HomeMy WebLinkAbout640 TERMINAL WAY - Building Permits(714) 754-5273 • Fau (714) 754-4866 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite:
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Applicant:
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640 TERMINAL WY
42428105
JOHN TAN
12035 DOHERN
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License: 621096 , .. _ `, . . \' , . , . , ,
Slatus: ISSUED
Applied: 07/13/2006
Issued: 09/20/2006
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_l A FIRE SUPPRESSIO�
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; .�SCOP.E OF PERMIT
SYSYTEM�INSIDE AN EXISTWG SPRAY BOOTH,
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� � i�, � ,-'�A '`� FEE SUMMARY � � -;� ; . - � �� r . �
� , Plan Check ✓ � $54.11 �/�� � �Calc ValuaYion: � �, Ss,000.00 ����
� , Permit:; - $83.25 � ' , Claimed Valuation: �Ss,000.00 `
� Othert !$0.00 �� ��-v--r,�'� i/' '�' '''�7�:f T' � ,�
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NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under Califomia 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 1 BO days, or if work is suspendad or abandoned
tor a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspectlona and (inal approval musl be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
zaas�as �sioo�
WORKERS' COMPENSATION DECLARATION:
I hereby eXirtn under penalty ot perjury one of tha following tleclarations:
❑ I have entl will maintein e cenificete ot consent to self-Insure for workers' compensetion, es provided for hy section 3700 of ihe Lebor Cotle, for ihe perfortnence o} the
work for which lhis permit is issued.
❑, I,have end will maintain workers' compensation Insurance, as required by section 3700 of Ihe Lebor Cotle,.Poctha,pertormance of ihe work for which Ihis pertnit is issuetl.
. My w/or�kere�' wm nsation Insura carrier end policy numUer are: i/. ` --�-� �j �.
Carrie, ��'--��/A�G����� ' Policy Number:-"' /�7�/ J � � �-S
❑ I certity ihat in the peAormance w rk tor which this partnit is issueq I shell not employ any person in any menner so as to become su�jea to the workers'
compensation laws of Calitomla, d ee that If I should become subject to the workers' compensatlon provisions ot Sectio 37 0 oi the�LLpp666000 r Code, I shell forthwith
comply.with these provisio� ��^� ,��i��' //�/
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Applicenl SlgnaWre: ' Date:.-----" �
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WARNING: FAILUPE TO SECUflE WORKERS' COMPENSATION COVEMOE IS UNUWFUL ANO SHALL SUBJECT PN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED
T}10USAND DOLLARE (5100,000), IN ADDRION TO THE COST OF COMPENSqT10N, DAMAGES AS PROVIDED FOF IN SECiION 37060F THE UBOR CODE, IMEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATON:
I hereby affirtn that I em Ilcens�ct deJp{ojy'�i s ofc� epter 9(commencing wilh Sectlon 7000) of
to cer antl e-�—ttecuCic. a (c� /F/ 7 // �%
Pfef�65ions Code, end my licanse Is in full
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CONSTRUCTION LENOING AGENCV:
❑ I hereby eHirtn thet there is a construction lending egency for Ihe peAortnance of Ihe woAc for which this pertnit is issued. (Sec. 3097, Civil CoCe).
Lendefs Name: LentleYs Atltlreu:
Signature: Date:
OWNER•BUILDER DECLARATIONS:
I hereby eMirtn ihat untler penalty of perjury that I em El(EMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business end Professions
Cotle: Any ciry or wunry which requires e pertnit to construct, alter, improve, demolish, or repair any strudure, pnor to its issuance, elso requires ihe epplicent tor such permit
to file e signed statement thet he or she Is Ilcensetl pursuant to Ihe provisions oi ihe Contraclore lJcanse Law (Chepter 9(commencing with Seclian 7000) of Dlvision 3 oi the
Business and Professlons Code) or thet he or she is ezempt thereirom end the besis for Ihe alleged ezamption. Any violation oi Sectlon 7031.5 by eny epplicent far a pertnit
subjects the epplicant to e civil penalry of not more ihan five hundretl tlollars ($500).):
❑ I, as owner of Ihe property, or my employees with wages as Ihelr sole compensatlon, WILL DO TNE WORK, end the structure Is not intentle7 or oflere0 for sele (Sec.
