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3278 TURLOCK DR - Building Permits
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 3278 TURLOCK DR Suite: Viciniry: RESIDENCE AND ATTACHED GARAGE Parcel Number: 41210604 Zoning: R1 R1 Applicant: BRESLIN, BILL Address: 1835WHITTIERAV " , - . - �_ , UNITF12 ���, �= _ ' Phone: 800-784$787 COSTA MESA, CA- - , �- Zip: 92627 . ...i� . �. . . , �i. � Owner: MUSTAFA, GHAZI.J, ' Address ; 3278TURLOCK DR , � � - � i� j / , � ` ' � - i _ � . /J� �IjCOSTA MESA,.CA' , � . � � Contractor. � 21ST�CENTURY ROOFING INC -�Address: 1835 WHII"fIER AV � ' UNIT'F12'� � . � � `� COSTA'MESA,CA Phone: : _ . � . . Zip: 92626 Phone: .800-784-8787 - Zip: 92627 License:. 807430 ._ � Arch : � � . ' Eng: Address: . - ." � � ` � � - _ Address: ' � . �� `. . Phone:` . I - , � Zip: - � % �License: Status: ISSUED Applied: 06/17/2003 Issued: O6/17/2003 ISSUED BY: �� .• � ' Phone: � � ticense: � � i , ,- SCOPE OF PERMIT- . - � REROOF RESIDENCE AND ATTACHED GARAGE: T/O EXISTING,WOOD SHAKE, 7/16" OSB SHTG, 1 LAYER 30# FELT, APPLY "40-YEAR � CERTAINTEED COMP SHWGLES (ASTM #D3462). 19 S�UARES � � � " � FEESUMMARY ��� Plan Check: $0.00 - - ' Calc Valuation: • Sa,zoo.00 Permit: . $111.25 � Claim Valuation: , � , ga,2oo.00 �, SMIP Res: , ,' $0.50 � ' _ � � � `SMIP Com: ��a- $0.00 � _ � �:= � . � ��� �Other. ` � �•�$0.00 � � � � �`,In'spection: � �'�$0:00 " - � � � , �,� ,._ , � �Total: $111J5� i� . �� � � _" . - � � � � � �' . \, . . �� � , � , � � PLANNING & ZONING � � � SETBACKS.`� . � MAIN STRUCTURE� Front 0- 0 � Rear �-�. 0- 0 -� Lek ' 0- 0 � -���� ,. - - ACCESSORY Front � 0- 0� � Rear 0. 0 , , Left - 0- 0 PARKING Exlsting: �0, � �-�Required: _0 �. Proposed: �; , . - Right 0- 0� , ' Right 0- 0 -',, � � ' 0 � � r� NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statuies 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 i1 work is suspendad or abandoned I for a period of 180 days. � , INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply wilh all applicable codes, and all required Inspectlons end flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiratlon of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 zaas�ae le��l - WORKERS' COMPENSATION DECLARATION: � � I hereby aflirm under penalty of perjury one oi the following tlaclarations: ❑ I heve antl will maintain a certilicete of consent to self-Insure for workere' compensatlon, as providetl for by section 3700 of t�e Labor Cotle, for �he peAormence oi Ihe �ork tor whlch this pBrmil is issued. heve snd will maintaln workers' compensauon insuranca, as required by secGon 3700 of Ihe labor Code, for Iha pertortnance of Uie work for which ihis pertnit is issued. My workers' wm ensation Insurence carner d poliry number are: / [� �7 Cerrier: �fi%�'ril� �l / /� � Policy Number: n � �� yb !, � �' � ,sC (This secNon need not be E�nple7etl the perm t is ve/ued at one hundred dollars (S100J or Iess.J ❑ I certity that in the peAortnance of Ihe work for which Ihis pertnit is issued, I shall not employ any person in eny manner so es to become su6ject to the workers' compensatlon laws of C mia, a egrae [111777���ttt d I ShouD 6ecome suh�ect to the workers' compensation provisions of Section 37 0 0l Ihe L or Cotla, I shall forthwith comply with Ihese pr ons., ///� � / Appliwnt Signature: X �� .f .� . � �ete: ��O �/ - 0 3 WARNINO: FAILURE TO SECURE WORKERS' COMPENSAiION COVERAGE IS UNLAWFUL PND SH4LL SUBIECT AN EMPLOYER TO CRIMINAL PE{7ALTIES AN CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARE (5100.000), IN ADDITION TO TME COST OF COMPENSATION, DAMAGES AS PROVIDED FOFi IN SECTION 31060F THE LABOF COOE, It�REREST, ANO ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirtn thal I am licensed under pmvisic torce and eflecL Lic. M. � ' Comrector's Signawre: C�apter 9(commencing with Section 7000) of Division 3 ot the Business ntl I Class 11 � `- .__ _— De�e:__ _ . (. entl my license is in tull CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm ihat there is a constmction lending egency for the pedormance of the work for which this permit is issuetl. (Sec. 3097, Civil Code). Lenders Name: Lendafs Address: SigneNre: Date: OWNER-BUILDER DECLAI7ATONS: I hereby etfirm ihat under penelty of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Busineu end Professions Code: Any ciry or county which requires e permit to construct, alter, improve, demolish, or repair any structure, prior to ils issuance, elso requires the epplicant for such permit ro lile e signeC stetement that he or sha is licensed pursuflnt to t�e provislons oi the Contradors License Law (C�apter 9(wmmencing with Section 7000) oi DiWsion 3 oi the Business entl Professions Code) or Ihet he or she is ezempl iherefrom and lhe besls for ihe elleqed examption. Any violetion of Section 7031.5 by eny applicent for a permit sub�ects Ihe epplicant to e civil penelty ot nm more ihan five hundred dollers ($500).): ❑ 1, as owner of �he properry, or my employees with wages as t�eir sole compensetion, WILL DO THE WORK, antl the structure is not intenaetl or oHered for sale (Sac. 7044, Business and Professions Code: The Contractors License Law dces not apply to an owner of property who builds or improves t�ereon, anC who tloes such work himself or herself or through his or her own employees, providetl ihat such improvemenis ere not Imended or oHeretl tor sale. tl, however, the builtling or improvament is sold within one year oi completion, ihe owneo-6uilder will have.the burden of proving that ha or she did not build or improve tor purpose oi saleJ. � ❑ I, as owner at the property, am E%CLUSIVELY CONTRACTING WIT}1 LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Profeuions