USED AS A DEN •- x�r**�r*********�*�r�t*�t***�t+��t�t�t*x�*�t�***��t*�t�******�r****�*��t�t*�rx��r�t**�t�*�*�t�*�r�t*� x * D,E V E.L O P•M E N�T ; E-R V I C E S ;R � Q L7 I R E M E N T',S `/' �� DATE: 7� S �/_ ZONING APPROVEb. BY ""�:`fi'�'� �,_� BUILDING APPROVED BY : DATE: •/ / /� � APPLICATION IS,SUED BY: .. DATE: /s lS�� fFiEiEiEiF3Ei(�iFiEiE1E�E1E�iE3EiElEiEiE�1EiElkiE�E iE 3E *If IEiEiEiF�EiEiElEiEif iF iEiE 3E If if iE iE iE iE 1f iP �N� 1E iE iE 1E iF 3E 3F iF �E �E iF ik iE ik if if� if it iE iE iF iElE 1E IE jE ik 3F �E iE 3F 3E iE iF iE if iE if if if iE iE ik 1f iE iE iE jE 1f iE iE iF iE 3f if iE iE'iE iE 3F fE iE iE �F iE �lE� �E ik 1E LEGALIZATION:N F E E �S U M M A R Y , STRUCTURAL SEGMENT:Y i , _- . �� BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 189.00 , � ' ', 1,22 � ' ' � SMIP/NON-RES PLAN 122,A5� � � ISSUE FEE ' HUII,DiNG-DIV-> PERMIT ISSUE PLAN-CHECK ;� TOTAL PAID � DUE TOTALS-�---> � 7.90.22 0.0.0 � 122,E35 ;;; 31,3.0.9; ,313.07 I.00 REVF.NUr DIVISION TOTALS--> COLLFCTED: � 190.22• UVER/SHORT: .00 HLDG PMT PLUMBING ELECTRIC MECHANIC �FIRE SMZP/TOT GRADING PLAN-CHECK ia�.00 .':. 1.%2 • �1E 1E iF �t if iE iE iE iE iE if iE iE iF if iE iF it iE jf if iE �(-3E k iE iE if iE fE iE iE if if if iE iE iE.iE iE i(-i! iE # iE 3E * 3E 3E iE iE iE iE 3E k iE iE iE if 3E �lE iE it 1ElE �lE if iE 1E iE �)f if iE iF iE iE iE iE iE I N D Z,V I D U A L� F E E,� Fl R E A K D O W N ' TYPE QTY D E S C R I'P T I O N UNIT COST � TOTAL COS'T SFR 25fi DWE-TY.PE C�-WOOD FRA�iE . -GOOD � 67.70 17,466,60 ED1D .OF E'EES _" ,', I CO�ISTRUCTION-ANDPLANNI .,---_.___�_ OOL&SPA � • - +� , - Date 1-nspector ' �Date Inspector � � APPROVl�lS � Permit # . AP`VALS Permit # 1. pTer*�porary Electrical Service or Pole ' O 52. Pool & Equip \ t Location 3�. SoilPipe;Undrgrnd. , y 53. SteelReinforcemen`�� i 3.'Electrical�Conduit Utility-Undrgrnd. � 54. Forms " 4.-Electrical "Conduit=Undrgrnd. 55. Electrical Bonding - 5'.�Steef-Reinforcement+ 56. Rough Plumbing & Pressure Test �6.�Electrical.UFER�Grnd. 57. APPROVALTOCOVER-GUNITE '- ':7t �Footings �'� Tl. �' � (` , � 58. Electrical Condui[�Undrgrnd. � �� '�. ,8t-Foundation. ,�.�_ � i ,- 59. Gas Pipe, O Undrgmd., Test , 4 I 9'. Water Pipe-Undrgrnd! . 60. Backwash Lines; P-Trap, O Undrgmd. � 10''. Structural Floo'rSystem ,' (,( (0 61. APPROVAL TO DECK ' 11. Property Sewer Line;& House�Connection 62. Backwash & Receptor-Final � , i � 12.; Sewer Cap - ' 63. Heater & Vent-Final , �i 13: Roof Drains a. : 64. Plumbing System - Pinal � 14.�RoughPlumbing � 65.�Electrical-Final ' 15�. Rough Electrical�Conduit ' �'•� 66. Solar System-Final � 16. Rough Electric'Wiring � � 67. Fencing & Access ApProval 17. Rough Wicing Sign. 68. APPROVED FOR PLASTERING � 18. Rough Electrical�T Bar Ceiling . 69. POOL/SPA SYSTEMS FINAL 79.,_Rough Heating & Air Conditioning _ FIRE_DEP.T. REQUIREMENT . 20.-Rough Factory Fiieplace �- �-`• d - �. 'APPROVACS�-•��Permit # �' - -. �. �' ". � � . 