7044, Business entl Professions Cotle: The Contractors License Lew dces not apply to an owner of proparty who builds or improves �hereon, end who Ooes such work
himsalt ar herself or ihrough hls or her own employees, pravidetl thet such improvements are not Intentled or oNered for sale. If, however, iho builtling or Improvement Is
sold within one yeer of completion, the owner-builder will heva the burden ot proving that he ar she did not build or imprave for purpose oi sale.). '
❑ I, as owner of the pmperty, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the pro�ect (Sec. 7044, Buslness and Professlons
Cotle: The contrectors License Lew does not epply to an owner of propeny w�a bulltls or Improves thereon, antl who contrects tor such pro�ect with a contracror(s)
license pursuant to the Contreaors License LewsJ.
❑ I em esempt under sec. Business end Professions Code for Ihis reason:
Signature: Date:
Owne� ID verified by drlvers license. ❑ Yes ❑ No Driver's License No. Expires:
Verifiwtlon of Ownership by (type of document, i.e. - property tan bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify Ihet no excavetion five (5) or mora teet in depih into which a person is required to descend, wlll be mede in connection with work authorizetl by this
pertnit, end that no builtling sirucWre, sceftolding, talsework, or demolition or dismantling thereof, will Ce more Ihen thirty-six (38) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, T1Ile 8, Celifomle Administrative Code).
❑ As owner-builtler, I will not employ anyone to do work which woultl require e pertnit from the Division of Intlusinel Setery, es notatl ebovo, unless such person has e
permit to tlo such work irom the divisian.
Signature: Date:
Divislon o1 Intlusirial Safery Permit Number:
CERTIFlCATE OF COMPIJANCE AND AUIHORIZATON OF EN7AV: I certiy under penalry of perjury that I have read this ap0lication antl state that ihe intormation given is
conect I egree to comply with all stete lews ena ciry ordinances releting to builtling conswction, end authodze representatives ot the Ciry ot Costa Mesa to enter upon the
flbove-described D�aPerty for inspect� purpQses. I egree not to occupy or allow occupency of any building authorized by ihis permit until fnel inspection.
COUE Y. INSPECTIONTYPE PATE INTRIRLS
1616 Fixed System Flnel Fire Prevention
1266 Paal Spa Final
pp0 Finel fie-Rooi
201 Finel Black/Retaining Well
202
203
204
Final Fadory Fire Place
Flnel Sign
Finel Demolition
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COOE� INSPELl10NTYPE
206 Final Mechanical
20B Finel Plumbing
210 Final Electricel
212 Flnal Fire Preventlon
220 Final Planning Approval
222 Flnal Site
250 Final Building/Occupency
PAIE IIIIIDEL9
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CITV OF COSTA MESA -
° BI/ILDING p/V/SION
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� DEVELOPMENT SERVICES DEPARTMENT B98-00850
J• � PERMIT PERMIT NUMBER
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(714) 754-5273 • Fax (714) 754-4856 BUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 640 TERMINALWY
Suite:
Vicinity:
Parcel Nunmber: 42428105
App�icant FORD, E.L.
Address:
Owner: SCHAUPPNER, VERNON E TR
Address 37305THAVE
CORONA DEL MAR,CA
Contrector: HOLMES ROOFING
Address: 00947 NORTH ELM
Status: ISSUED �^
Applied: OS/18/7998
Issued: 05/18/1998
Zoning:
Phone:
Zip:
Phone:
Zip: 92625
.'.i
Phone:
OR4NGE CA - Zip: 92667
License: - 607894
Arch / Eng : �
Address: F� ' �
Phone:
Zip:
. License: � "
SCOPE OF PERMIT
reroof 6250sf commercial building w/built-up
FEE SUMMARY
Plan Check: 50.00 Calc Valuation: $o.00
Permit: $124.75 Claimed Valuation: gs,2ao.00
Other: $0.00 •� ,
Inspection: $0.00
Total: $125.37
PLANNING 8 ZONING
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Fmnt 0-0
PARKING Existin : o
NOTES:
Rear 0-0
Rear 0-0
Required: 0
teft, 0- 0
Left 0- 0
Proposed: 0
u
Right 0= 0
Right 0- 0
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 tlays, or ii work is suspended or abandoned
for a period of 1 BO days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred inspactions end final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of ihis permit:
FOR INSPECTIONS CALL: (714) 7545826
WORKERS' COMPENSATION DECLAqATION: .
I hereby eifirtn under penalry ot perjury one oi ihe following declarations:
❑ I �eve and will maln�ein e certificata af cansent to self-Insure for workers' compensatlon, es pioNGetl tor by section 3700 of the Labor Code, tor Ue pertortnance of ihe
work br which this pertnit is issued.
❑ I have and will meintain woilcers' compensation insurance, es required by Section 3700 of the Labor Code, tor ihe perfortnance of ihe work fw which ihis permit is issued.
