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Home My WebLink About982 TRENTON WAY - Building Permits) CITY OF COSTA MESA . BUILDING DIVISION > � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us r '!��S FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: P09-00032 PERMIT TYPE PLUM STATUS: ISSUED . APN: 14105247 DATE ISSUED: 02/24I2009 '' ISSUED BY: CAC JOB ADDRESS: 982 TRENTON WY CM Vicinity: . . � ' SCOPE OF WORK: REPLACE WATER HEATER OWNER: PHONE: APPLICANT: PHONE: BERTOLET, GRANT R � BRYANT,ROBERT 714 641-1545 CONTRACTOR: C AND R�DRAINS INC Address: 7525 MAC ARTHUR 8L. City/State: COSTA MESA, CA � - ARCHITECT: - ENGINEER: - ZipCode: 92626 Suite/Unit: Address: 982 TRENTON WAY City/Slate/Zip: COSTA MESA, CA Address: . � � City/State/zZip: . - LicenseNo. 531746 `:�-��.�n32 PHONE: 714-641•1545 CELL: License No. License No. PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: PERMIT FEE: TOTAL FEES: $0.00 $35.80 $35.80 PHONE: PHONE: ..f�.;:.'j� , .r,_. _ NOTICE: 7he vrork authonzed by this permit shall comply with all applicable handicap access requiremenLs under Califomia sfaNtes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) . EXPIRATION: PERMIT EXPIRES 780 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. . � . INSPECTIONS: In ordei for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtainetl. Failure to obtain inspections and final approval will result in the expiration ot this permit. 4pDE�, INSPEGTONTYPE � N 1 �� INSPECTIONTYPE Q�jE ,INTIlULS 1816 Fized System Final Fire Prevention ZOB Final Mechanical , �� 1268 Pool Spa Final 208 Final Plumbing � 200 Final Ra-Roof 210 Final Electncal 207 Final 61ock/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Plars 220 Final Planning Approval 203 Final $� 222 FinalSite .- ., 20a Final qemolition , 250 Pinal 8uiltling�Occupancy a �% WORKERS' COMPENSATION DECLARATION: � 1 hereby affirm under penalry of perjury one o( the (ollowing tleclarations: ❑ I have and will maintain a certificate of consent to self-Insure (or vrorkers' compensation, as provitletl for by section 3700 of the Labor Code, for Ihe performance of ihe work for which this permit is issuetl. I have and will maintain workers' compensation insu2nce, as requiretl by seclion 3700 of the Labor Cotle, for the peAortnance of the w�rk for which this pertnil is issuetl. My workers' compensation Insurance carrier and policy numberare: �� Carrier. �This seCun need rrol oe m/n�petentl nlh�ve1 permrt is vai�eItlf aZt rnne /n;und.ed d�llars (Stoo) aiess ) PolicyNumber: �i�V�/1�11�/i�'llbi ❑ I certify that in the peAormance of the vrork for which this permit is issued, I shall not employ any person in any manner so as to become subject to the vrorkers' compensation laws of Califomia, and agree that it I shoultl become subject to Ihe vrorkers' compensation provisions of Section 3700 of the Labo otle,�lorthwit com with these pmvisions. / 71TL'�nooi�cz�rs � re yo� / WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLP.RS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensed under provisions of Chapter 9(commencing wi�h Section 7000) of Division 3 of the Business and Professions Code, and my license is in full torce and eflect. �� 3 Lic. # b Class # Convacmr's i ny e Da�e CONSTRUCTION LENDING AGENCV: ❑ I hereby affirm ihat there is a consiructbn lending agency for the pedortnance of the work far v.fiich this pertnit is issued (Sea 3097, Civil Cotle). Lender's Name: LenOer's Address: SigwWre OWNER-BUILDER DECLARATIONS: 1 hereby aKrm thal under penally of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for