Cotle: The contractore Llcense Lew tloes not appty to an awner of pmperty who bullds or Improves thereon, entl who contracts for such proiect wit� e contractor(s) license pursuent to ihe Coniractors License Laws.). ❑ 1 em exempt under sec. Business end Professions Cotla tor this reason: Sipnature: Date: Owner ID venfied by dnvefs license. �Ves ❑ No Drivefs License No. Vedfiwtlon ot Ownership by (rype ot tlocument, I.e. - pmperty tax bill or deed): Expiras: DIVISION OF INDUSTRIAL SAFETV PERMR CER7IFICATION: ❑ I hereby carttly that no excavation five (5) or more feet in dept� into which a person is requiretl to Cescentl, will be made in connection with work euthorized by this pertnit, and that no builCing strudura, scaflolding, felsework, or demolition or tlismantling t�ereoi, will be more than t�iry-six (36) feet high. (Chep. 32, Gry 2, Ar12, Sec. 341, Ttle 8, Calitomia Administretive Cotle). ❑ As owner-bulltler, I will not employ anyone to do work which would require e pertnit from the Division oi Industrial Setery, as notetl above, unless such person hes e permit to do such work irom the division. Signature: Date: Division of Intlustrlal Sefery Permit Number: CERTIFlCA7E OF COMPLIANCE AND AUiHORIZATION OF ENTRY: I certity untler penalry of perjury that I have reatl this apDlication and state thet the infortnetion given is correct I egree to comply with ell slate laws and dty ordinances rela�ing to building construction, end euthonze representetives of Ihe Ciry ot Costa Mesa to enter upon Ne ebove-dexribetl properry for inspection puryoses. I egree not to occupy or allow occupancy of any building au�honzed by this pertnit until final inspection. i aWre f L al Own ) � D e � .c � , 6 / �" /� � And/Or Authorized Applicant �— Date � COOE t. INSPECTIONTYPE 1fi16 Fixed System Final Fire PrevenNon 1268 Pool Spa Final 200 Final Re-Roof 201 Finel Block/Retaining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition � . I �1111.. . � � -� �% COpE� INSPECfIONTYVE 206 Finel Mechanical 208 Final Plumbing 210 Finel ElecMcal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Finel Building/Occupenq Appliont to 1i11 In all soaeez axcapt t�ose within neary DorEer Iines anE sign a11 aoDroDriate tlaelantions. . .. . . . .. . ..._... _. . ____ ' _ • CITY OF COSTA MESA ' .. ... PERMIT NO. _ TRACT NO. LOT.NO. � BL . � � � � _ 2G,2] ]/2�/Q3; _ . , . Q, pa TL , CONSTRUCTION PERMIT , • ' fi?�-,gps • ' ' • - : � �. ApplicanYi Meiling Address � � : TVPE OF CONSTRUCTION � �NEW ADD � ALTERATION' -REPAIR ' . ' . . �� • . � - ' �- . . PrajectAddress ''I � K- � ' = - " ❑ CONVERSION ❑ OEMOLISH ❑ OTHER - � ' - -' - ' . � i - ' S' , _ . { � � T' sf �";dJ� DESCRIPTION OF WORK �Owner'sName \/ r- hone . ._ , - � . ' - ' '2 INGHEG TI ' � AddfBss 3 Z 7'Q�- ��u�� mi'l� ' � � TVPE OF PERMIT GRADING FOUNDATION �' STRUCTURAL � A. P.�3W� - � ZONE _ - � W � Arch/Eng.� '�- r . License Na � h �� P ` � ❑ TENANT. ELECTRICAL PLUMBING ❑ MECHANICAL � - � . �PLNG. REF. �j= � � - � BUILDING •� - , , �`Q � Addfeu� ' `• � ... � O.'OTHEH . � ' ' � • . ' _ TO BUILDING' .REAR VARD (70 P/U ¢ � . 7h, ' 4 � � R PER V INE � �, Contrector:s Nam -P one �' . !G $ PROJECT DESCRIPTION � SQ: P7. OCCUPANGV � . - . , , _ � i � , � . �EFTSIDEVARD RIGHTSIDEVARD� � I, Addfea�malfing) �• k � ' CONSTRUCTIONTVPE VALUATION$ ' �" � ' � � ' ' 20N� �' • � GRA�INGCU.VDS. ACRES � ' PKG.SPACEREQ. PROVIOED� � �i � � , LicenuNo � �/ � g�2- � ' � .. . : , _ . , . . . i � , LICENSED CONTRACTOR DECLARATION ; � :� � , � Ramarks:g ��H� TAL Oer' A.L^1 � -r:o � STREET WIDTH ; .: '.PARK FEE $ � j ��'� I�bereby'aHirm that I' am Ilcensad untler provlslons of Charter 9(commencing � � . , � ,,. +F � with sectlon 7000) of Divislon 3 af the Bu5ine55 antl ProTasslons Cotle, antl � �Q � � - T � -,T�� �.� SPECIAI CONDITIONS: - { " .' my Ilcense751n full f rca antl eifect. ' i - - v Llcenie Ci � ' "' ' L{ nse o.� Z ; i � ' PLUMBING � „ , ' ' . : ' _ � ' . . , � J Leeby afflrm tOha= hava a cartiticata of consent to self-insure or a cer� ' ' Bar Slnk, Pr � nt r- ��r �P ,Y 1 Auromatic Washer '.,_� EL M ter' Oover 1 W am+s , _. � � 519 atu ' ���� � { r ?� � ERS COMPENSATION DECIARATION � • - - ' � " - Backf ow eve e - � � Sewe Connec �on�, •� �� • :- : - P � - `- � - . 3 v Vor kers' Compensat lon InsurSnce or a cer t i t ie tl! copy thereo f (Sectlon � � , � i Construction Pole ; Sub Panel ' v � i 3800,- LZD. C.) ��1-71 $. � Backflow Irrigation � $plar Collectors " I� � � ! Po17cY No. �_R_� ComPanY 'x ��� . .-- � � . i . , ' Cooking Unit � Sub Pole ' � � Q� rtifieO�toDY li hefeby turnish00 j � y ' BethtUbs SOlaf Piping - ` � ' . � � ' 1 ' L7 Certifl c 5 flletl with the City Bu I,n fl. , a , Dishwasher � ' -' ; ; Date ? qppucant� - . � Clarifiers So�arTank � . , 1 Motors 004 HP ❑1X-8 � EXEM 10 �FROM WORKERS COMPENSATION DECLARATION � • - � � . Dryeis �OGaS���Electric "" �InaSolar 09-15 HP 07645+ + ' Dishwasher `. Swimming Po pa ; ,(Thissoction neatl not ba completetl i7 the permit Is tor�ane �untlretl (5100) or i � � � � � t ; less)' ' � � i '� i i � � • � } � — � Panl � ' � ' 'Microwave � � , . . . I cartlfy,that in the periormance of the work tor which this perm�t is IssueC I � Drinking FOuntains � . U�inel � � . � � : 'shau`mt e lo an ��1� ;�Wbeeome subject to the � - . } ; , - �.. F.A.U. � , � � Pole'Light ' � Workers" p y ori �uws of Califo a� �r � a �/` ' ( Floor Drains ; � '�� yVater Go ' � + � . ' Da[e _!��i9nature oul0e o � ' ' ' ' r . , 1 � � Worker ', Compenwtlon 9provislons;o/ the LaGO Catl� become subject to the� '- ' Floor SinkS - i - �-?