My workers' compensalion Insurant¢ �Mer entl poliq number ara:
Cartler: Policy Number:
(ThJs section need naf be completed i! thm permit is velued et one hundred dollers ($f 00) o� less.)
❑ I certity that in the partortnance of ihe work for whic� �his permit is issued, I shall not employ any persan in any manner so es to become subject to ihe workers'
compensetion laws of Celifomia, end egree that N I shoultl become subject to the workew' compensatian provislons of Sectlon 3700 ot the Lebor Coae, I shell fonhwith
comply with thesa provisions.
� /
._p Appllcant SignaNre: /. � /I Date: S � // d� / �i d�
'� WARNINO: FAILURE TO SECURE WORKERS' �pMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMP�OVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED
TFKKISAND DOLLARE (5/00,000}. IN AOOff10N TO THE COST OF C/JMPENSAiION, DAMAGES AS PROVIOED WF IN SECfION 3lOfi OF THE LABOR �DE, IMEflEST, AND ATTORNEI^S FEES.
�
LICENSED CON7RACTORS DECLARA710N:
I hareby ettirtn that I em licensed under provisions of Chepter 9(commencing wlth Sectian 7000) oi Division 3 of the Business end Professions Code, end my license is in full
rorce and eflect. Lic. a d f< qass a G 3 S
Contractors Signeture: . o�- Date: r/ i.+� -`�i d�
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn that there is a construction landing egency tor Ihe pertortnance oi the work for w�ich ihis pertnit is issued. (Sec. 3097, Civil Code).
Lendafs Name: Lentler's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby ettirtn that under penelry of perj4ry that I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for the follawing reeson (Sec. 7031.5, Business end Professions
Cotle: Any ciry or counry which requires e pertnit to consiruct, elter, Improve, demolish, or repair any sWcture, pnor to iGs issuflnce, also requires the applicant for such pertnit
to file e slgnetl s[etement thet he or sha iy licensed pursuant [o the provisions ol the Contrectors License Lew (Chepter 9(commencing with Section 7000) of Division 3 oi ihe
Business and Professions Cotle) or ihat he or s�e Is exempt iherefrom end ihe basis for Ihe alleged ezamption. Any violation of Section 7031.5 by eny applicant for e parmit
subjects �he applicant to a civll panalry ot not more ihen five hundred dollars ($500).):
❑ 1, es owner ot lhe D�aPerry, or my Bmployees with wages as their sole compensation, WILL 00 7HE WORK, and the structure is not Intended or offered for sale (Sec.
7044, Business and Professions Cnde: The Contractors License Law tloes not appty to an owner oi property who huiltls or improves Ihereon, and who does such work
�Imself or herself or through his or her own employees, provlded that such Improvements are not intended or oflered for sale. If, however, Ihe buildinq or imDrovemen� Is
sold within one yeer of completion, Ihe owner-bullder will have ihe burtlen of proving thet he or sha tlitl not bulltl or improve for purpose of sale.).
❑ I, es owner oi the properry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Businass and Professions
Code: The contrectors License LeW does not epply to an owner of properry who builtls or improves Ihereon, and who conirflcts for such pro�eq with e contractor(s)
license pursuant to ihe Contradors License Lews.).
❑ I em exemp� under sec. Business and Protessions Cotle for Ihis raason:
Signelure: Date:
Owner ID venfeC by dnvers license. ❑ Yes ❑ No Dnvefs License No. EKpires:
Vedflcetlon of Ownerehip by (rype ot tlocument, i.e. - property lex bill or deed):
DIVISION OF INDUSTRIAL SAFETV P�pMR CERTIFICATION:
❑ I hereby certiy ihat no excavetion five (5) or more feet in Cepth into which a pereon Is required to tlescenQ will be mede in connectlon with work authodzed by this
permit, and thet no buildfng structure, scaffolding, falsework, or demoGtion or dismantling thareof, will be more ihan thirty-sfx (36) feei MgR (Chep. 32, Grp Z, Art 2, Sec.
341, Title 8, Celifomle Adminisirative Code).
❑ As owner-builder, I will not employ enyone to do work which would raquire e pertnit from iha Division ot IndusMal Safery, es notetl ebove, unless such person has a
partnit to tlo such work imm the divisian.
Signature: � Date:
Division ot Industrial Safery Permit Number:
CERI7FlCATE OF COMPLIANCE AND qUiHORVA710N OF ENTRY: I certify under penalry of perjury iha� I have read this applica�ion end state thet the information given is
correct. I egree �o comply with all stete lews and ciry ordinances releting to builtling construction, end eulhonze representetives of Ihe City of Costa Mesa lo enter upon ihe
above-described property for inspection puryoses. I egree not to occupy or allow occupancy oi any huilding authonzed by Ihis pertnit until final inspodion.