21.: Ducts, in'Structure `' .. . "", ~ `: _ '" i: ' - `" �'�''-' V . , � � �,ti ,, _ � r �_ _70. Underground� Hydro ��, 22..Ducis, Ventilating.,: . '? t- � e7�, product"Pipinq O Gas ��Oil 23. Gas:Pipe Rough & yest - '� -�� °; � !� ` -72, Underground Flush'', � ��. .;� 24. Roof Framing � �� - ^ ` F � J3:'Undergmd. Storage_Tank O Gas ❑ Oil 25. Roof Sheathing �� " �� Z JM` ' 74}=0verhead Hydro��.. �-. i _y r 26.:T�Bai Ceiling (Structural) & Monocoat ^; � .. . -�' . }, 75.e.Dry Chemical - � 27."-FramearidFlashing" H�'`: � f� � � '�.� 76.DryStandpipe �^ _ ,. � �, _28. Lathing�&Sidin9 ; �n�: - -�,.' � ,.•r 77=�FIXEDSYSTEMiFINAU�� ^ 29. Insulation ' � ^` ' ' �j�. � ,Q•, - - � .�,. :, 78. FIRE PREV. PINAL ' - 30. Drywall Nailing ..-. -_ � � t - HEALTH DEPT�. REQUIREMENT 31. Plaster Brown Coat' = � " � '. � -79. FINAL IN$PECTION �, _. r '�32.-Electrical Power Meter�Final - �- � 80�-FOOD CERTIFICATE ISSUED_ - �33. Final Electric� + . � �" Notes: - _ � - - %-% a� - y34._final Heating & Air;ConBitioning' _: ;k � � •� �: . �_ '.� �� ! 35. Final Gas Pipe-Test� `� . � ti - �� - = " " , 1'" �t 36. Hood or Canopy ' - . ;_ � _ �. _ , ; .-, - 37. Final Factory Firepiace' ��- = �L1. ;+ -' y = 39. Final Plumbing � ,� - '� ' � "* ' " 39. VJater Service:Final{� :- - . , ��40. Gas Service-Final ' "� � " .� " �" " � - � _ . c ; F. . � �r `41.'Solar pomesfioFinal -� *� � � �� ° '�� - w � s L O� 42. Backflow Preventer` ' - ' i " _�,:', : ' - - _ _ _ t -� . - 43. Backflow Irrigation- � . � ' ^ � ' �44.. Landscape Irripation System� _ i � `i �~ � i ' �� - �� , .+ �; e., � � - �� - '45rSound Attenuation. - • • � - !��: �- + - ' •^ �.�� -� • 6. H ndicap Regulations '' ' � ,= � - 47 � INAL STRUCTURE & BUfLDING � � � � �- 48.�FINALPLANNING . . . '�� - � -.� " " � J • 49.TEIectric�Release to Edison ; -;'� `� . . . - '� =50. Gas=Release to Southem California Gas Co ' � :!" ' `- `" : ' � ; -51. CERTIFICATEOF'OCCUPANCY " No. Date S�E�nou7PEss: 3q15 LAVENDER LN OWNEN'SN�ME:MR. & MRS. DELATORRE aooxess:34].5 LAVENDER LN COSTA MESA . CA 9267_6 UNR: 0 '�flG1/ENGINEER: j,GAPE DESIGN ' - eec.xo.:� RODflE33: SSOO W. HOLSA AV. � . uxrt:130 � H.Fi. CA 92649 . PEBMITTEE:MR. & MRS. DELATORRE (7].4�)545-7.467 nooxess: 341'S LAVENDER LN NONE . COSTA•MESA CA 92626 IItENSED CONTMLTOH OECUMTION: I hereDy alfirm t�at I am IicenseC un0er provislons af CAaO�er 9(mmmencinp vnth Section 7000) a/ Oivislon 3 oi the Business an0 Pmfessions COUe, an0 my license is in �ull lorce and eilecl. CITY OC.: ST�TE L1C.: QASS: ' Wte: SiOnaNre: 9NKENS' fAMPEN5ATI0N OELUMTIOX: I here alfirm that I Iwve a certiM1cah of consent to selNnsum or a certilirate of Workers' ,m0ensation Insurance, or a certitied coOY �herrol�5eciion 3800, Lab. C). POLICY NO.: E%P. O�TE: ' COMP�NY: . ' ❑ CertifieE copy is hereby fum¢he0. ❑ CenilleA copY is liletl wit� the ciry BuilOinp Divislon. . Da�e: Applicant E%EMVfION FBOM WOBKEfl3' COMPENS�TIOX OECIAlUTION: (This sedion nee� not he complelea