- ; - � - � �Nater He en -- - - �--- � - - -- Fixtures , , jR'en2Je�,,. � _ � � j I NOTIC : If(. ter�makin thirtleclara�lom ou sh - < ' y u,must forthwitn ' � ' , ' , _ . - � , �. , Device BoiceS , i'a-. � � � comply 'wltM Such .Orovislons-,Or .this' Dermit '� 5ha11 be ;tleemed• revoketl.. ; ;�i Gas ServiCe` � � ��Outlet5 rWate�rvlCe ' ' .r � { � , � � .� � ' Sign' j , ,� , �{ � � CONSTRUCTION II.ENDING AGENCV � � I . � ' ' ' i , � � I y g g - y � performance ' � i � : OuNets � � � � � I hereb affirm that Ihero ii a'con5truc8on lantlin a enc for the� ;� IntelCeptOrs , . F/'. ' � ; 1 ( Stending SeCtions . i ! � O � of the wofk fof WF�ICh. thI5. p¢fTit i5 �i55uBtl ,(58Cti0u '309Z, Civ C) - � . •- � - � � , I LenGar's� Nama NON.s"-s.. • _ ' <: '. ' - +- ,} � , - - ' - . Switches j � . � qTresh Compactor r��%'` ; • " ,. � Krtchen�Sink ._ , _. . : I . . • l -LenCer'S AOGress , �� .. ' � . ' _ � . �' '' , � i7 . t �� , <: c;,. _ '�;. � Garbage Disposal f { OWNER�BUILDER UECLARATION . j ' . + � i' ��� ' � l ��atO�ies , I . _ • (�' i � � � + '. I nereby:aitirm th5t 1 am-exemptfrom tne�Contractor's.Llcansa Law tor the : �� � �. � � Generator. �0-5.KW �5-15 KW � L ,� �" ' ! following.reason:,(Settion-7031:5 Businessantl Professional;Cotle: Any ciry or P T�ap, �- ' ' - �� �•- !'county whicn requires a permit to constru<t, alter improve, tlemolish�or repair � � � . - _ _ � � � Transforrtie� � 15-50 KW � � ' � ;1' �� ,�?%r � � � any stru<ture; prior to its Issuance,�also �equiros t�e applicant for such Dermit Roof�Drains � - �.+ �_ t= - � - � � � t� file a�signetl 5[atemenYthat he/she Is Iicensetl pursuant to the�provisions of ' ' . , ' � � " . � � ❑5U+ KW, . - ' ',Contractor'z License Law (ChaD�er 9 (commencing with-Section:]000) of ' .- ! ' � ` � � •, � ^ . ' � - . , � �'Riinspection Fea �� $15' 1 "snlon .3"of tne �Buslness antl R'otesslons Coae , oR. enaL he/she Is�exempt f` Showers n , w �" ' ReinspeCtion�Fee ! $15� . -�ifrom antl the' basis for t�e allegetl exemption:�Any violatioo-of Section � - ' � � � ' _ , � i - Meter ❑up to 100.ampi � � 'f �sque Fee' � � $ 3 f -:h.5 by. any applicant tor:;a � permit-subjects the apPilcant to a' cWil • 1 -�' � � . . ! , � ' _. �enalty ot not more than tive nunarea aoua�s (S50o): "� ��� ; t • � Service Sink i Z z � Issue Fee � a 3 � , rS - � I L� • I .! I , 2onin9 APProved BY � [ , Date� I LJ I���ai�owner ot the'propert'y or:my amployaes,wlth wages.as tneir sole _ . . � �� � � � . �,� � compensation wlll!tlo the work, antl�the'structure�is not Intantletl or ofteretl � . r: � t j� ,- MECHANICAL � . j � i qppj�qtion Approved By ' -`Date ' ' � ' far wle 1(Seciion 7044; Buslness! antl' Protessional., Cotle:. The � Contractor's � „ _� _ . . � _ � ��� ,�•!� � i ' License Law tloes not aOPly to�an owner of a propertyiwho builtls or improves � j BO11e� � 't C� Refrigeration System : � I j Appliration Issued By '� � ,� Date. �'� � thereon,;an0 �.wno tloevsuch work himselT/herself or tnrou9h his or her own � �- � % � � ' � - i employees, provitletl that such'Improvements are;not InSenaoa or otferetl for � -• ❑O�,100,000BTU ❑100,OOOBTU, , � � , � , „ ��� i � sale. If, however, the buflUing or improvement Is soltl wlthin one yearbi com- � j Duct Under Ground � � � , , : � ' , ', � SUMMARV OF FEES • -1 . 3 � � pletlon, the ownenwill have t�e burtlen of proving he/she Citl not buiitl or im- : � - �� • ' ! ' - � : • 1 i ;�romiorthepurposeofzaie). ! ` , �. ; . j ; Duct-Structurel ,, i ' SystemRepeir/Alteration ! � IBUILDINGPERMIT $ „v,SMIP � .�$•E's ; LJ I, S5 owner of Lhe property, am excluSWely controctlnglwithlicensetl com � { � ' � PERMIT r ' � . I ' f eraciorsto construct.the project.(Settion 7044, Business antl Aofesslans.COCe:�. ._y. Duct,- Ventileting,_ ;_ _V,i _ �,__.i„Y__�; ,' ' � ,PLAN CHECK; $ ' ' , i { Tha Contra<tor•s License Law does not apply to an owner ot properly who � � - - - ' I ; 4 �� ! � ISSUANCE •. �$� � � bullOs or Improves thereon, antl who contracts tor such projec[s with a con- '. � ExAaust System ❑ Multiple �t � l . I t � � •PLU_MBING � � $i � ,_i 1 . � ' traclor(s) Iicense pursuant to the Contractor'S Licanse Law). - � � � - � .� ` � r GRADING ) $� � '� • • t t r � . � ; iPLAN CHECK� : $, j +$ 5 � lam exempLunCer Section � � ; B, 6 P. C. (or thi5 reason � ( FvepVFact. Blt. ICBO # ' ± � � , , � 80 r : . + j , � , - ' - ; � . . . - ; � � ; . � 'aELECTRICAL ' $ " • : f ' � � Date � ' ' � owner` � ' � - '� � � Heating:System & Ductmg � � : � � j 1 � j . MICROFILM $ 1 � ' �'I hereby certiTy-that I�have reatl this appllcatlon-'antl•state that th�e�above- - {PU�.N CHECK� 1 $� � �bt00,000�BTU �100�OOOBT� � - - - • ' ' � ' ' 1 . InformaLon Is correct. I agrea to co 1 with all cit antl count ortlinances ' � � i : +i i ' � � 7 � � ' � ) , ' ' �' TOTAL!FEE ; $ � � 1 anA stata laws relating to bulltli nsi u<tlon,;antlYhereby authorize repre- � , . , - MECHANICAL , • � i . � ; . , .santatives of;[his I to on t�e above-mentlone0 HOod oi Typel ❑- . � � � $ . � Inspectlonourp � P � Pro erty or , , _ $15 � � , ADVANCED.PC � $ � � i. Cano T e II ❑� Reinspection Fee' .PLAN CHECK•. 1 $; � LESS f � Signature � .� � ' DaSe • ' � � '� � ; � ' � , � ' d0 orivers' Llce 6'r 5 � •` ' � Registers ! , � Issue Fee . 5 3 � ' ' � • ; � �� FINAL�FEE: � $ ( $' � � � , � � . . . . . . . � _._._ _ • CMF 086546 rev. 12/82 White - Builtl(n9: Canary - Applicant; Pink - Accounting; Goltlenrotl -Assessor - � ' � - - - "' ; � � • f . _ _ . . . �_.. . . . .. . .� . .. F � r� . :y. . ` • • if:i "{ - . � . . � . . CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT N0. G 2�yt 5~ LOT N0. G ADDRESS Q �/ ? A� T„�ie/�c�� �i( DATE G� �� � �S —T� The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he-she-they) (was or were) �i advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the city at the time the final tract map was approved. The city assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. RECEIVED CiTY CF COSiA i;;eSA F''.