�� � -�,,, � -r/ i d' / 5' 6�
Signa ure pf Legal Owner(s) Date
And/Or AuNorized Applicant Date _ _
CODE �. ixsvecnox*rve
1616 Fiaetl System Final Fire Prevention
1266 Pool Spa Final
200
201
202
203
204
2446-66
Final Re-Roof
Final BIocWRetaining Wall
Final Factory Fire Plece
Final Sign
Final Demolition
QATE It�llS
S =it —y� :vt�
CODE♦ INSYECTIONTYVE
206 Flnel Mechenicel
208 Final Plumbing
210 Final ElecMcal
212 Final Fire Preventlon
220 Finel Planning Approval
222
250
Final Site
Final Builtling/Occupancy
��
U1I�96S
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FH0.IECTRODflESS: 64O �(ERMINAL WY
OWNEfl'SNAME: S'C.iAuYPNEx VER�ON E 1R
aooeess: � 3 31 HEATH�R LN
NEWPORT BEACH,CA 92660
AflCNIENGINEEfl:
�DOflE53:
flEC.NO.:
UNIT:
UNIT:
PERMITTEE: EARLS PLUN,BING ( 714 ) 772-3470
RDDPESS: i533 W, T,INCOS.N
ANANHEIM CA 92A01
UCENSEO CONTHRCTOB OECLAMTION: I �ereGy aflirm Ilui I am IiCrnSeE uMer O�oviSions 0� ChaOter 9(tOmmeridn0 �^�� Settian
7000� ol �rvision 9 al iha Business antl Pmtessions Code. anG my licBnSe iS in lull �orte anG e�fect.
cirruc.:005�3F� STqTELIC.:zS%SS����'�S C-36
oaie: �� ^ � `�Z- Signawre: _
WONREBS' COMPENSATION OECLAI1A710N: I hereUy aflir � I �ave a certilicaie al consent to sell-insure or a certificaie oi Workers'
ComDensation Insurance. or a cenilieA copy t�ereol (Section 3800, LaD. C).
roucrxo.: UCA-1 ] 686 E%P.ORTE: O3IOS I93
comraNr: �NICARE
❑ Ceniliea coOY �s ner/eE�y IumisneA. G� Certilietl copy is/jl.il¢�O�xii� t�e tiry BuJdinq DiviSan.
Daie: �� _I � / • � AppliWni: /1` �-/ a/�
E%EMPTION fPOM WONIIEBS' COMPENSATION OECIAMTION: (itis 5ettqn IIMG noi Ge cqnpkle0 il Ne pamt 6 �a ane huMreU (5100� or Itts�.
I cenily ItWt in Ine oetlormance of ihe wOrk tar wNCI� tNs permil is it5ue0. I Slull nol emDloy a�ry Derson in atry manner so as to become
su�iec� to tne Workers' fAmcensauon Lavrs oi Ca4lamia.
Oate: 7�� SignaWre:
NOTILE: II. alter makinA ihis aeclaratim. you s�ou10 Oecome su0ject to I�e Workers' Cumpensa6on pmvisions o� I�e LaUor
COE¢. you mu5t lari�wilh tomDN �+t� SUt� provrsiwn Or INS p¢rmit Slull �¢ Geem¢E revakeG.
CONSTBIlCTION LFNOING AGENCV: I AereOy atfirm lhat Ihea is a conslruclian lentlinq agenry tor the Dedormante ol Ihe wark for
wnicn �nis permit is issued �Sation 3097. Civ. CI.
LENDEP:
ADONESS:
OWNEfl BWIDEB OECLABRTIDN: I her¢by a��irm IIWI I am C�¢m0� ��dm IIIB fAnlraClorS' Siate License Law for ihe folloxinp reasan
(Section 7031.5 Business ana Pmlessional fAAe: Any cily ol couniy v/�icn re0uires a Dermi�to conslNct, atier, improve, demolish, or
repair a0y 9rutlWe, D�iw �a iI5 iSSuance. al5p rEpmreS I�e apptiCdni loi suCA permil Io lile a SiqnCE Slaiement llidt IlPlshe is lic¢OSeA
pursuam Io t�e pmvision5 ot Ine Comracmrs' State License Law (C�ap�er 9(commencinp with Section 7000) ol Division J ol IAe Business
anE Pmteuions CaOe) or iNt lie/s�e is e�empt t�erelrom anE rtre Easis for t�e allepeE eremptmn. My violation ot Section 7N1.5 Dy
any ao0licam lor a permit sublects ihe applicam io a civil Denatty al nat mom ttun iNe �unEreE Uollars �f500�.