t�e following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a pertnit to constmct, alter, improve. tlemolish, or repair any slrucWre, prior to ils issuance. also requires Ihe applicant tor such pertnit ro file a signed statement that he or she is licensed pursuant to lhe provisions of the Conhactors License Law (Chapler 9(commencing wit� Section 7000) of Division 3 of the Business and Professions Cotle) or that he or she is ezempt Iherefmm and the basis !or the allegetl exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than fve huntlred tlollars ($500).): O �, as owner of the property, or my employees vnth wages as their sole compensation, WILL DO THE WORK, and the slructure is not intentletl or oRered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who dces such work himself or herself or [hrough his or her ovm employees, provided that such improvements are not intended or offered for sale. If, however, lhe buildinq or improvement is sold within one year of completion, the ovmer-builder will have lhe burden of proving that he or she did nol build or improve lor purpose of sale.). . � I, as ownero( lhe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRAC70R5 to consWct the project (Sec. 7644, Business antl Professions Code: The contraclors License Law dces noYapply to an owner of property wfio builds or improves thereon, arW who cont2cis (or such project with a cantractar(s) licensa pureuaN to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for Ihis reason: SignaWre JOS�-d8 �3/Ol� Owner ID verifed by Ariver _...:ense. ❑ Yes ❑ No Driver's License No. Ezpires: ' Verification of Ovmership by (type of document, i.e. - property tax bill or tleed); DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: � ❑ I hereby cetlify Ihat no excavation frve (5) or more feet in depih into which a person is required to descend, will be made in connection with wnrk auttrorized by Ihis permil, antl that no buil0ing sWCWre, scaffdding, falsework, or demoli�ion or dismanping thereo(, will 6e more �han Ihirty-six (36) leel high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle 8, Califomia Administ2tive Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require a permit from the Division of Indus[rial Safety, as noted above. unless such person has a permit lo tlo such work from the division. AOW��'s SignaWre Da�e Division of Industrial Safety Permit Number: HAZARDOUS MA7ERIALS AND EMISSIONS CERTIFICATION: 7. Will the applicant or presenl or future building mcupant neetl to file and certify a Business Plan for emergency response [o release or threalenetl release of a hazardous matenal? ❑ Yes ❑ No (Section 25505 of the Calilomia Health and Safety Code requires, with some exceptions, that a Business Plan be filetl with the Cos[a Mesa Fire Depahment by every business which has at any one time during a reported year a quantity of hazartlous materials equal [o or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic fee� of compressed gas at standartl lemperaWre and pressure�. 2. Does or will the applicant or present or fuWre building occupaM need to file a registration form for acutely hazardous materials? ❑ Ves ❑ No (Section 25533 of the Califomia Heatlh and Safety Code, with some exceptions, requires registralion with the Costa Mesa Fire Department 6y each business which at any one time has on hand a quantiry ot acutely hazartlous matenals equal to or greater than a weighl of 500 pounds, or a volume of 55 gallons, or 200 cubic feet o( compressed gas at standartl temperaWre and pressure). 