^:'!i�:C .., :. ��.;I�! J I�i� AM PM q�8�9i1U�11�12�1i2�3;��5�6 E BY ,.�l�ik.P��Q-iL� � Purc�ser BY ��//�.w�.tw� Developer and��% orized � representative - BY Lender �5 . AOV�iwnt to flll in all sDatas ex��p! t�osa within neary Cortler Iines an0 sign all apo�ooriate 0eclantlonz. =� �]^ E'+/ � ���:� I 3��� T� - CITY'OF COSTA MESA.-.. ., . . - - i - ` � '� _ �' � PER IT N i ' . TRACT NO LOT NO. B . � — ' ' —�'� ?"'. � • ' '` —' • � �" ' � ' -I .. . i . � ;, �', � CONSTRUCTION PERMIT . � � J } ' `: ' .-. `� � 1' ; y � ; � _ , ' i . . - : �. _ ; .. . .` ,; , . i ' ' � •.. � . - ' � , _ � c �- , .` . �. � ApplicenYs MailingAddress � � �' � ` Gb 48 � us � T/pE.OFCONSTHUCTION �' � NEW2 ADD ALTERATION�- REPAIR '� , 1 r •+; , :� _y ; ' � i .` : � ; . � , ' RojeitAddress' 3 Z 7g' Tii/tY�OG/�� � - � " • � �O CONVERSION ❑ DEMOLISN O OTHER~� ; ` � � . � C? I �� ' x, "• � _ � � 1 Owner•sNameG�!/.zi dnA's'i%Fn "`; , ' 'ohona��'a2Pt' � �'DESCRIPTIONOFWORK • � .? t �{ � � , � . . i n' ' � ( ; : : '. � r i .._ ' . _ IN E ULA 1 �i I • -- Address. 3278. 2U2'LdLi/ .. I� ' � .. _ .' ' - . . - . ' .• . - , � . - , TVPE OF PEHMIT. � GRADING FOUNDATION� - STRUGTURAL �. A P s#" '' 'ZONE : " - t � i ' AfCh/Eng � ^ • LICBn40 No.; � ❑ TENANT ❑ ELECTRICAL� �PLUMBINGy O-MECNANICAL � . �pLNG. REF.3Y:,4 � ' - ' BUILDING ` , �_ : Addless� -- °'' � - . '' ' ' .- _ ' ' !D.UTNER � �. . '_ ' . : ' 1 i , ' ' - `' i ^ TO BUILDING - ' REAR VARD (T0 P/L) - ' 1 � '( 7 COntfeCtOI�S NeRI I C+ oL ' �.[ NOai �� ho�e�J9-27n`/ , PROJECT DESCRIPTION' S� FT.� - �' OCCUPA CV �v� ' P PE V INE 1 � . . � AddIB55If118iI1ng) �Z-jZG� n/'C'L�l.6ob6�[iC,uNA'>Ii/LLS ���NSTRUCTIONT,VPF ' I� ; �VALUATION$- �AJ9: � . �'LEFTSIDEVARD j, ; ` �' RIGHTSIDEYARD � , jn g ��. ` .�. �C Z7--'2�6r1.S�2' 1 ' ' Z�NE ' GRADINGCU.VDS: ' ,ACRFc� PKG.SPACE,REO. � � � � • � ppOVIDED � �%� " . License No. ., , � I:ICENSEDCONTRACTORDECLARATION ; � � ;, . , � ( Ramarka: , , ' � � � � ' . � � . STREETWIDTN � ' �� . ` 1 �PqqKFEE$ � � � � ' �': � I.hereby�affirm that.l�,am IlcenseE untler provisions of C�arteP 9 (commencing ` �' ' ! � • ' � � - -��' wlth sactlon 7000) 01 DIVISIon 3 of tha Buslnass an0 PloTesilons Gotle, antl � .!� �_ , � j � j'.; �� � � } � ',SPECIAL CONDITIONS: ' � ! �r�%; � � - F i - f' F "� Ty Iitensa-IS In fUll 10fte dn0 el/Btf. � p r • ' ' " � �-- � ' � Z�is�l0 ? � ` ' � � . LJcense Clau' ` • Lice � Na T : ? ' � PLUMBING �. + 1 : ; . . . � ' � t ` � � � � � r P,. / _ 8 i ` i . .. i t ' � i ! i . � ' , ', �lp, Signature � �' , � , ' BarSink ' - SewarCap�' f ' � � � � � ELECTHICAL ' ' -�1'itKERS' MPENSATIONDECLAR ION,- + � - � � . i i ; 1 I i ' � � � ,�i-_�eDy alnrm t 1 have a cartificate of co"nsent to uH-insu�a oi Inwte �.,_.,_ gackflow.Preventer...,_'. (_._.i .._Sewer Connection�_ .�_ :.�. _„._y. �... _ �+utomatic Washer � i I `.Meter ❑over 100 amps } '� • � B1 WorkerY Cortipe Ion'�In5urarice �,-oi' a certHietl 2 ereof (Sectlon- �' '' ' ' �� � Sub Penel , 3800, lab. C.) � ' I ' ' . . . , � PoIICY No. O -�Z � ' • + , Y � �: 4 . f � ? r Baiktlow Irripation , � Solar Callectors � { ��U Con3truction Poie ! , ; ! -� : ~+ ,, . i + � ; i . Bathtubs � Cooking Unit � j • '. ( Sub.Pole ' . i e Certifletl�<opy IS he( � SheC. � � i � , ' ; Solar Piping ; � � I � � . + � Certifle0 c etl with tha Nty ullaing rxt i ( � � t � i Dishwasher { � 1MotOrs �04 HP � 1 h-8 � � Data � - � ' � APDlicant � , . � � Clarifiers i ! Solar Tank ; ; � � . . i i . . . j 3� . -EXEM ION!FROM'WORKERS•'COMPENS ION DECCARATION` "j - + - - ' � j "- Dryers'�Ges' �ElectnC "' ' ;InaSolatFO9-16HP 01645+ `�� � t (rNs 5ectlon neatl not be como�etetl H the De It is for,one huntlroa (S1o0) or � Di5hNA5her � ; � Swimmiitg Pool w/Spa ' � less) j ' . = � �l � ° 1 � ' � � Drinkin Fountein5 � Urinal { � � Fan, 7 � � jMicrowave ,' ! ' «. � I 1 certi}yithat In t�e perfo�man<e of the work Tor which this permit ISlssuetl I 9 . � . t [ 1 � f � . � � E ' � s�all; not employ any perzon in any manner so las to be oma suEject. to t�e � � , --. - . ' � ' �- i Worke�s Comp¢ nutlon`Laws oi Calito ' " � " ' ' � : ; � � �A��� � ,Pole Light f R e ,�l w, j . �-, . . Floor Drains� � yVater Gout � t F � • � Date x- /�.a" '7 ' Signature ' ' � � - � � - � � - � , ; 'NOTICE: It, after.making tnis.OeclaraUon,.you oultl become.subie<t to,they _ ; Floor,Sinks : � _ „ Water Heater-_ _: } _ _ _ �_ Flxtures. � I � ' (Renge _. ( j ; 1 , ��Workers'� Compenwtlon provlslons of tne Labor Cotle. You must forihwith ' � - � � - � . . � - ' - ; � Comply wit�. such :provlsiOns'+Or "-th6( permlt shall Ge,tleemetl� fevokatl. �'� � Gas$efviCe� t yOUtletS WatefrServlC2 J � Device eoies ( ; { ! i �Sign� � � ' �� � ' t � CONSTqVCT10N�L'ENDING�'AGENCV. � ` �'' � � � � ' �- " � � � � � . - � • I �ereDy xffirm that there Is aiconstructlon Ientling agericy.for the-performance� ��: �nte�ceptors . 5 � y. l f 1 OUNets � ' j , ; �Standing $eCtionS 5 � � � i � ot the -work 'for whi<h%this• permit �is �IssueO �.(Se<tion ;3097,- Civ. C.)� � - - - - - � ,' � � � � ` ' � : ; Kitch'en Sink � � r � ��, � - � � ' ; ✓� I .i � �+� ! . jTresh Compactor � � - - ' - � r : � � � Switches • � ! � 1 , : a � l.enGer 5 Name� � - . � , '� �LenCar sl Atltlresz � � ' A^ .. .. �• ,. . -. . . i � ' . , • - ' ' c : � ' Garba e Dis o5al . t ' � OWNER BUILDER DECLARATION f ' ' '-' 1 '..% j �., � ' ?7 f La�atories 7 s _ � � �d . � � ' r- � -� { } E �. . 