I. as owner of Iha D�oOerlY a� �' employees wii� waAes as t�eir sole wmpensation, wi0 Aa ihe woM, antl tAa
❑ slmcWre is nat inttnEeO or allere0lar sale (Seciwn 70aa. Busineu aM Pmfessional COEe: The Coniractors' Stata Licensa �aw
Oces not ao7N �o an owner of a propeny wM 6uilOs or imvroves Ihereon. an0 wtro aoes sucn woM himsellmersell or �nmupn
�is Or �er Ovm empl0y¢CS. prOviGet Itul Sucl� impfwemenls arE n0� inlenOeE w offere0 fOr sate. I1, howev¢r I�0 DuilUinp or
imOmvement is wW wit�in one year ol compleiian. ihe axner will tuve �he EurCen al 0«B �she Oitl nol UuiW or improve
lon�e Ourpose ot sale).
I, as owner ol Ine proDeny. am erclu9very coniractinp vnin Iimnse0 contracta�s to consiNct ihe projep (Section 704a, Business
❑ anU Proleuions Catle: Tlie Contrxtors' State �iceree Law Oces nW apply lo an owner al property who �uilAs or improves �Aereon
and who contracis lor suc� projects wit� a contractm�s�license pursuam m i�e Contracmrs' Sta�e License Law�. I am aware
I�al pmal OI 1�¢ir Worke(5 Compenuii0n insurantt SMUIE Ee prOviGeE IO m¢.
� I am e�empt unCei Seclion: B. 8 P. C
for IhiS reason;
oaie: O+vnec
1 Go nereGy cendy I�al I am aware al anG unGerstanG Rrc r¢puiremenis ol Cdlilomu Mealt� anA $alety CaUe Seciians 25505, 25533, an0
255� ana Ihat I or any IuWre 6uilding occupanl wilUvnll nolldrtle one) neeG io wmpry mih uie state codes anE ine repuiremenis lor a
permil bt conslNction or moGi6Wiion imm I�e Air Oua4iy Mandqemeni DiStrici, qe5i0ential conS�Nttion applia�ions are exempl Imm
Inese pwvisions.
Oate: pppbwm:
I Aer¢py [etlily Ihal I have read IN5 applltation an0 itale ttNt I�e a0pve iniotmation is cOrrlCL I agree Io fAmpty vnih all ciiy anE cauniy
orOmances an0 9a�e Wws relating to OWNng [onSVuttqn lntl hert0y auttpr¢e reD���u�iv¢5 ot tlris dry to enler upon I�e above�mentioneU
prop¢tly IarinSDection pCu/tposes.
�a�e: �D'I � � /Z SignaWre'�
Oriver's License or Sociai Security
AOplicanl: Pmk—Revenue; Galdenrod—Assessor
CliY OF COS'iA Mt.'SA BUILilZNG PERMIT PERM NO: P 05947.6
PE:RMIT NO: F 059926 PLAN CH�CK NO; � GOVT: N SUPP; N
CONSTRUCTION '_YPE; PERMIT 1'YPE; PLU PURAOSE: U":d
JOd Dc;SCRIl� � iOiV , IN5IALLED WATER HEATER SQ FT;
CLAIM VALGd; CALC—VALUE; GROU? OCC: /
COMMEN'.S: MAL :N PERMIT
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Z O N I N G R E Q U I R E N E N'i S
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------------ N.AIN BUILDiNG ---------- ------ -- ACCESSORY BUILDTNG ---------
FRNT; f'7' IN REAR: FT IN FRNT; FT IN REAR: FT ZN
LEFT: F7' IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL; 42928105 ZNE; REF NO;
PLANNING NGTcS>
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D E V E i O P M E N T S E R V I C E S� R E Q U I R E N. E N T S
y
20NING APPROVED BY f llATE;
BUILDING APPROVED BY ; DAlE; �
APPLICATION ISSJED BY; . DATE• ��� y(/ �
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LEGALIZATION;N F E E S � M M A R Y STRUCTURAL SEG�NF.:V::N
BLDG PMT PLUMBING ELECTRIC MECHANIC FlRE SMIP/RES G�ADING
PERMI7'
PLAN
ISSUE FEE
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20,00
SMIP/NON—RES
BUILDING—DIV—> NERMIT ISSU� PLAN-CHECK TOT'AL PAID DUE
To•rr.Ls----> �.00 zo.00 o.00 z�.00 z-i.00 ,00
REVENUE DIVISION TOTALS--> COLLECT�.D; 27,00 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM,IP/TOT GRADIhG FLAN—CHECK
27.00
## 3E i!- N� N� ## iE it if # iE N� iF fE iE #b If if� iE # tE �f k 3E # iF if i(� lE K-!f k%!f i(� if �t iE 9E iF-X� iE% M- iP I( ff 3f 1F #�)f IE fE # i( #�f� X� i( iE #% if # M� f(� i4 iF Y. iE \� �t iE # iF IE X�
I N D I V Z D fJ A L� F E E B R E A R D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAi, COST
PLU 1 WATER HEAT'ER AND/OR VENT 7,00 '1,00
END OF FEES
CONSTRUCTION AND PLANNING PO�_ & SPA
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Tempo�ary Electriwl Service or Pole 52. Poo1 &£quipment Location