if I�e permit is lor ona hunOred (51 W) ar lew�. I certity Ihat in I�e perlormance of the work foi wAich tAis permit is issuetl, I shall not emDlo y� any manner so as ro beioma suDiect ia tAe Workers' Com ensation laws Calitomia. `��C""w"L � " . Date: �� 'Z� S'rynamre: -- � - NOTI E: II, at4 r malun0 �his OeGaration, you slioulG D come SuEjecl ro the Workers' Compensaibn D�a�sions ot Ne La�or Coae, you musl IarthwiN wmply wit� suc� Drovisions ar tNs permit sAall be tleeme0 revokeE. . � CON37BUCTION LENOINC IIGENCY: I hereUy atlirm ttwt I�ere is a construcuon Ien0in0 a0ency lor I�e peAormance ol Ihe work tor wNch tAis permit is issueU (Sedion 3097, Civ. C�. . LFNOEH: nooaeu: ' - - OWNEB BUILOEB OEIXAMTION: I here6y aflirm t�at I am exemD� irom [he Contracrors' State License Law for the lollowinp reason �Section 7031.5 Business ana Pmlessianal Cotle: My Uty of counry whic� requires a De�mit to consiruct, alter, impmve, demolish, or reDair any stmctum, pnor to its issuance, atm requims the aDPlicant tor such permit to lile'a sipne0 statement ttwt �e/she is licensed pursuant ro tAe provivons ot Ne Contracrors' State LicenSe Law,(C�aD�e� 9l�mmencinA with Secqon 700U) of Division 3 af ihe Business anG Professions CaEe) or t�at he/s�e is exemD� ��ealrom anA IAe hasis for [he allepeG exemptlon. My tialation ol Section 7031.5 Oy �y applicant lor a Dermfl suUlecis Ihe ap0lican� to a civil penalry of not more than /lva �unGred Oollars (5500�. • 'I, as awne� ol ihe proOenY or my employees vni� wa0es as iheir sate comDensation, wlil Oo I�e woM, and I�e L� s(ruclure is not intentle0 ar otteretl lor sale (SeCUon 7044. Business an0 Pmlessianal Code: T�e Comractors' State Licenu law Eces no� aDDN �o an ovmer oi a D�opeM � �uAEs ar improves thereon, an0 wlro Eoes suc� work Aimsell/herself or tNouBh N5 or �er ovm empbyees, pranEed that such imD��ments aa notintenEeO or aflered for sale. If, Mwever the Euiltling ar Improvement a saW wiNin one year of comDletian, Ihe wmer wi0 have the hurCen ot provinp �Us�e EiE not hui10 or imD��e br t�a Durpose of ulel. . I, as owner of the pmperry� am exclusively conlractinB ��h Iicense0 contrzctors to consimct tAe prolect (Section 70/4, Business � ana Professions Cade: The Contactors' Staie LlcenSe Law Aou wt apDH �o an owner ot properry who bmlds m improves [hereon anE wAo contracts lor suc� prol��'M�A a wniractor(5) license Dursuant to t�a Contractors' State L¢ense Law). I am aware that Oroal ol t�eir Worker's Compenution insurance S�ouIE be D�tleO ta me. � I am eeampl un0er Secilon: 8. 8 P. C. �or I�is rea on: (/ ' ' Od�¢: !