3. Does or will Ihe applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program (or acutely hazartlous malenals)? ❑ Yes ❑ No (Section 25534 of the Calitomia Health and Safety Code provides that the Costa Mesa Fire Departmenl may require the preparalion, ceAification and fling with the Fire Oepartment of an RMPP by businesses which are requiretl to register acutety hazardous matenals with the Fire DeparlmeN. 4. If an RMPP is presently required, has Section 25534 of the Cali(omia Health and Safery Code been tully complied wilh? ❑ Ves ❑ No 5. Dces or will ihe appliwnt or presenl or future building occupaN require for ihe work which is tha suhject of this application a permi� lor such conSWClion or modification fmm Ihe SoWh Coast Air Quality Management DisMcl or from any other air pollution control tlistrict or agency? ❑ Yes � No (Sectbn 658502 of Ihe Cali(omia Govemment Cotle 2quire5 [hat the requesletl inlormation be fumishe0 on applications fa non-residenlial building permits). 6. Will any part o! the facilily lo be consiructed under this permil be wilhin 1000 feet from the outer boundaries of a school? ❑ Ves ❑ No Qf'yes", ihe facility mus[ meet the requirement o( Sections 25534 and 42303 of Ihe Califomia Health and Sa(ety Cotle). 7. I( a permit from the South Coast Air Quality Management Dislrict or other air pollu�ion control district or agency is required for the work which is ihe subject o! this application, have all of the disclosures prescribed by Calitornia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf yes", attach ceAificate of compliance from the appropriate air polNlion conlrol oKcer). � . CERTIFICATE OF COMPLIANCE: 1 certi(y that under penalty of perjury lhe information qiven above is wrrecc I agree to wmply with all state laws and cily ordinances regarding Hazardous Materials and Emissions. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that ihe infortnalion given is correcL I agree to comply with all state laws and city ordinances relating to Duilding constluction, and authorize representalives of the City of Costa Mesa to enter upon the above-descdbed property for inspection purposes. I agree not to occupy or allow occupancy ot any builtlinq authorized by this pertnil until fnal inspection. ignal eolLepalOwner(s� ( � And/orAult�p A plvant / Dale (714) 754-5273 • Fax (714) 754-4856 • �wiw.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No VICIO1�Y: d 982 TRENTON WY d Parcel Number: 14105247 � •� , " ��`. .��, PF�,, qpp�icam: BOBIE, JOHN Address: 22911 SAVI RANCH PKWY YORBA LINDA, CA Owner: BERTOLET, GRANT R Address: � 982 TRENTON WAY COSTA MESA, CA Contractor. SERVICE CHAMPIONS Address: 22911 SAVI RANCH PKWY YORBA LINDA, CA Phone: 714-777-7777 Zip: 92887 Phone Zip: 92626 Phone: 714-777-7777 Zip: 92887 �icense: 799170 SCOPE OF PERMIT REPLACE EXISTING FAU LESS THAN 100K BTU LOCATED IN THE CLOSET ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood wlMech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handleis < 10000c(m AirHandlers> 10000c(m Floor Furnace Floor or Suspend Healer � $23.50 514.80 50.00 50.00 $0.00 50.00 50.00 50.00 50.00 50.00 50.00 50.00 50.00 50.00 50.00 50.00 $0.00 50.00 50.00 50.00 � Quanlity 7 0 �0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Status: ISSUED Applied: 17/73/2006 Issued: 11/73/2006 �IS UED BY: vC'� Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler Commercial I ncineralor Domeslic Incinerator Comoressors / Absorption Svstems Upto3hp/t00kBTU 3 To 15 hp / 500 k BTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers , Up to 3 hp 3To15hp 15 l0 30 hp 30 to 50 hp Over 50 hp . Olher Mechanical Fee Investigalion Fee Plan Check Fee Reinspection Fee TOTALCALCULATEDFEES COMMENTS / SPECIAL CONDITIONS Quantity $O.Oo 0 50.00 0 50.00 0 50.00 0 50.00 0 30.