2. Soil Pipe�Undrgrnd. 53. Steoi Reinforcement
3. Electrical Conduit UtilitV�Undrgmd. 54. Forms
4. ElectriCal Conduit•Undrgrnd. 55. Electricai Bonding
5. Steel Reinforcement 56. Rouqh Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER•GUNITE
7. Foocings 58. Electrical Conduit•Undrgmd.
8. Found2tion , , 59. Gas Pipe, O Undrqmd., Tet[
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd. '
70. Structu�al Floor System 61. APPROVAL TO DECK
i t. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent�Final
73. Roof �rains 64. Plumbing Systum - Final
74. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
7 G. Rough Elettric Wiring 67. Fencing & Access ApProval
77. Rou9h Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Contlitioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
27. Oucts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping O Gas OOiI
23. Gas Pipe�Rough & Tesc 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Ta�k � Gas ❑ Od
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Geiling (Structurall & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry StandpiPe
28. Lathing & Siding i 77. FIXED SYSTEM FINAL
29. Insulation ; 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIRE1v1ENT
31. Plaster Brown Coat 79, FINAL �NSPECTION
32. Electrical Power Meter-Final . 80. FOOD CERTIFICATE ISSUED
33. Final Electric ��� Notes:
34. Final Heating & Air Conditioning �-•
.
35. Finat Gas Pipe�Test ', ,
�
36. Hood Or Canopy
37. Final Factory Fireplace
38. Final Plumbing ,L/ Q�I G�
1 �-
39. Water 5ervice-Final
. 40. Gas Service-Final
41. Solar pomestic-Final
42. BackflOW Preventer '
43. BackflOW Irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap fiegulacions
47. FINAL STRUCTURE & BUILDING %
48. FINALPLANNING
49. Electric Release to Edison /
50. Gas Release to Southern California Gas Co '��
51. CERTIFICATE OF OCCUPANCY �
No. Date
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JOB ADDRES$ ��p TPrminal W
GENERAL CONTRACTOR �,,,,e,._R.
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INSPECTIONS
�SOIL
GAS
W ATEP
ROUGH PLUM6ING
� PROP. SwR. LINE HOUSE CON.�
YSPRINNLING SYSTEM
MISCELLANEOUS
ROIIGH MEATING RN� qIR CONDITIONING
TEMPORARV SERVICE OR POLE
UN�ERGROUND � POWER �
ROUGM WIRING
TRENCHES (1 FORMS I—I SiEEL REINF
FLOOR SYSTEM
BONO BEAM [�
SHEqTHING
FRAME AND FLA51
LATHING — IN [
PLASTER. OROWN
STRUCTURAL, FIN
HENTING, VENT.,
PLUMBING. FINNL
ELECTRIC, FINAL
BUILOING, FINnI
REINFORCE
CDii
via i �
LDING PERMIT N0.
SUBCONTRACTOR
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COSTA MESA BUILOINGSAFEYY DEPAR MENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING . . _ �r� , i �. ...
OWNER ffR CR/lGT.1
MAIL /�
ADDRESS •O• �:16X %�
ci7v �OST/� �%lFSA
CONSTRUCTtON Nm �
I FNf]FF
BRANCH
ADDFES'.
AODRESS
TEL.
No. (o'fG
TEL.
ADDRESS
TEL.
CITV NO.
� STATE GTV
IIC. NO. LIC. NO.
� SI2E NO.OF BLOGS
o. OF LOT L NOW ON LOT
a VSE OF
� E%ISfING BLDO.
�
� Sep2rate permits are required for
� elec[ric, plumbing and heating work.