/ � � 0 Own¢r. _L I Eo AereOy ce ity that I m aware of ana unAerstantl Ine reauiremenis of CalifM 25534 anA that I or any iNum 6uilEing occupant wiil/will not (circk we) nee0 ro � permit lor constructbn or moGifwtion tmm Ihe ar Oualiry ManaAement Distriq tAese omvisions. � Da[e: Applicant: I hereby certiy that I luve aad this apptiw0on anE state that the a0ova informai aNmances aM staie larrs rNatlnp to UWOinA �nstructian and here autlwr� repi pmDeM �or insDection pu wes. Date:� '�� Sipnature: —~' Dnver's Li ensa ai ial Secunry N: 16a1A6 W�i1e—Builtlin¢ Green—COCa Enfortemen�: Cenarv—AUD��cant; (O� ��V�J / Healtn ana Satery CaEe Seclions 25505, 25533, an0 �pty with sai0 state ca0es an0 Ne requiremen(s for a :SiAential construction ap0lications are eeempt imm 6 wrteci. I�aqree Io compty wifh all pry anE counry nGtives al 1�i5 dty lo enlef upon lhe abOve�mentlone0 �� / ik—Fevenue: GOIEenroE—Asaevor � CITY OF COSTA MESA - BtJILDING PERMIT' PERM NO: E 045006 PERMIT NO: E 045086 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V-N PF.RMIT.TYPE: ELE PURPOSE: ADD JOO DESCRIPTTON : DEN ADD-ON 25A SQ FT SQ FT: • CI�AIM VALUE: C.AL�C=VALUE: GROC7P OCC: R-3 �/ COMMENTS': REFER TO k�U2LDING PERMTT #845004 � ��*�r*+t��*+cx��****�e�e*+t**+t�**+��x��*x�*�x******+c*�r�*+�+tx��*x�r�***�at**��+r��*�rx* ' Z O N I N G� R E Q U I R E M E N T S S E T A A C K 5 ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT:. FT IN RF.AR: FT ZN ' FRNT: ET IN REAR: FT IN LEFT; FT IN RGHT: FT IN � LEFT: FT IN RCHT: FT IN PARKING REQ • PROV: PARCEL: A1237401 7.NE: � REF NO: PLANNING N(5TE5> � �)h 3E �1F iE i(� iE if iE K iE If iE i! i! k if 1E iE dE if if iE �)f iE �lE �F jF �F 1E iE iE iE ik iF;fE 1E 1k iE iE iE iE iE iE iE ik it iE * IE iE if iE iE i61f iE iE �IE if 1E �E iE 1E iE * iE if IE 3(-iE if �1t iE if iE # iE iElt D,E V E L O P M E N T S,E R V I C E S R E� U I R E. M E N T S ' NING AYPROVED HY DATE: _ 'HUILDING APPROVED BY : � ' DATE: _ APPLICATION ISSUED RY: �' DATE: �-Z.�� B� �t**x�****�t**�***i�i��tifit**iF�F�iFiF'�FiF�FTF'iF3F�F'if3F�'3FS�7F �F �F'iF3FiFiFTF�F7F***�t***�t�t* ��F� �t* iE 1! iE iE 3E iE if iE iE iE iE iE it if jE 1E 3f 3f If !E iE iE ik jE iE iE 3E iF ik iE iF 1f �f i! 1F �f i! ik iE iE iE iE iF ik iE iE if iE jf IE it iE dk iF if jf i6 if iE if iE 3E if k 1E iE iE iElE iE iF 3E iE iE 3E iE 1P ik iE LEGALIZATION;N ,F E E S�U M M A R Y , STRUCTURAL SEGMENT:N 4� DLDG PMT "PLUMHING ELL:CTRIC �MECHANIC , FIR� SMIP/RES GRADING PERMIT� 7.50�� ' ' SOt ' SMIF/NON-RES� PLAN . ISSUE FEE 15.00 � BUILDING-DIV-> PERMIT . ISSUE PLAN-CHECK TOTAL PAID DUE TOTAL'S----> 7.50 15.00 0:00 22.50, 22.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 22.50 OVER/SHORT: .00 DLDG PMT PLUMDING SLECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK 22.5� �if iE iE iE 1E �1E iE �16±E iE IE iE 3f iE 1E 1E if af �If iE iE it 3F ik i(� iF 3E iF it jE iF iE ik if iE if if iF iF if 3E iE �1E iE iE �IE iE iE ik ik it iE # if iE iE �lf iE iE iE # iE iE iE iE iE if iE iE iE iE iF it iE �)f iE iE Ih 3f I N D I V I D U A L F E E Fl R E A K D O W N 7'YPE QTY U E S C R I P T I�O N UNIT COST' TOTAL COST ELE 8 RF.CEPT/OUTLET 1 ST 20 EA. .75 6.00 ELE 2 RECEPT/SWITCH 1 ST 20 EA. .75 ' 1.50 END OF FEES 0 � 0 .i .r�,�. �r:� .. . , ' . -�i". ....' .. - 0 0 I CO�RUC�ON AND PLANNii.d /OOL & SPA - APPROVALS Permit# � Date Inspector qppROVALS Permit# Date Inspector ' 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location '/ '� , _2,, Soil Pipe�Undrgrnd.; ,_ . 