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 50.00 $0.00 50.00 538.30 NOTICE: The work authorized by this permit shall comply vnth all applicable handicap access requirements under Californla statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days, or it work is suspended or abandoned for a period ot 1 BO days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetlona antl (inel epproval must be obtained. Failure to obtain inspectlons and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (774) 754-5626 244fi-a8(8/00) WOHKERS'COMPENSAnON DECLARAnON: I hereGy attirtn untler penalry of per�ury one ot the tdlowing deGaralions: ❑ I heve entl will malntein e ceNTicate of consent to salt-Insure tor workers' compensation, es proWded for by secilon 3700 of ihe labor Cade, for Ihe pertortnance of ihe work tor which Ihis pertnit is icsuetl. �Rlave arM witl meintaU� workers' campensation insurence, az requiretl Dy secUon 3700 oi the Lebor Code, for Ihe peAortnance of t�e xroAc for which this permit is issued. My workera' compensetlon Irtsurence caMer nd pdi number ere: cemer:__�n�n �oV¢�S ��WOeKSn'�io�.�N9, �, PoIlcyNumDer. iFA)3OCOO�SO� ❑ I certify Ihat In the poAortnance ol the work for which Ihis permit Is IssueQ I s�all no� employ eny pereon In any manner so es to become sub�ect to the workers' wmpensatlon laws at Celib�r W,intl agree th d I ould become sub�ed ro tha warkers' compensatian pmvisions oi SecOon 3700 ot the Lebor Code, 1 shell fort�wilh comply with these p�� J/� �/ 1 ��_' 'AppllteuYSignature_ .�lt Date:, _ � 1'S �O �P WFRNINO: FNIl.URE TO SE Oql(ERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMI P NALTIES AND pVIL FlNES UP TOONE HUNDRED T110USAND oOLLARE R��)• IN ADORION TO TNE WSi OF COMPENSATION, DAAWGES AS PROVIOED FOR IN SECfION 31060F TME LABOR CODE, INiEREST, AND ATTORNEI"5 FEES. LICENSED CONTRAC70RS DECLARATION: I hereby afllrtn ihat I em foroe enU eNeCCUc. M ol Chapter 9(commencing with Sectlon 7000) of Dlvislon 3 0l the Business end Prolessims Catle, entl my license Is In tull CONSTRUCTION LENDING AGENCV: ❑ I �ereby eHirtn that there is e consiruction lentling agency for the peAormence ot the work tor which ihis pertnit is issued. (Sec. 3097, Civil CoOe). Lendefs Nema: Lentler's Atltlress: Signeture: OWNER-BUILDER DECLARATIONS: Date: I hereby effirm thet under penalry ol perjury thet I flm EXEMP7 FROM THE CONTAACTORS LICENSE LAW tor the lollowing reason (Sec. 7031.5, Business flnC Professions Code: Any cily or counry which requires e permit to consirucL elter, improve, demolis�, or repeir any structure, prior to its issuanca, also requires the applicant for such pertnit lo fila e signetl stetement that ha or she Is Iicensetl pursuant to tha provisions o1 tha Cantrectors llcense Lew (Chapter 9(commencing with Sectlon 7000) of DMsion 3 ot the Business end Professions Code) or Net he or she is exempt iherefrom and t�e bazis for Ihe elleged exemptian. Any Woletion o1 Section 7037.5 by eny eppllcant tor e pertnit sub�ects the epplicant to a civll penelry c� not more than tive huntlred tlo0ars ($500).): � I, as owner oi Iha proparry, ar my employees vrith weges es Iheir sole compensation, WILL DO THE WORK, and the struaure is not intended or offereC for sale (Sac. 7044, Business and Professlons Code: The Contractors License Law does noI aOPly lo an owner ot property who Dullds or improves thereon, and who does such work