VSE OF BUILD�NG AND WOFK TO BE PERFORMED
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1 horoby ackno�+ledBe t�et I �avo reatl this appllcaUon and state
thnt t�a oEove ��7ormation Is corract antl eB�eo to comply with
nll laws regulatlnp bu(itlinp consvueNon, antl I ahall not amploy
eny parson In a�alntion ot the workman'� compansation laws of
tho Steta of Ca��farnie.
1 �araby cartify thet 1 am proporly Iicansetl ea e conttaeto� untler
the Stata of Ce��lornia Busineu entl Protassiona Cotle, Dlvlsion 3,
Chepnr 9, entl ihat sueh lieenses ere In full forea entl effxt, or I
em exampt frorn Na provisipna of t�a S te of Ca =ornle euainesa
antl Pro4euiona Cotle; • bn 3, �ep 9.
Sipnatura o � �
Parmittea
AuthorizaG Apa�t
@,1921 I/15i79 ��• 10.50 TL
� Uf�
APPLICATION FOR STRUCTURAL PERMIT
RF�CEIVEDR� DATERECE1�(f.D nn.TciscuFn�
� I / � / \ �
RMIT NO.
FIRE �
ZONE TV E GROUP
APPROVED
BV DATE
ZOf� NO.OF USE OF NEW
�r/ PLAf�S BUILDING
VARDSAPPROVED VARDSAPPROVEC
MAIN BUILDING ACCESSORV BUILD
(FROM C/L:/FFEET)
&
VAR �
c.u.v. �
APPROVED
VALVATION PERMIT FEE S
d PLAN CHECK S
$ ���m TAX S
�V
TOTALPAID S
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TION IS FOR m
T FEE ONLV: �
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OWNER Gpyp�y CONSTRUCTION "'� � DaTE 8-io-55
JOBADDRE33 6lt0 Terminal Wa,y B�iLDfNGPERMITNO. 1630
GENERALCONTRACTOR O�.mer-builder VALUE $ 2"j��,QQ
Subdiviaion $3It
LOT BLOCK TRACT Industrial
INSPECTIONS
Footiqg Trench i
Foundation Forms and Grade to Garage
Rough Framing �K�
Plumbing, Rough to Slab
Plumbing, Rouph Cnm lele Z�
Temporary Pole.r;j
Wiring,Roughli '
,Heatiryg, Rough
.Heating, Final
Sewer. House Sewer. St. �//i�
Tank or Cesspool
a.ln� Out
Plumhing, Final, Fixtures
Plum6ina. Fin.al GasTest
• �.
�iCiiTiF6��L� �'��
DATE I SUBCONTRACTOR
PERMITSISSUED
I NUMBE
�. �'a�
�"��`"°-`-`.�"` l�°'� ��``�°-'c�--y
/i -% �'!�
a Bnilding Department APPI.ICATION FOR PERMIT \
N1 EAST 20th STREET 19 B U I L D 1 N G '
. COSTA MESA� CALIFORNIA �
PLOT PLAN
Show location and distances from
property line and between buildinga
e��
�,' •.�\•l,
OWNER A�.�*r a1C.
JOBADDRE55 640 Tenn
GENERAL CONTRACTOR
AP No. 116-7O0-1 ➢,�,]��
INSPECTIONS
SOIL
G�5
W ATER
ROUGH PLUMB�NG
PADP. SWR. 41NE I � MOUSE GON.
MISCELLANEOUS
ROUGM HEATING eN� �IR CONDITIONING
TEMPOR4RY SERVICE OR POLE
UNDEAGROUNO ❑ POWER ❑
ROUGN WIRING
TRENCNES I J FOFmS STEEL REINF
FLOOR SYSTEM
BOND BEAM 1 STEEL REINFORCE (—]
SHE4THING
FRAME AND �LFSHING
LFTHING — IN �� OUT �
PUSTEA. BROWN COnT
STRURURFL, FIN4L
HEnTING. VENT�. AEGRIG. ANO �.C.. FIN�L
PLl1MBING. F�NAL ANO GA$ TEST �
E�ERRIC. FiNRL
BUILOING, FIN4L
DAT�2-17-79
2 )ING PERMIT N0. �193br--
ZONE VALUE
PE V GROUI
SUBCONTRACTOR
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX1200 COSTAMESA,CALIFORNIA92626
For Applicant to Fdl in Comple[ely — Use Ink Only
BUILDING O /
AODFESS
OWNER OR
TENANT
MAILING
ADDRESS
' TEL��� �
CITV i. . i. Pf/J NO.
BRANCH +�
AODRESS I(
ARCHITECT
OR ENGINEER '
ADDRESS "
CONTRACTOR l`
ADDRESS 1`
CITV II
STATE ��
LIC. NO.
S12E
OF LOT
VSE OF
/�
TEL.
