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ciTv oF COST E �C STRUCTION PERMIT PERMIT NO. � S r�Z,aa��� LOiN� uNi� r rvo. 0259 I I/25/B7
P.ojectA�ress�� //lw/�C / � 9io66 '
Applicant's Mailing Add ess �A�DE����A [.l1NA� fI•�-� TYPE OF CONSTRUCTION NEW ADo ALTERATION REPAI R
Owner's Na�} e %� � ����! Phone �.�I� � CONVERSION ❑ DEMOLISH ❑ OTH R . ' O _ � A p # „ ' � Zone .
y/�� E CRI 70NOF Oji USEOfBLDG. �
Addreu (1— I nW �� ���(�jp a� �(��I�,,�M �j � 2 � n/Q S Main Building: Accessory Buildin9: Z
E
Arch/Eng. License No. TV�E OF PERMIT GanDiNG FouNDA7ioN STRUCTuaA� T Front p
Addrei5 ❑ TENANT �ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N
Contractor'sNa�ne �C���G- ���µ� � ���� � O7HEn �p'`-� � Right 2 N
Address (mailing) � �� � /}" �,).p FROJECT DESCRIPTION SQ. FT. OCCUP Cv ?,7 K G
�� �j � CONSTRVCTION TVPE� VALVATION $�� g Left 5 q
City License No. _ � �
ZONE GRADING CU. VDS. ACPES p�ng. Ref. # Parking Req./Provided E
LICENSED CONTRACTOR DECLARATION Q
I ner¢by a�lirm that I am Iiconsetl untle� prOvi5iOn5 O/ C�arte� 9(CommenGln9 Remarks: O 3� O Planning Noees: ?j'� M
wl[n section 7000) ol DlvisiOn 3 ot tha Bu51nes5 antl ProteSsionS Cotle, antl T
my Iicense Is In lull (orc �awtl e(IOct. �^ � ��%- - S
L1cen Id55 • r i enso ✓�-�Q � /
Date ��� SI9 t a' y �� �" - PLUMBING FEES
WORK 5' C MPENSAT�ON DECLAqATION BetSink ShOwCrS ELECTRICAL FEES
I hereby alii�m Iha� 1 �avn a CerIIflCetO of con50nl to SOIt-Insuto or a WrllliWte
of Worke�s' ComponsatiOn InSuranCO, o� a CnrUliBtl copy thar00f (SaGtlOn BackflOw Preven�er 52rvice Sink
3800, Lab. )n �.� : i y� [� � _ � P.uromutic Washer Trans(ormer � 15-50 KW
Policy No. ��/�/-� �°^. Company�T, L�I'w/"� Backflowlrrigation Sewe Cap CqnstructionPoleSub. ❑ 50+KW
� tiii COOY ii he�eby Iumish¢tl.
Cert ti co d with the dty tlin I.I�n1 s%i��/ /.' Bathtubs Connection Cooking Unit . Meter �up to 100 amps
'Q Date �� AppliWnt �1 �✓��
� EXE� N FROM WORKERS'�COM�TION DECLARATION Clarififf5 a Colleclori Di5hv25her Meter over 1008mp5
(ThizsectiOn n¢etl nOt be'compleietl H[h0 parmlt IS tor one huntlrOtl (E100) Or
less�. Dishwa5her lar Pipin9 Dryers �Gas ❑Electric Sub Panel
I certify Ihat {n the pe�f6Gmance o1 thC wOrk tor which this pCrm�t i5 ISSuetl, I
shall not employ any perion in any mannor so as to becoma suD]oct to the Drinking Founlains olar Tank Fan Motors �0.1 HP �1'h- 8
Workers' Compensation Uws ol Calibrnia.
Date �^Si9nature Floor Drains $wimmin ool w/Spa F.A.U. Inc. So�ar �9�15 HP �16-15+
NOTICE: II, alter making this tleclaratlqn,ryou shoultl becomo subject to tha
Workers' CompOnSatiOn provlsions ot lhe Labor COtle, you must fOrlhwith FI00� $ink5 U�in FixtU�¢S MiG�Owdv¢
comply with such p�ovi5iOn5 or thi5 pe�mll shall b¢ tleemeG �evoked.