9 P � � i i � i 1 bereby,ztfirm�that 1 ain.exempLfrom the'Contractor's�Licanse Caw tor the - , r_ � -� ., ; Gen¢�atoi �0-5 KW �545 KW � � � • � . following reason. (Sectlan, 7031.5 Bu51na5s antl Professlonal �Cotla: Any tlty or � P-Trap� ° � '�� �� �_ � f:' `} f� �' 1 ' f � .county wnich'requires a PermlLto con5trucY. alter imDrove; Oemolish or.rapair I �., , � � • ^niy strutture; prbr to it5�issuance,.also reqWros t�e'aDP���ant;for such permit '' � RoafArains; : ff- �; � -� i j.l ' � � :� Transformer 015-50 KW i � ! � � . � r3,aile a slgnatl 5tatemenLihat he/stie I5 Ilcensetl pursuant to thelOrbvlsions of� � '' -- ' "' f��� � O5U+ KW; , � � � � � ',Contractor'S'LJcense Law�(Chapter 9 (commencinglwkh Section7000) of ! ' ' • ' c i � � ' '� - " � - ; � ! , i ; .Hainspection Fee � f75 1 ,}5`}iilOn 3._of the Business antl�Professlon5 COaO).O�:tha4 hB/ShG;is.¢x¢mpt ' ' � $hOWEfS f� � � � i � � � � � RemSpeition�Fee I ' /�$15d � ' ' ' ' ' '2refrom anA the,batis for the'allagetl exemption. Any,violation'oi;SecHon � . ' ' 'T ' ° ' ' ` ' '� ' � � ' ; Met2r ❑up [O 100ampi � � �Issua Fee� � � f ' $ 3 i ,7,033i5 Dy,.,any'appliwnt for:aipermi['subje<ts'�theixppllcant to a civil ! � "i ^' " - j S ' � � � � "1� ' � '� ' � eenalty of not more than nve�huntlretl eollars (E50o). • r � - t I +: : . Service Smk �'i` , �i. � . Issua Fee =± ; t � ,S 3i . � ' -" - : } � - -- . � . � LJ i.�.� . , r" ', } t i ' � , i � 2omne,APProved BY , - ' Date as�owner of�the�Droparty orrmy amD�oyaes with wagesias their sole , � � : � , � ' 1 � ; compensation' w114Co the work; antl the'structura is not Intentletl or ofteretl ' �`" ; s, ; 1 �! MECHANICAL , � � r ��pliption Approv+ed By '� � 1 � '�ate I ( .Tor sale'(SecEion 7044', Business antl�Professional'CotlenThe.ContractorY � � - � /1 - � � � LI<ense Lzw tloes not apply to,an ownei of a property�who bultCs or impro,vei { Boiler. .r t j - Refrige�ation System � ' y�; (� .(i- ✓� � �� � � � � K � � ��� ' 8�� �3 � � ' t�ereon,!antl wno ilo¢s;5ucti wD�k.himselt/he�self o� thrOugh hls o� �e� Own � • �- � ' -� F ; � ' • �/; F APpliqtiOn ISUBd By '� �`�-/ netB - ', amployea5, provlAetl tnat such improvements are not Intentletl or offoratl for , � �6100,OOOBTU ❑100,OOOBTU' � 1' � 1 � i �� sale. If, nowever, the builtlin9 or Improvament is soltl within oneyear:ot com- Duct`Under Grovnd � � . � � � , , �� ' ' : : � ; SUMMARV OF FEES � � . � � ! � 1 pletion, t�a ownar}will have the burtlen oi proving he/she tlttl not builtl or Im- ' �� � . - ' � ! � ' . , � i � � j � rovetortnepurposeof,sale)�. , �,:; . , DUct-Structural S stemRe eir%Alreiation { i'-� $I 1 j SM�p , $ � ! f � � . . � � 7 Y , P , , , I ��(ir y� ;BUILDING PERMIT ; � � � I, 5s owner of the property, ain exclusively con[racting�with'licensetl con- , . . , � � � , � 1 ; 1 , � ' .�tractorsto <onstruct the;project (Section 7064, eusineu antl Professious Cotle: � _t Duct -. Ven[ilatin9 ? �.. ' _ . _ � I ,�. � �; i 1PLAN CHECK� j $', � � PERMIT � � . ; The� Contractor's-Cicense-Law Uoes-noYapply�to an ownerrof'property who"7 . . . . � , � ' ' � ' � • ISSUANCE ! � $ � ' builtls or improvas thereon, anA who contracts fnr suc� projacts with a con- j : Exhaust System O Multiple �: { ; � � � I/. i �+ !PLUMBING ! } $� � . � y I t tractor(s) license pursuant to the Contractor�s License Law): f � � � ` • - - � ; - � � R 1 I GRADING � � � � $ ' � ' ;• � I�am exempt unEar Sectlon � e. & V: C. tor [h�s reazon � j Firepl/FaCt. Blt. ICBO � � � ' � � �j ;'� � iP�N CHECK� $i � � � } 1$; � �i ' ... . . . i 4 S � � � i I! Date . �! Orivers' Llcenu or55 � � CMF'0865-46'rev:12/82" WM1Ice=Bui � : + � � ' Heeting System & Ducting : � ; j � ; . � j s/ �ELECTR�CAL� - $ � : ' � � • ! ' � ; � � � � � � ) ? : � MICROFILM , $ � � i`A�stata.th'at:theabove,_} J,O0.100,OOOBT.U�100,000B ___ .,.,.,__ �✓; PLANCHECK: �$ � . i f� ��anacountyortlinances , � . • I ; , . � "'`�' " ' 7 ' � � ' TOTAL'FE6 � $ � heraby aut�orize repre- - . - ' . MECHANICAL' $ � ' � � 4 . . , entlonatl property for � 1 Hood o� Type I ❑' ; � � ' ' - � � ' � � � n ' Cano T � e I I ❑� � � ( j Reinspeccion Pee' � ;li $15 �p�qN CHECK> > $ � � LE55 , � ' DateU'�.��'�. , • . , , t j � - j ADVANCED,PC � $ t � — Re isters 1 � � � � i ! ' 1 i i � � � � k � a � • � � 9 � � . I�eFee ;$-3 ' � . j . � � FINALFEE, � $ i- ��� PPliwnt; PinK -,4ccountin9: Goltlenrotl'ASsesioi .`.. _.'.-.. -" ' - - _,_ _. _,_ _ � ..+. •� � • . _. _ ....� ._ � .. . _. �,.,, _ ,., _.» -" __,,.,,_ „_,�_ � . � .- - , . .. .'� "_ ' _._. __. ___ . _ , . . . . . . ' : C O T J V �i _ _._.�_ .__ . . � -- --, ---- -- - �-, - -- - - -- - - -- --. . . .__ _ �. .._ ._� ADY����t to till in all zpaees exeep! those wit�in haavY borEer Iinas anE zign all a00roodate tleelanbonz. . CITX OF COSTA MESA� ; r T- - � . 1 , - � � - �^ : . � o� T` �' - : . CON�TRUCTIONPERMIF� i� , ` !• P TNO � IT AC�NO LOT,No.., �s�o , ��„ u_ � '� _ i �, R� � ,, ,, , .� � � � � I � � �=�'�S '� y �-• i �'= � t�-'.I I � � 36��� h%27J8�'y' ?5:1'e5c }Ti . . ' � . . ' F. NpplicanYs Mailing Addreu ' • e � � • TVPE OF CONSTRUCTION � � NEW ADD •� � ALTERATION= � REPAI R - 1 �, � ' � � � , �� � � � �'' 1 _ : : ; �- 1 -' �. ' PrOjBCtAddfea' �' T � OQ • � '-� - „ ' .� � ❑��ONVERSION;❑ OEMOLISH ❑ OTHER- � _ j ' ' t '! _. � �, i p ' � ` ,i ' �.�. /Y t - ' .,� I . - ' - , Owners�Name � � Z ��P On �:� DESCRIPTION�OFWORK ' ' . , , _ � � . y � , , . : ri ' . . -� . � : F ' �'� 1 �.• o I � � . . � - ,� . � . .Z ING EGULAy/TI 5" I . i Add�Essl �- r � � ',T,VPEOFPERMIT' �GRADING� FOUNDATION� �STRUCTURAL - /a P���' � �I �' ' D � r ZONE ' ,,` � _ 4 � ;� 1 , t�' � �' ' 1 �Y ' ' ArCh/Eng.; �' Li enseNo, �CL.�; � I � ❑ TENANT �ELECTRICAL�.PL"UMB�NG ❑ MECHANICAL � ' �PLNG. REF yp . . � ' �'%; . ' �BUILDING �� � �� � � � ��' � �� Addteu' � ^ " � � ' Q�ATHER � � �•' ' • . � " � � . . ,TO BUILDING ` • ' - ^ � : . � -� � � 6^������ > - . . • . . . Pfl PE V INE ' I REAR VARD (TO P/L) . i � � '. � ' ' ,I. LLZ�'L¢d ' �. PRQIECT DESCRIPTION � 5(7: FT.' � .. ` �oCCi1aANCv ' . Contrector's Name' - � °� hone - . . - . , ._ + ' ' � �" � i � �CONST,RUCTIONT.VPE � �VP:LUATION IO�� 'L'EFTSIDE V/iRD � RIGHTSIDE VARD' � . � ' �i � Addrezs (ma � �ol i.s.