TEL.
NO.
CITV
UC. NO.
NO. OF BLDGS.
NOW ON LOT
Separate permits are required for
electric, plumbing and heating work.
VSE OF BUIIDING AND WORK TO BE PEPFORMED
I hereby acknowletlBa that I have reatl thls applicetion antl rtete
that the ebove intormation is eorrect antl apr80 to cOmply with
ell lews reBulatlnp builtlinB conrtruction, antl I shall no2 employ
eny person in violatlon of the workman's comp¢nsntion lewa of
t�e State of California.
I hereby certlfy thet 1 em proparly Iicansatl aa a eonttector untlar
the State ot Callfornia Bualnesa and Profeulons Code, Dlvlsion 3,
Chaptar 9, and that auch licenses are In full force end effect, ar I
am ezempt fram the provisions of the Stete of California B�sinecs
end Professlons Cotle, Dlvislan 3, Chep er 9 �
Sipnotura ot
Permlttae - ' �
or �7
Avthorizetl Agant Date
APPLICATION FORiSTRI)CTCiRii. PERMIi' 5.50 TL
RECEIVED V PERMIT N� 49361
A.P. NO. �% �' � f � �
BUILDING / ./Q
ADDRE55 `.V
L F—
VNIT OR
SPACE NO.
TR.NO. LOT
NEW ADD LTER
USE
ROVE
�
PLANNING ACTION
�%/9/A�I'3L /�
BLY
R MOVING DEMOLI:
1N�.
� VALUE DD
E
� /�...
GROUP / 'e
flavE �at � � �
DATE
APPROVED
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THE AMOUNTSHOWN UNDER VALUATION IS F m
THE PUFPOSE OF E5TABLISHING A PERMIT FEE ONL . �
VALUATION PERMIT FEE S � Q Q �
O PLAN CHECK y � '^
0
$�� TA% E � f
� � U
TOTALPAID E ,t��/\
`' ' :i�i� .
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 31] COSTA MESA, CALIFORNIA
FOR APP[/CANT TO f/Ll /N COMPLETELY
TYPE OR PRINT
BUILDING �O TCISQ�� W
ADDRESS IS
COSTA MESA. CALIFORNIA
ER
TEL.
CITY NO.
AR iCT LIC.
OR ,INEER NO.
c.��Y STATE
JC11 LIC. NO.
LEGAL I LOT /I �{I�
OESCRIPTION NO. U BLOCK RACT
APNO //(p� �J Q�'� I ��
SIZE // NO.OF BLDGS.
OF LOT �Q�� I T G NOW ON LOT �
USE OF �V �
EXISTING BLDG.
SETB4CK LINE FFOM �
CENTER OF STREET �O � FEAR YARD ,
Private IRoad _ I _
SIDE VARD LEFT � RIGHT �
DESCRIPTION OF WORK
NEV. I S II ALTERATION I II ADDITION I
REPAIR I IIMOVING I
SIZIEDING 1Z B l�i ROOMS 1
EXTERIOR�WALL [p�. ROOF
COVERING •+x COVERING 1
USE OF BUILOING AND WORK TO BE PE
1 HEPEBY ACKNOWLEOGE THAT 1 HRVE RETO THIS FPPLICATION
pND STATE THAT THE f�BOVE IS CORRECT AND FGREE TO COM-
PLY WITH ALL CITV OPOINRNCE$ ANO STATE LRWS REGVLATING
BVILDING CONSTRIICTION. J��A/'r—'
//l /'
SIGNATURE OF � �A
PERMITTEE
Servonic Instrumenta� Inc.
AUTHORIZED AGENT
BY
;.,j a�sc.�j,j1
;: .
FEE RECEIVED
APPLICATION FOR PERMIT
eu��o�r�?�ANCE DEPT.
CITY OF COSTA MESA.
foR oFficF usE on�cy
I'�'RECEIPT NO. I PERMIT NO. i
0Y
COSTA MESA, CALIFORNIA
� ZONING
NO.OF USE OF N
I PL1N5 � BUILO�NG
issueo
LINE ST,� ��.�S '
�D�.cY.J FT. IN.
�� �. e /
FT. IN.
�/
O FT. �N.
_ _'
THE AMOVNT SXOWN IINOER VpLllAT10N IS FOF THE
PUFPOSE OF ESTRBLISHING A PERMIT FEE ONLY.
VALUATION � —
PEftMIT FEE $
g /// � PLAN CHECK $
CJ
TOTAL FEE $ � �