53. Steel Reinforcement f �' J 3. Electriwl�Conduit•Utility-Undrgrnd. �' 54. Forms � 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding :i' � . "' 5.�Steel Reinforcement, 56. Rough Plumbing & Pressure Test • - 6' Electrical'UFER Grnd. 57. APPROVAL TO COVER�GUNITE - '- �7r Footings -• � 58. Elec[rical Conduit-Undrgmd. - '8 _Foundation . �'� 59. Gas Pipe, O Undrgrnd., Test - ' �.9. Water Pipe�Undrqrnd.� , � 60. Backwash �ines, P-Trap, O Undrgrnd. � 10. Structural Floor. $ystem � 61. APPROVAL TO DECK ' 11. Property Sewer L�ne & House Connection 62.� Backwash & Rece tor�Final � P �j ` 72. Sewer Cap - - :�.� 63. Heater & Vent-Final � 13. Roof Drains. i 64. Plumbing System � Final �� 'A.; 14. Rough Plumbing . � 65. Electrical-Final ; 15. Rough Electrical-Conduit � � 66. Solar System-Final ��' . 16. Rough Electric W�ring �Z�-� 67. Fencing & Access Approval ti 17. Rough Wiring Sign �, 68. APPROVED FOR PLASTERING � 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating &%a�r Conditioning _, � � -. PIRE DEP,T. REQUIREMENT _ 20.� Rough Facto'ry Fireplace _ � '.: ; � � � APPROVACS�-• � Permit # - 21' Dutts, in Structute =- - . , 70. Underground Hydro 22._ Ducts, Ventilating % � a� �,� 77. Product Piping O Gas ❑ Oil 23. Gas PIpe�Rough & Test _ - � ' � , 72. Underground Flush ' � 24. Roof Framing � � ' - -� �'.73:. Undergrnd. Storage Tank O Gas ❑ Oil 25., Roof Sheathing - - � ' � � 74, Overhead Hydro:' 26:�T�Bar Ceiling (Structural) & Monocoat :-. -- � 75:: Dry Chemical � 27.-Frameand Flashing ' . ` 76. Dry Stantlpipe ' ._ '�_ � '28. Lathing-& Siding. � ' � . .. � '" � ' . 77. FIXED SYSTEM FINAL ' 29. Insulation �•�� : ' . '' 78.� FIRE PREV. FINAL 30. Drywall Nailing - _. _ , � HEALTH DEPT. REQUIREMENT � 31. Plaster Brown CoaN " � ' � � '79. FINAL INSPECTION � 32: Electrical Power_Meter-Final +" 80..FOOD CERTIFICATE ISSUEO- -�33.:Final Electric � 8,(7 Notes: ' ' " ' w � � � 34..'Final Heating &'Air Conditioning' .. � � ' ; � _ ' ' � ' - i 35. Final Gas Pipe-Test- _ � � - ' • - . + , - 36. Hootl or CanoPY" ". ...t� ... ' ' . � -, . . ` .- . 37. Final Factory Pireplace' � - - � �� " � - � . '_ ' 38. Final Plumbing - - ` ,- � _ , f 39. Water Service-Finab. , � • ��. � � � . ' . , , 40. Gas Service-Final _ _ -• ,_ ' ; . -41. Solar pomesticFinal" ,• ` �, �� , ' � �^ - 42. Backflow Preventer ' _ , .r , • � `" 43. Backflow Irrigation� �� - . - • • � - 44. Landscape lirigation Svstem� . � � � "" ' . � _ - - ^�+ - - 4 . - - 45. .Sound -Attenuation e - • - ' . _ , � 46. �Handicap Regulations ' • _ _. - - ; i ', 47.-FINAL STRUCTURE & BUILDING '� � ` -• � -. :. 48�FINALPLANNING " "�� -- ' � � t 49.� Electric Release to�Edison ;�. �; -,. 50: Gar Release to Southem Califomia Gas Co ''' : ' _ - 51. CERTIFICATE OF OCCUPANCY No. Date