��% /�G¢L�i� %�� � : � . , " ' ; S � ' � ! . :f - � - - 1 - � � ' � ' ' PKG.SPACEREQ. � PROVIOED' � " • 1 - ,m �� LiCense NO. � �� r -;� Z � � -�S �+ � � ZON€ � GRADING GU. VDS] ACRES � , � : _ , . . . . . . . � i . . . I I- : GCENSEO CONTRACTOR DECLARATION �� � �� ' ' � Ramarks: � � � � ' � � � � � I ' ; � I STFEET WIDTH � ' ' ; ' ' �PqRK FEE$ - ' A �>f Ilhereby�affirm that I�am Iicensetl untler provislons of Charter�9 (<ommencing °� � , ' ' ' t � ' � ' - � � � i . � � - � with saction ]000) of Division 3, ot tha Buslness antl Prote4sions Cotle, anE ' � 1 � � � � i . ? � r ! � + � � SPECIAL CONDITIONS: � � ,:: j" + -!�� . ' my IIC6nie!IS In Tull f rca dntl Tact. � ' ' � . , • . � � M Cicense leis' �— �. I<e e Z I ; ' ( r ' PWMBING ,� i i i � � •, � • . te � $i9nature � � ��*. � , . ; j � BarSiok� �� � SewerCap' , � � j 1 i � . ELECTRICAL ; . - ; J T��R ER COMPENSATIOND A 10 'Y�„'teby afTlrm.Mat.l �ave a cerU Itate OttonSentto Self-InSure.ol a teftlilwte._' �-.� � gaCkilOW'PfCv2ntef - SBw2f'Connettlon� '^r--- �� -� - -�- _ AUtOmat¢ Wa5h2� t � ? __ �Meter_Dover tOb amps :� _ � � � � � � 9:�x Workers' Compensatlon InsurSnte,�of a CerUfletliCODY the�eol l5ectlon ' - � � � _ - � � � ' 3800, Lab. C.) �i� � p9 : � ' i ! Backflow Irrigation ! f Salar Collectors �' ; Construction Pole � } � .Sub Panel�' , i j � � � Poucy No. � /2ml2�c:c Comvany � '' ���'r� {�� ' ' ' � ' ' � ' " -� � - ' � ' ' Cooking Unit � Suh Pole � � • ` I ❑lerUe �co iz harety furNshatl. � �,p: � � I � � Bathtubs � ; � '� Solar Piping ' i ' � t , � � � � . I 1 . � �- : ! � EX E rtlrl0 <� M'WOHKERS'COM ENSATION DECL' "ATI� ' � � ' Dishwasher � ' � MotUrs �0-1 HP �ih8 y.. Date f Applic2nt � � r� -��� ' �S � { Clarifiers ; 1 , i So1ar Tank _ .� �� � � �' � ' � ' , _ � E ! .. i. V hy�f��� .. . . . ; _..' . -, _ � - Diyers �❑Gas� -�Elecv�c ' Inc.Solar��9-15 HP �16-15+ ' ' (T�Is �EcH neetl not be completetl if the permit is for one hunCr tl(5300) or � Dishwasher � � t Swimming POoI w/Spa � • � � . � . ' fless) �! J ; ' ; . t . . � ,- . � . . , � � , , � Fan i ' � i �Microwave i , • � ! :' , I cerHfy �t at in the Periormance of the wor f Cw Is pe ��t Is.lisuetl I, � �� D�inking Fount3in5 ! U�inal + � � � ; shall•not mpl any perian in any man eco sublectto the ; , , , _ � � � ole ' ' � f ' ; Worker ' om lon Ldws of Californi , ,' � � ; i Floor Orains i Water Closet� ' � k � j 'Li9ht � ) Date - Signature � ' ' � ' ' ' ' , ' . . � , �^NOTI :'If, fte -makirig�thirtleclarati , you�shoulOFbecome subjecbto t�e � -- FIOOrSinkS - --__r. ..�.:; . . Wat¢r.Heater - - - - - - ___ _ _ _ ang2 _ _ .; _ F.A.U. : � �P Fixtures � { { q I , �^ , Worke s'; �C mpensation Drovisions�ot the Labor Cotla, you,mustitorthwith -' , , ' '. � . �, ` - � , � � comply �wlthj SU[h p�ovl5iOn5'yo�ytnis':pG�Tit Shdll be tl08meU. �evOkeO:: 1�j,' G25SCNiCE ' 'OUt18t5' �WetEfS¢rv¢2 � .� � � � D¢viC¢ BO%¢5 ��^ � � �Sign! �` � � � ' CONSTRUCT�ION;LENDING AGENCV ,� i � � �-. ' � " " - '� ' � ' • . • � � 1 hereby�aNirm tha[ there Is a constructlomlentlmg agencyfor the performance ,,y ' Int2rc¢ptors � � �' � �„ - Outlets � �j �Standing Sections. � I � � ot tne ,work for which � this; permit - is � Issuetl -.(Sectlon 3097; Clv C� � � - � � � � . . � � �. � -• � •- : � " ' ' ' Kitchen Sink -,� ' ` � .- ! ; '� a � - Switches . ' , � . P �t � Lentler s Name�" - - � 1 -� E .v . : Trash Com actor � : -Lenaer's 'Atltlres P' � - . ' � � OWNER BUIIDER DECLARATION` + Y ` � J ' � ,.•. � •' ? `�: � _�� ��et011eS:� � i � � � �= �. � ,• �. � w + .7 . Garbage DlspOsal � : �- � � 1 � -� i �. I i � I hereby�a7firm that I am ezertiptYrom tha.Cuntractor•s llcerise Law tor tna .� � � - - - Generator �0+5 KW �5-15 KW � f ' ' �-following reason�(Se<tl6n'J031:5 Buslnessantl Protessional�Cotle: Any c�ty or j, �3 { P T�api � I jry � � i �r � �_�� , y. { .� . . { . � i 'county whic� requires a permitSo constNct, alter, improve, tlemollsh or.repalr _�. - , . . . � Trensforme( 015-50 KW � � .j � i -� i .# any structure, prlor to ks Issuance, also reqWres tne appliwnhfor suc� permit ..• i RoOf-0iain5 �� : 7 �. ''. I� f: � y� � r I � � ` . ' � .�ile a si9netl statement'that he/she is litensetl pursuant to the!provislons af �! ', � � , ' ' ' � , � ; � 1 ; ❑5U+ KW p ' � �� �Reinspection Fee $75� � k:-Lontractor's License taw (Chapter 9 (commencin9�,with�5ection,-�000) of r � r ; .G cy � � � -+ ' � � � . � I �slon �3 of t1ie:Bu5ine5s antl� Professions Cotle) or, that. he/sharis�eaempt �- Showe�s ; C - ReinSpection,Fee'� $15 ,a efrom�antl the basis for t�e allegeC exemptlon. Any violation•of. Section • ' ' ' _ � � ' � ' . ` , ' ' - Meter ❑up to 100�,ampi Issue Fee � i ' $ 3 i "io31.5 by%any apDlicant tor�a%permlLsub�acts'the applicant to�a:avll , "�f � ' -, ;a � � '�', � I _ . . � - • � _ _- - enalt ot not more than flve hUntlretl tlollars Sefvice.5ink � � �-` • laue FBe �� 5 ' � ' Y (5500); 4 C , � � . � : t � , � ,. . .i i , . . � . � -i 3 . 2onin9 A�PProved BY � Date -'� I�asvowner of;the property or�my�employees with wages'as their sole'' . , � ; � . � 1 .� � compensation-, wlllstlo the wo�k, antl�the,st�uttu/e:IS not IntentleA o� ofte�etl � ._ j-•. � S' 'i � �-. MECHANICAL' ,, '! �� ppp�����e� qpp�oded By ' � ' a4e �� Z � �� ; tor ulei(Section 7044, Business'antl{ProfeSSlonaLCotle::The�Contractor'S , � , . , �•. � • 1 License Law�tloes not appty,to'an bwner of'a property wFio builtls or improves Boiler. ' �� ��- Refrigeretion System � , -' ' f .