himsalf or herseN or Ihrough his or her own employeas, provided that such improvements ere no� in�entletl or ottared for sale. If, however, ihe 6uilding or improvement is sold within ona year oi completion, tha owner-builder will have �he burden ol proving that he or she ditl not build or improve tor purpose ol sale.). � 1, es owner oi the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consimct the projeci (Sec. 7044, Business end Prolessions Code: The comrectors Llcense Law does not apply to an owne� ol pwpeny w�o bulltls or improves Ihereon, and who contrecis lor such pro�ect wlth a comractor(s) license pursuanl Io t�e Contrectors License Laws.). ❑ I em exempt under 58c. eu5iness end Prolessians CotlB tor thl5 reason: Signatura: Date: Owner ID ved/letl by tldvefs Ilcense. ❑ Ves ❑ No Dnvers License No. Expires: Vedfice�ion ot Ownership by (type ol document, i.e. - properry taic bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTFICATION: ❑ I hereby cenity Ihai no excavation tive (5) or more feei in tlepih into which a person is requiretl to tlescend, wlll be made in connection wlih work euthodzed by Ihis pertnit, end that no building struaura, scafldding, falsewark, or tlemolition or tlisman�ling thereol, will be more ihan thirty-six (38) leet hig�. (Chap. 32. Grp 2, An 2, Sec. 347, Title 8, Celltomia Atlministretive Cotle). ❑ As owner-DUIIAer, I wlll not employ enyone to do work which would require e pertnit Irom the Divlslon of Industriel Sefary, es noted ebove, unless such person �aa e permillo do such work Irom Ihe division. Signature: Date: Dlvision ot IntlustAel Safery Permit Number: CERTIFICATE OF COMP�IANCE AND AUTHORVA710N OF EMRY: I certify untler penalty of perlury ihat I have read this epplication end stalo Ihet t�e inlormatlon given is correcl. I egree to comply with ell stete lews and ciry ordinences relating �o bullding constructlon, end authodze represematives ol the Ciry ol Costa Mesa lo emer upon the ebove-descnbed praparry lor inspection Ourposes. I agree not to occupy or ellow occupancy of eny buil0ing aut�onzed by this permit until linal inspecUon. COOE �. IMSPECIION T'PE 1816 Fixetl System Finel Fire Prevention 1288 Pool Spe Final 200 Finel Re-Roat 201 FInaI BIocWReteininp Well 202 Finel FeC�ory FirO Plete PI�k] 204 Finel Sipn Final Demolitlon �g � CODE 1 INSPECTIOX TYVE 206 Final Mechanical 20B Final Plumbing 210 Final Electdcal 212 Finel Fire Prevention 220 Finel Planning Approval 222 Finel Site 250 FinalBuilding/Occupenq �.1 411.: / . . �� G CA ADvlicant to flll in all CiTY UF cOSrn MESA CONSTR CTION PERMIT Project Address �'_�.� 7Y� � • Applicant's Mailing Ad�dr��e..sy5_ Owner's Name' _gt[LJ � Phone Address J Aroh/Eng. License No. Address ' Contracmr's Name � on � Address (me'i'�nl S�J/'�7 ��` City License No b�i`L�/J � LICENSED CONTRACTOR OECLARATION I bereby affirm [hat I am Iicensetl untler provizlons ot C�arter 9(commencing with section 7000) of Oivision 3 ot the Business antl Professions Cotle, ana my license is in (ul e antl ettect. Licens C s i en �"late Si9na[ure ORKERS'COMPENSATION DECIARATION � . nere0y af�irm tnat I have a certificate o( consent to seli-Insure or a certificate of Workers' Compensation Insurance, or a certi(�opy thereof (Se tion 3800, Lab�y'(,��,�„i==�"�— Policy No. � �� Company Ceriifietl copy i5 hereby furn shetl. C r"f' , i �iletl with the city ild� �' isi . Date� Applican EXEMPTION FRO WORKERS' C PENSATION DECL RATION (ThissectiOn neetl not be mmpleletl if ttte pe�mit is to� one huntlretl ($100) or IessJ. I certity that in tne perto�mance of the wo�k to� wltich