CONSTRUCTION LENDING AGENCV Gas$ervit2 Outlets a[erClOSet DeviteBoxes
1 he�eby atlirm tltat lhere I5 a Conztruc[Ion ending agency tor the performanCe Pole Light
of tne work tor whicb tNs pgrrpit i� issuetl (Sec[ion 3097 Civ. CJ InterceptOrs Water Heater Outlets Ran e
LenGer's Name ��� � � 9
Lentler4 Aatlress � A Kitchen Sink i Water Service Switches -
OWNER BUILOER DECL� �� Sign
I hereby a(firm lhat I am exempt trom the Contracior's Ucense law for the Lavatories Auto-Wash Garbage Disposal Standing $ections
foliowing reason (Sectlon 7031.5 Business antl Professional Cotle: Hny city or
county wnich requires a permit to construct, alter, improve, tlemolish or reoair p-Trap Laundry Troys Generator �0.5 KW �5-15 KW Trash Com actor
any 5[ructure, prior to Its izsuance, also requlres the apP�icant for such permit P
to tile a signetl statemen� [hat Ile/she is IicenSetl pu6udn[ to the Provisions ot ROOf DfdinS
the Contractor's Li<ense Law (Chapter 9(commencing wl[h Section 7000) of
Division 3 of [he Bu5ine55 antl ProlCs5ion5 CoOe) o� that ne/5M1e Is exempt
therefrOm dntl [he ba5i5 IOr t�e alleqeC exemption. Any vlolation of SecliOn
7031.5 by any applicant tor a permit sub)ect5 Ihe applicant to a Civil
�enalty ot not more [han five huntlretl tlollars (E500�. $ 3
1, as owner of the prOp¢rty Or my employees witn waqos as thelr sole ilein5pectiOn F¢e $15 ISSue F¢B
compensation, will tlo the work, antl tho sVucwre 15 not intentletl or offeretl peinspection Fee $15 155ue Fee $ 3
tor sale (Section 7044, eusiness antl Profezsional Cotle: The Contractor's MECHANICAL FEES
License Law tlo¢z n0l appry lo an owne� of a propOrty who builtls or Improves
thereon, antl who aoes such work himsel(/hersell or Ihrou9h his or her own DEVELOPMENT $ERVICES IREMENTS: �/^�Z
employees, provitletl lM1a[ Such improvCmenls are not Intentletl or ofler¢tl lor BOiI¢� HOOd O� Typ21 ❑
sale. 1/, howuver, Ine bUIlCing or improvament I5 Soltl withln one y¢ar Ot com- CanOpy Typ¢ II ❑ Zoning ApprOVed By Da[e
pletioq the owncr wili haw Iho burtlen o/ proving he/sha tlitl not builtl or Im- Duct - Under Ground �� _
�rove /or tne purpose ot salo). Builtling Approved By Date
LJ I, a5 owner ol the properry, am exclusivelv contrrctin9 witn Ilconsotl con- Duc[ -SVuctural q¢frigeration System Application Issued By Dat ���
vactorsto consvuct tnu pro)ect (Sectlon 7044, Businass antl Professlons Cotla:
The Contractor's Litanse Law doos not appry m an ownar oi properiy who Duct - Ventilating �0.100,000 BTU ❑100,000 BTU SUMMARV OF FEES
builtls or Improves lhoroon, antl who conVacls for such pwjoC[s with a con- , M
trattor(s) license pursuant to Ihe ConlraCtOr'S Liconso Law). 1 am aware that BUILDING PERMIT $ _r �� $MIP $ � �
roof o( [neir Worker's Com ensatlon Insuranco snould bo Exhaust System ❑ Multiple ❑ S stem Repair/Alteration
p p provitlatl to mo. PLAN CHECK $ PERMIT
❑ I am exempt untler Sectlon B. & P. C. (or this raason Firepl/Fact.8lt. IC80 # Fire Dampers PLUMBING $ �SSUANCE $
Dato Owncr Heating System & Ducting Registers ENERGY P.C. $
PLAN CHECK 25% 3
i hereby <ertlty that have read this applicatlon antl state that the above �0�100,OOOBTU �100,000 ELECTRICAL $ '� U GRADING $
in(ormation is corro . a9rae to como�Y with all tlty antl <ounty ortlinancos .
ana state rela g tU bulltl,�(g constructlon, antl hnreby autn Ize repre- •, �- MICROFILM $
sentativ I is ci y o e r upon tho abovo-menUonPa ppp pert tor PLAN CHECK 50% $
Inspetti n r os . // �- MECHANICAL $ ' � TOTAL FEE $
. Si9natu L� Dat1 �
Drivers' nse or 55 yp Reinspaction Fee 515 Issue Fea $ 3 PLAN CHECK 25% $ ��
CMF OBfi5�46, rev. ]0/84 White - Builtling: Canar - Applicant: Plnk � Accounting; Goltlanrotl - Assessor
,
. CONSTRUf,TION AND PLANNING ' �' POOL & SPA
� APPROVALS Permit# ' Date Inzpector qppROVALS Permit# � Date Inspector I
r
�1.,Temporary Electrical Service•or Pole 52. Pool & Equipment Location - 1 '�'
,2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcemen[ � ��
3. Electrical Conduit Utility-Undrgrnd. 54. Forms ''� �� �
�
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding .
5. Steel Reinforcement 56. Rough Plumbing & Pressure T,G'st
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE , -
7. Footings , 58. Elecvical Conduit-Undrgmd.
S. Foundation •� 59. Gas Pipe, O Undrgrnd., Test •
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, fl Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK �; �
i i. Property Sewer Line & House Connection 62. Backwash & Receptor-Final :� �
12. Sewer Cap 63. Neater & Vent-Final � r,
13. Roof Drains 64. Plumbing System - Final ' ''` ���
14. Rough Plumbing 65. Electrical-Final �� �' i
15. Rough Elec[rical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electriral-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT '
20. Rough Factory Fireplace APPROVALS Permit # _ I
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71 . Product Piping O Gas ❑ Oil �
23. Gas Pipe-Rough & Test 72. Underground Flush si'
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead,_Hydro
26. T-Bar Ceiling (Svuctural) & Monocoat 75. DrY�Chemical '`,
27. Frame and Flashing ..76:' Dry Standpipe �
r.. - �
28. Lathing & Siding ' `�'•�, �77. FIXED SYSTEM FINAL �' ,�;
29. Insulation -' "•- ' 78. FIRE PREV. FINAL •
30. Drywall Nailing _., HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED •
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Gnopy
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 p
45. Sound Attenuation 1 mpl te Inspections .
46. Handicap Regulations `� � �
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed � � ,
49. Electric Release to Edison •
t ,
50. Gas Release to Southern Califomia Gas Co -
51. CERTIFICATE OF OCCUPANCY ,
No. Date
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31711
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626
4PR 23-7G��s�OO1446 v*****5.00
APPLICATION FOR BUILDING PERMIT
For Applicant tq Fill in Completely
RECEIVEO BV D TE RECEIVED D� qTE ISSUED
BUIL�ING %-� 37O L{_ '�f3^,//a
nooaess 8�I y To......+sc v`-rft�T / /
PERMIT NO.
OWNER K���Qi.� CQ �pNy\c� ''C\L�c,N A.P.NO. � 71
BUILDING � � � �
MAIL ADDRESS
ADDRE55 �`'f`� T�+""�N�
TEL.Sµoo`�Sn TRACT LOT � BLOCK
crtv G M , No.
CONSTRUCTION W A D A TE P
LENDEF �i.yk� X.�
BRANCH " •
OWNER
ADDRESS " VAL E
ARCHITECT . TEL. E $
OR ENGINEER N .
FIRE �
ADDRESS " 20NE � TVP GROU
C`KN/� �� i,i'-'p"� APPROVED ��j,���
CONTRACTOR � \ BV DATE
ADDRESS "
TEL Z NOAF USE OF NE
QTV �� NO.
PLANS y BUILOING
STATE CITV vMAI�N BUILDING ACCESSORY BUOILDING
LIC. NO. " LIC. NO.
SI2E NO.OF BLDGS. (FROM C/L STFEET) •
OFLOT (pO X �3� NOWONLOT FRONT FT. FT.
USE OF �¢S
EXISTING BLDG. S FT. F
SIZE OF �j'b�� X 12' NO.OF �91� o�uvc,a
NEWBIDG. ROOMS STORIES �.SIDE FT. FT.
EXTERIOR WALL ftOOF
COVEFING 'f�' COVERING ��V+vi�N..a REAR FT. FT.
USE OF BUI�DING AND WOpK TO BE PEFFORMED DISTANCE BET. BEf. MAIN &
MAIN BLDGS. ACCESS. BLD('aS.
VAR� DATE
�2S�D�C�T:p �qY(o pO�T�ON GU.P.3F` APPROVED
APPROVED
��L. rpi �Lh- Q+C i S'r�ll �SJTO 0
J
I hereby acknowletlge that I have reatl this application antl state C� �,
that the above information is correct antl agree io comply with
all laws regulating builtling construction, antl I shall not employ
any person in violation of th0 workman's compensation laws ot
the State of California.
I hereby certity that I am proberly licensetl as a coniractor under SQ. FT.
the State of Calitornia Business antl Protessions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VA�UATION IS FOR
Chapter 9, antl that such licen�s are in full force end effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV:
am exempt from the provisions ot She State of Celifornia Business
VALUATION
antl Protessions Cotle, Oivision 3, Chapter 9. PERMIT FEE $
Signature of o �
Permittee S��a ,'�' PLAN CHECK $
Authorized ABe^t �-/� �.sy�c ���c� � �!
TOTAL FEE �/� �b
3 OWNER
S JOB AC
� GENER
AP No.
y INSPEC
soi�
GAS
W ATER
ROUGH P
_iii_i� LOT i� TRACT ���4 FIRE
SPRINKLING SYSTEM
MISCELLANEOUS
ftOUGH HEATING ANO AIR CONOITIONING
TEMPORARY SERVICE OR POLE
UN�ERGROUND � POWER �
ROUGH WIRING
TRENCHES � FORMS � STEEL REINF.
FLOOR SVSTEM
BON� BEAM � STEEL REINFOFCE �
SHEATHING
FRAME ANO FlASHING
LATHING - IN �J OUT n
PLASTER, BROWN COAT
STRUCTURAL, FINAL
HEATING. VENT._ REFRIG. AN� A.C._ FINAL
DATE 4-23-70
BUILDING PERMIT N0.
RIPTION of WORK Legalize Pati
ZONE VALUE$ 37g,00
�UP J TYPE IV 2
SUBCONTRACTOR PER