� �' � � I' Z(y � ' i i APPliption Issued BY " ate ��Nareon,!antl ,who �tloesi such work hirtiself/he�selt o� th�0ugh his or her own i -� - ' 1 1 � � . •. '� � - ' � � employees, orovitletl that such�imorovements are not intentletl or otteretl for � ' Dutt1'Under.Ground � � ��0-100p006TU.O100,0008TU '�'I ' � sale. II haweveq the builtlin9 orimprovement Is �soltl within one yearbf com- < , � , '� � ' � , � ' t � ' t ( SUMMARV OF FEES �,. t � � � -�� � pletion, the ownerlwlll have the burtlen of provin9 he/she Citl not builtl or Im i .- p . � 4 ' �' �j,� �-� i � � i ' �rovetorthepurposaotsale). 't -� � �� :� ,; , , -: � Dutt-Structural ��,� j _ SystemRepav/Alteration ' BUILDINGPERMIT $ SJ�i3�' SMIP � , $ � '��' I, Ss owner of the Droperty, am excluslvely contracting-wlth�licensetl conj, - � . � � i � � ! ' �7 �� '� � ' �' 4 p , • , _tractorsto.conslrucLtheproject.(5e<tion7044,Businessantl.ProtasslonsGotle :� _.�_ Duct: Ventilatm9;.f'R.r„ r � , 1� ' I _ � ,_� . . PLANCHECK; �j $ � .j PERMIT �+ ' ' The Contractor's Llcense Law does not apply to an owner of�property who ..�. n� � - ' ' Q ISSUANCE � �$�� � � builtls or�improves theraon,'antl who contracts for such projects with a con :I�� '�+ Exhaust Syst¢m ❑ Multiple��� � 1 ' ` � µ � ` ' ��P�UMBING ' $ �� � � � � tractor(s)`Iicensa pursuan[ to the Contraccods License Law) � ; , - ' ' ' � � � ' � � � , j � GRADING � $ a ' ❑ �'am exempt untler Saction ' e; h'P C tor'thls reason �, ' Frtepl/Pa[t Blt. ICBO � . ! , k � 1 1 PL.A.N CHECK' . � $ � � � �� ' i . • Date � ' O`wnerf � „ M� A"� ` Heating Syttem & Ducting i ' j ' i • 1 , � ELECTRICAL i $ ' � •' �� � �, j ' � $ ( � , � • ' 1 � � �� � � � � iPLAN CHECK I � MICROFILM • $ � -I�-�ereCy1cerUty�that-I`have�rea thli� plicatlomantl-state�tfiabthe�above - ❑6100;OOOBTU 0100,OOOBT , - • • - ..-) -1 ' � $ � 1 � ' ' information is c e . I agr t omp wlth all cliy, antl county ortlinances . - � .-d ..� , ; �"4V -.•'� •� � �. � � � ' � { ' � ', TOTAL'FEE� I $ ; � ' ' antl�state laws e gqt A g m truction; antl herebymuthor e reore- , . i � � , � „� 'MECHANICAL � $ , � 7 � � � sentalives?of' o en r u0 n'tne above•me tionetl" pr pe y tort- I �HOod 0� :�fyp0 I ❑: � J � i 7 . pemspection Fee ' $75 ; i . � . LESS � 1 . � ! � Insv,ectiomp . I � . s � � ' ^^ t � r Cano � JT�� e II ❑� , ! � , i � ' ;PLP,N CHECK� , $, � y � � � 519nahre . ' _ ' i • � �Data ' ' r, . 1 � � � , � - � � . � , . � • '. � � . � ; � ADVANCED PC $ �a � -�L;� �' Drivers' Licensa or�55 � � � '� + � � f � Registers ' j � . r � Issue Fee � $ 3�- � � j � � �FINAL FEE+ $ �� " , � _ _ : . _.._ ' __ _�-_ '_ _ __ �..._ _ _'... " . '__.."_ . '" __ ___ __" '_ ' '.- '" _ �_ _'_ ' ' ' _' "'- _ " '__ _ ' "._."` '__ __.,_ ._ _ - .� ' � � . . ._ _ -. . ..___'_ "'_ _ .' -/ . . CMF 0865-46 rev. 12/82 White - Builtling; Canary - Applirant; Pink - Accounting; GOltlenroE - Assessor � . ' � .. • . . . xdry.,,7K r s , .i ` ..` ; .,� ,.i� . •.K� . k. - �.. ,�. . �. � . .. �. , .. .. . . _ '"'}-. ' __ ._ _____' .._ . _ "____' ' ._'____"'____'_"'__' _ _ . _' _ _ . ,.�. . �: , , ^_ ci :^�-�- a �PO4kh�.,`'e'+`�PAo � •��-. , . . � CO�VS7RUCTION�AND,PLANNING, > . x c ; - _ . � .. _ ,; - � ` � ' "� .� -� m ' � ri ', �' _ • • i� : 'Date � liispector ` '.` . . '. Date = �Inspectoi .APPROVALS Permit # � •• :: APPROVALS^ � Permit� - (�- � 1 N Y i � f� ' '� �� 1' � � « 1, Temporary,Electrical SerJiceorPolO ' M1; =^„� f;. ; �'��l' !�52:, Bool &�Equipment Location�� �� _ ;�-o ��8�� ' � . n � - ; � 2i Soil Pipe Und �grnd� � o _ - � i �' - �' � �; `, � � �53° Steel Reinforcement � = ' - 3' Electrica� Conduit Utilitv Undrgrnd ' ° � i - - ��54��Forms - , - � `� ` ' ' � � ,, 4: Electrical Conduit-Undrgrnd; - 1 � �' "'� % _ - �'55�. Electrical Bonding•-� � = - - � - � � • cr � . •5: Steel �ReinforcemenL� � j ' " �'' � - - ' - ' 56.� Rough Plumbing & Pressure Test . - ' ' P C 1 :}^f ' I n: ^ ` A� '; ' _ - �;57-. APPfjOVAL T0 COVER-GUNITE: , 3--: ��� 6. ;Electric1l _UFER Grnd.` „_ � ,�-o : - . _ ,. � . _ , .. . - 7. Footin95 , . ", . � � � � ! c , ' -' '� ��'; � ':58. . Electrical°Conduit-Undramdi : � � lj a i .>. 8. Foundation tl., i t- .� I �� � � 59. Gas Pipe:��`Undrgrnil., Test' �. - ' "� ."i'� - -i ! , i - �n� . 9. Water Pipe,Unilrgrnd.�.� � _ . "' �� � "�� - s- � {� "' �gp, Backwash Lines;�P-Trap, O Und�grnd. - � ,I „ + i r 10. Stiuctural Floor System � �_°: ' � ' y •, �^. i' ', ' �61. APPROVA'L"TO DECK ` - , . � e �� l�t t. Property Sewe�r Line & House�Connpccion � ' �-,r ; " ' 62. Backwash &'ReceptorFinal -_, � ' _ , �12. Sewer.CAp � � . ' "o' � � ' � "-, � ��63. Heater &:Vent-Final. ' • � I E� I ' + -� �' �93. Roof�Drains � �. � ' �", .�� � �� , � ��'gq. PlumbingSystem-.Final� ' � - . � , �i [ 74. ,Rough Plumbing' � � i� � � � *� ��� �65. Electriwl-Fina1' - � - - � � l v i � � �✓ `-5: �; r; 15: NRough �Elec�trical-Conduit? j� jF'--- � -'� '�f-� ' � � ,�-� ' "� "'66TSolai+System-Fin`al '- '�� � ' j -� "' �= " �-"' - : c, 16.;yRough-EleiTriciWirin9� �� I E ' .I �. n •-''� r � ` ;{' r !.- '' ''' . . ' . �-----v �.. � . � _ -� � dl _ �*�' �67. Fen6i,ng'& Access.Approval. r�. �, ' � 171';Rougli Wiring.Sijn`' ' ' � i '' . j ; F � : � = '' � ? 68. APPROVED F.OR PLASTERING �yt � .�' , �� . ��, i �-.i, �:t� ;.... - '� 18: 'Rough�Electrical-T BaF. Ceiling' l� .� : ; - � ., � _ � 69. POOUSPA SYSTEMS FINAL �. � '� r� � p� � : . . . ' , ,l.v-. ' 19r�Rough`Heating & Air�Conditioning ! � ; � ; � i � i � � � ,�FIRE DEPT.�REQUIREMENT � ` - j ' - - � - 1 3 � � . ,=1 '- � i 20. �Rough_Factory Fireplace � � � �F � I f ; . i � APPROVALS � Permit # �� - � � � ,� - �'21.'DucTs, in St_ructure� �� , � � �; � i � � � 70.� Undeiground Hydro - '� � � �.^ i � , f _' S ;� 22. �Dpc[s, uentilating ;. ,� � � �� `• � � � � � 4 .71.