Ihis p¢rmR IS iSSuetl, I shau not employ any person in any manner so as to become subject m tne Worker5' Compenzation Laws of CalitOrnia. Date Si9nature NOTICE: If, after making this tleclaration, you shoul0 become subject to the Workers' Compensa[ion provl5ions of tbe Labor Cotle, you must forthwith comply with such Orovisions o� lhis pe�mii Snall be Oeemea �evoketl. CONSTRVCTION LENDING AGENCV I hereby affi�m that tM1ere is a con5lruction Ientlin9 d9en[y !o� the pe�fo�mance ot thu work for whicM1 this permit is izsuetl (Section 309] Civ. C.) Lenaer's Name Lender's AtlOress OWNER BUILDEH �ECLARATION ' I bereby affirm lhat I am ex¢mpt from [he ConVaclor'S LlcenSe Law tOr Ihe following.reaSOn (Section 7031.5 Busln¢ss antl ProfeSiional COtll: Any clry o� county which requires a permit ro consVuct, alter, improva, tlemolish or repair �ny 5tructure, prior to Its issuance, also reqWres the aOP��ant for such permi[ file a Slgnetl Slat¢ment thdt hC/She I5 IlcenS¢tl purSuant lo th¢ prOvlSions of e Contractor's License Law (Chapter 9(commencing with Sectlon 7000) of rvision 3 ot Ihe Business antl Profe55ion5 Cotle) or Ihat he/she is exempl - therCfrom antl the ba5i5 for the allegetl exemptfon. Any violation of Set[ion 7031.5' by any ap0�itant (or a permi[ SUDjec[s [he applicant [o a civll �endlty of not more Ihan tive huntlretl tlollars (5500). IJ I, as owner ot the property or my employeas with wages as thetr sole compensation, will tlo the work, antl Ihe structure is not Intentletl or oHeretl for Sal¢ (Sec[ioni7044, Buiiness antl P�ofessional COtle: Tha Cont�acto�'S ' License Law tloernot apply to an owner of a proparty who builtls or improvez thereon, antl who aoes such work himself/nerself or Ihrou9h his or her own employees, providetl that sucn improvements are not intentletl or ofteretl for Sale. If, nowever,-the bulitling or Improvament is sola withln onn year oi tom- pletlon, tne owner will nave the burtlen of proving he/she tlitl not builtl or im- pfove tOr the pufpo5c of Sale). ❑ I, as owner oi tha property, am extlu5ivery contracting wlth licensetl con- irac[o�s to con5truct the pwject (Section 7044, BuSiness antl Pro/es5ion5 COtle: The Con[ractor's License Law does not appty to an owner ot property who builtls or improves tM1ereon, antl who con[racts for such projett5 with a con- tractbr(s) I�cense pursaant to the ConVactor's License Law�. 1 am aware that ' o�oor of thelr Worker's Compensation in5urante Shoultl be provltleC to me. ❑�I am exempt untler Section B. & P. C. tor this reason DatC I hereby certify tna � iMormation is correc antl state laws relatli senta[ives of lhis ci inspection pappqse{/, Siqnature��yy�� ! — Owner _ I have reatl this I agree�to compl lo builtling cons � to e�te� upOn the above xtlinances �ize repr¢- ioertv tor exceD� t�ose within �eavy bo�tler Iines anG sign all apOroD/iate tleclarations. , TRACT NO. , LOT NO. UNIT NU. TYPE OF CONSTRUCTION LI NEW LJ ADD LI ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLOG. TVPE OF PERMIT LJ GRAOING �L�I FOUNDATION U STRVCTURAL ❑ TENANT ❑ ELECTRICAL IGSPLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION Sp. FT. pCCUPANCY— CONSTRUCTION TVPE VALVATION 5 ZONE GRADING CU. VDS. ACRES_ Remarkz: " Bar Sink Backflow Preventer BackflOw Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories P—Trap Roof Drains � Reinspection Fea Outlets S15 Boiler Duct- UnderGround Duct - Structural Duct - Ventilating Exhaust System ❑ MWtiple ❑ Firepl/FacL Blt. ICBO # Heating System & Ducting ❑aioo,000 sru �ioo,000ar� Reinspection Fee � $15 IF 0865-46, rev. 10/86 White - Builtlin9; Canary - Applicant; Pink - qcroun[inq; Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collecrors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater • Water Service Auto-Wash Laundry Trays laue Fee Hood or Typel ❑ Canopy Type I I ❑ FEES $ 3 , � FEES Refrigeration System ❑aioo,000sru ❑ioo,000 System Repair/Alteration Fire Dampers Registers Issua Fee $ 3 A.P. �W S Main Building: E T Front B Rear A C A�ght g Left Ping. Ref. # Planning Notes: Automatic Washer Construction Pole $ub. Cooking Unit Dishwasher . Dryers ❑Gas ❑Elecn Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generetor �0-5 KW ❑ Fee 7217 5/04/37 F_nn Zona Accessory Building: Z O N I N G R Parking Req./Provided E Q M T S ELECTRICAL Transformer ❑ 15-50 KW ❑ SO + KW Meter, LJup to 100 amps Meter ❑over 100amps Su6 Panel Momrs �0-1 HP �1'/a-8 InaSolar �9�15 HP �1645+ Microwave Pale l.ight Range Standing Sections 5-15 KW Trash Compactor $15 luue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning APProved By Building Approved By � FEES S3 a SUMMARV OF FEES BUILDING PERMIT $ SMIP 5 PLAN CHECK $ � PERMIT PLUMBING $ ISSUANCE 5 � PLAN CHECK 25% $ ENERGY P.C. 3 EIECTRICAL $ GRADING $ PLAN CHECK �50% $ MICROFILM $ �/�) MECHANICAL $ TOTAL FEE $ , �_� PLAN CHECK 25% $ CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# Oate Inspector AppROVALS Permit# Date Inspector 1. Temporery 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 Pip�-Undrgrnd. 60. Backwash Lines, P-Trap!-L•] Undrgrnd. 10. Strucwral Floor System 61. APPROVAL TO DECK = 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Fin�l 12. Sewer Cap 63. Heater & Vent-Final �'� x 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 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Produc[ 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 (Structurap & 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 37. 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 Z��'� L� 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 � INSPECTIONS SOIL G/5 W ATER ROUGH PIUMBING PROP. SWR. LINE Q NOUSE CON. � SPRINKLING SVSTEM MISCELLANEOUS ROUGH HEATING ANO AIR CONDITIONIN TEMPORARY SERVICE OR POLE UNOERGROUND �- POWER � ftOUGH WIRING TRENCHES � FORMS � STEEL F FLOOR SYSTEM BOND BEAM � STEEL REINFOftCE SMEATHIN6 FRAME AND FLASHING LATHING - IN n OUT � PLASTER, BROWN COAT STqUCTURAI, FINAL HEATING, VENT., REFRIG. ANO A.C., F PLUMBING, FINAL AND GAS TEST � ELECTRIC, FINAL BUILDING. FINAL BUIL SUBCONTRACTOR r �U�U� ^ CDSTA MESA BUILDINGSAFETY DEPARTMENT P.O. BOx 7T00 � COSTA ME9A� GALIFORNIA BT6RE For Applleant fo Fill In Completafy TYPE OR PRINT ADORE'8II /�� Ye �� N� a` COSTA ME3A, CALIFORNIA 0 � ARCHITECT �' k� 61ZE ). O� �Lpof. >W ON t eti a � vu� � .� 3 o R�a� DESCRIPTION OR WORK ��, �1 NEp6sY ACRNOWL[pO6 TNAT 1 MAV[ AND eTATB THAT TN6 AOOV[ 1� CORR! PLV WITX ALL CITY pgDINANCv AND I oU1lDIN0 CONOTrtYCr�ox_ . i dUc 2o-6a�qOD eo7� *�**13.5C APPLICA710N fOR PERMR BUILDIN(i . For ONlce Use Only ZONING ZON[�_' NO.OI Ui[O�N[W '( �UNs � OUILDINO e w':,�.e..Tra �-i� #ss i� 1, I NOTS: NOGV60V[RHANOSHALL�6L888THAN 80' TO BID[ O RiAR P. L 6AVH6 �1 ALLOW[D S (U.B.C.REQUIRHMHNTI YARDeMPROVHD YARD9MPROV6D MAINBUILDINO ACGEYHORYBUIlDINO 3 �, — 30 � — 3 _ — DATH -� 9-G ��ifPafE1' � � � — � �. �. � 0 TM[ AYOUNT OXOWM UNDBR V�LU�TION 19 �OR TX[ j IUHPoO[ O� �9TAGLIBNIHO A PLRMIT P[H ONLY. � s Jt < �urwon�z¢ewa¢r�r //� li Lot- i,� g�4 I � COSTA MESA BUILDING-SAFETY DEPARTMEM P.O. BOX 1200 COSTA MESA� CALIFORNIA 920R0 For AppUmM ro F(11 In ComplN�ly TYPE OR pRINT �uaoiNa C, 1 ADDRHYY COSTA MESA. CALIFORNIA (nO�X/ea� lHOII � t[R 11RAR / �� 3 R�a� DESCRIPTION OF WORK i{ .. _ee....... � •nn use o� e Si At AIN 24-�001991 * +�** *99.00 A►PLICATION FOR PERMR 6UILDING For Offlc� Ut� Only ZONING NO.OI U{i0I ►IANI pUILDII i- ur r `�- T- -�. 5 NOTH: NO EAVH OVERHAN6 BHALL BH LC88 TMAN 90•TO81DHaREAR .L ewvee �• ALLOWHD (U.B.C.RlQUIRBMHNT. YARDlAPPROVED YARDBAPPROVHD MAIN BUILOIN6 ACCB880RY BUILDIN6 ' ( RROM C/L fTR6[T S �R f�T PT. � R.�YID J . PT. L BID PT. PT. / RB„R 2• S PT. Ff. DI6TANGC B6T. BE7. MAIN 4 MAIN BLD66. ACCES9. BLD09. VM.�C DATB 1 X6R6GY ACNNOWL�DYt TNAT.1 MAVd 11�I1C T111� AIIIJGTON I�ND BT�T6 TNAT iN[ /1OOV{,IB COqI{[R ANO /�OR6[ M COY. PLY WITX �Ll CITY ORDI�MMCY AryD �ii MW� RIOYMTINO em�o�no conarnurnow. �e . /1 � � AUTHORIZ[D AO[NT a m � o� � %% so. Rr. � TX[ IIMOYNT BN �C'N UNO6p VALUATION IB POR THH � NRPO6[ O► iQiACL16MIN0 A PlHMIT I66 ONLY. VALUATICN a PHRMITFEH � — � 'o�� 7r'f'.2 � s — � TOTRLFEfi � A� No. 4-0 2-4 LOT 4 TR INSPECTIONS Sii soi� c�s W>'ER AOUGH PIOMB�NG PROP. SwR. LINE [] MOUSE CON. SPRINKLING SYSTEM MISCELL�NEOUS ROUGM ME�TING �NO �IR CONOITIONING TEMPOR�HY SERVICE OR POLE UNOERGROUNO � POWER Cf ROUGN WIRING TpEHCNES FORMS I STEEL AEINF. FLOOR SVStEm BONO BEAM �J STEEL REINFORCE SMEATMING FR�ME �ND FL�SMING L�TMING — IN OUt PL�STER. BROH'N COei STRUCiUA�L. FIN>L HEnTIH6. VENi., REFRIG. nN0 �.C.. FINAL PLUMBING. FIN�L �ND WS TEST ELECTRiC,FINaL BUILOING. FINA� . DATE SUBCOHTRACTOR RMIT �?�S3�.Q '� COSTA MESq BUILDING-SAFETY DEPARTMENT 7kOO � O/2O/%8 7.50 Tl; P.O.BOX72p0 COSTAMESA,CALIFORNIA92626 7400 'I�0/20/78 7.50CATD APPLICATION F071iS11RU�11�M'IG��A1IT � A� For Applicant to Fill in Completely — Use Ink Only qECEI V OATE RECEIVED D e `�s u �•�—� ADORESS �V � Ye�'1�D N 2. �'�� / /'.(�{�(� + '/ PERMIT NO. OWNER ��I'�il� `` lJl�'�� 1�� A.P.NO. l'6.5�—T � ADDRESS !�J.Tr2�1�DYI �1C ADfDRIESS / O� I�eN �h LUZ �/ I• GTV ST� TEL. 3 RACT L BLOCK r'les a n,o.,syo-o623 CONSTRUCTION EW ADD AL ER P LENDER / O I�L '�— BRANCH R 1 OWNER Y�k� � Ver��=1 ADORE55 VALUE ARCHITECT TEL. S $ OR ENGINEER N _� FIRE ADDRESS ZONE TV E GROUP APPROVED �iI1� CONTRACTOR oUJ 11 E �-- QtJ. 1 �Ea BY DATE ({/ � ADDRESS TEL. ZONE NO.OF �7 USE OF NEW PLAN$ L BUIL�ING ♦ CITV NO. STATE CITV �'AROSAPPROVED VARDSAPPROVED IIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUILDING � (FROM GL STFEE 512E T NO.OF BLOGS. OF LOT � ��/ NOW ON LOT � FRONT FT. USE OF EXISTING BLDG. f-' S I e h C� 51 � FT. FT. Separate permits are required for L. SID F-r. electric, plumbing and heating work. REAP O FT. FT. USE OF BUILDING AND WOIiK TO BE PERFORME� DI5TANCE BET. BEf. MAIN& i f I MAIN BLDGS. ACCESS. BLDGS. aTl O Co„er— No LOG1d J rfwG�WQ GURP.# APPROVED rr. �ibe� �T1aSs `%mOT1M APPROVE �' I hereby acknowlatlge that I hava reatl this app�lcation and stete thet the above informatlon is correct and a8ree to comply with all lews regulating building construciion, antl I shall not emplay any person in violaSion of the workman's compensaHon lews af iha State ot Californie. /�' � � I hereby cettify thet I am properly Iicensed as a contractor unde� I,�� SQ. FT. the Stete of California Businass antl Protessions Coda, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Cheptar 9, and thai such Iicensas are in full force antl affect, or I THE PURP06E OF ESiABLISHING A PERMff FEE ONLY: am exempt trom She provisians of the State of Cal7fornia Business VALUATION PERMIT FEE $ entl Prof¢ssions Cbtle, Divislon 3, Chapter 9. � Q I � mQ PLAN CHECK $ r� SlBnature of_.('�df - _ � ��OI Permittee i�Jz��—JQv-- $ TAX $ � � Authorizetl ABent TOTAL PAID S � N n w i 0 7 m e a N m m 0 � U