� Produc[ Pipi'ng O Gas 0 Oil � ! • � :.ii�y9. �Gas��Pipe-Rough & Test � ` ? r ', r � � % � � ;721 Underground Flush' '` � ' � ' `�2A. Roof Framing+ � , ' o ; ; ; ; �; ,, � . � �:' , . , . � � � _ � � , _ ( : ' -,- j � ,73J Undergrnd. Storage Tank10�Gas . � Oil . � , �� �. ; -� �� QG. .Roof Sheatliing � � � ;_' i �'�; i � i '� r � �� �74: Overhead Hydro � � ' . ' F ;. 26. T-Bar Ceiling (Structurall� & Monocoat` � � � � � � � �. "� � `� � J5. Dry Chemical f . ��� � ' _ �,�27. Frame and Flashing; i i � �i �i � � � � '76.; Dry Standpipe � . ' �_ ; ! r� `28. °Lathing,&'Siding� ,� ! � � �� !, � ( � � � � � ;77. FIXED SYSTEM`F,INAL. ' �- � - , �i 29.};Insulatioq: ' ; � i � A (� i � � , ;78: FIR EV. PINAL� , . . ' . � . • ' � � q � 30. �D�ywall Nailing � `� � -� �'� � f 4 �i � � i i , � ' Notes: " � �,. � I� �i ' 31.'Plaster�Brown Coat � ` . � � !;� + • ' - - - - � . -' -�,- � - �- - �. ..�V. T- �� i � �'.�"� i � � 32.+Electrical Power Meter-Final � ' ! � � � , . - � � -, _ , � i i i � � . 33."Final Electric � ' I � It � � � � � - ' � � . � ' � � � ' � ' 34. Final Heating & Air Conditioning V� ' , ', � � � ' � � , •�- ` e i � . I �� _ 35. Pinal Gas Pipe Test ' , - � ; � ` ��^ � - � .t j �' � � � - " -• : . ; , �.- 36. Hood or,CanoPY'' � � � � :�� � r � . . ; " . , . - . � - - , _ . ; .. � -,1'„ �el_ � � . ., i .. . • . � •. - . r . . . . . .. , - - 37. Final Factory Fireplace;�, �% c� �, i.. i , A - ; , � 38. Final Plumbing � t � � ; �; a { + ; � � j i � " ` 39. Water�Seivice-Final ` , ', E -� � . ' . - - , ' � r' , 40. Gas Se�vice-Final � ' • L � �: ; i _ � � : � � ' ' � ' , - 41. Solar pomesticFin'al � - � 1j _ �_ � , ? .'_ � �_ ' � .. • . . � , . . ; ; i , ; - i ', , ; . . _• 42. Backflow P,reventer , i - - ' � . � 5, _ . _t_ . � � 43. Backflow Irriga4iori �� ( J � `F"'�: _ �: �_ � - - � ' • , , �{ 44. LandscaPeJ�rigati�on'SY.stem 1 � . - .� � - � ' _ -.i �. , � �� . ' . - _ - , . �. _ 45.' Sound',Attenuation � �, ; � ; � � �{ � j 'o ; { ; ; - : ., . , ; . � � i i 46. Handicap Regulations j � � r � � � ' _ y . �• i `•, , • � � . . � - , • � 47.�FINALSTRUCTURE&BUILDING� , i � . � i i '� i i 48. Special Requirements Completed r� ' ' j� - : t ' . , �, •'„•• -,� . . . . - . ., 49. Elec[ric Re�ease;to!Edison i � '� ' i ' • � . � � ' , i , . �, - , ii • ---_•. - --i--- --- -- - - - �•i'-,� � � . 50. Gas Release to Southein California Gas Co � � ' ' � . . � ' :,�, . 4 � - � ' ,�. 51. CERTIfICATE OF, OCCUPANCY : ' ' ! _ __= _ ' _" ,_ .'_ ' i • C � � � y � , - - - -- ,- . , -, , ' � I No a Date - ' ! � � � _5. ,�,�„ AOP��Gnt to till in all soaees ezceol tnom within neavY DorEer nnes anC si9n all apvrooriate aeelantions. ..�.AQ... TL f C OFCOSTAMESA'-- -j '---�- -���— - , -� � - -- . . . . _ . - , . _,- .� , ._. _..''9584' "5!9'Cl83__._,. �. ; � PERMIT. 0... � TRACT NO. . LOT NO., , ' BL , � �, � tr � -� t C.�ll$TRlJCTION PERMIF. � , � _ -�i ..� � • . : , ��5�'. � - . , : ., ,' i � .. :' - " ; . ` ,- � . '= _ - } ^ ' .. " �} i � i `� j � _ i (ippli4C,enYS Meiling AddfBu � f ; 'TVPE�OF CONSTRUCTION: � � NEW �. ADD� ALTERqT10N' REPAIR _ t fP ' �, ; " I f , � ; �-. ' ; ,' F,_ r ' I • \1 FrojectAddress ��� �� � ' � I O.CONVERSION � DEMOLISH �'OTHER _ � j . � - � _ � w - . " . � ' ' i � DESCRIPTION,OF WORK . "• � � . �• � � •, , � � �_ � _ �~ .. _ N Owner s Name s ' � � 'C`- 'Phone ; `,��� . . � � � ' ' i I G � E U A I S �` x! � . t . .Addr255� 'r 1 � � ' ;TVPEOFPERMIT: � �GRADWG � � FOUNDATION ' �STRUCTURAL � A.P.'# , 20NE ' � �" ' � Arch/En � � License No. 1 � ��3 � - ' ' - - • - � � - � 9� � . . - ❑ TENANT ��ELECTRICAL O PLUMBING ❑ MECHANICAL. - pLNG. REF.9W'.;, � � ',BUILDING y �J.' .. 'UII'� -: I ; "O OTHER i . �.^ - „ � �' . , _ . . � _ 1 i ^ 1^i , AddfESi' - TO BUIIDING - 'C. i . '� • - �� y , � • , • . . . � i p PE TV LWE" �^ i °REAR VARD (TO P/U1� L a +rr � Contractor's Nam ' houe � �,• PRQIECT DESCRIPTION� 50. F7.' OCCVaANCv . ' - - . - . � - - - I + � � � - i - :LEFTSIDEVARD ' i • • RI�GHTSIDEVARD^ �� ', � � AddIE55 (melling) � � ..� , CON STRUGTION T•VPE ' � , � VALUATION $ ^ � � - - 1 , � '' � L'icenseNa: ��(����Z � � � ZON� � { GRADINGCU.YDS: �ACRES FKG.SPACE;REQ. � � • . PROVIDED � � ;,. �r , LICENSED CONTRACTOR DECLARATION y �, � � Remarks: �, � �l� ' � , ..� - STREET WIDTH . � ' �. �PqRK FEE $ . ' '�� . I�hareby afflrm l�at'f am Iicensetl untler provislons ot Charter�9 (cominencing - ' { r . , with sectlon 7000� of �Ivislon 31 oT the Business anG Professions Cotle, Sntl � . ' ' � � y , ' - '� � i ; SVECIAL CONDITIONS: ' �� � : i a' � ° ; - � � my Ilcanse' s In fuil fo antl , , � L1cen{a '�` �, ,e �� �— ' j � PLUMBING � � � . . '� � � i^ � - � Y�"Y ya/flrm�that�I.haveacerHilW of.con5e , , • � / � � �2 R COMPENSATION D ATION � 1�: � . : 1 Bar Sink : Sewer Cap _ , ` ELECTRICAL ' n(�to If-Inzure�or a�certlticate �= r gackflow Pre'venter"--�- 'k- ' � —SewerConnection' � - '� - - . Automatic Washer._.., .. . �Meter. �over,100,amps � , , _ . � {x,.:�Workers' Compensatlon Insuran ,ior a certif tl�cop thereof (SecHon , - • � � 3800, uG. C ' ' � - �! - ' ; - � + � , Construction Pole , ,Sub Panel' � ' ' t � , i � � aj . , � % � � ' Backflow Irngation { � � Solar Collectors � � � � Polic No. �� Com anY . • - - ' ♦ � � . � r : � ' � � � • � Cooking Unit j � Sub Pole � � i ertHietl�cbpy is nerdby turnishetl: � � � j� � 1 Bathtubs { ' � ` $olar Pipin9 � � i � � 1 , i 1 � ' ' j �tlll etl Gopy 1�IeCwiththecity �i on � ,� � � � � � � � � ' Dishwasher . � � � �Motors �0-1 HP ❑iX$ ' � , Date S '}r� -�� • ,APP�Icant � � � _ qarifieri � I . I , Solar Taok , . � . . ' , . ` , '_".! _ � � EXEMPTION'FROM WORKERS CO P SATION Dg LARATION : � � � � tL ' Dryefs ❑GasTOElectnc ��� .� � Inc.Solar 09d5+HP �1645+ � �+ j, Dishwasher •Y ; Swimming Pool w/Spa , ; - V I � � ;(Thissectlon neatl not be completeC it th ermit Is for/ ne huntlretl (5100j or � t . . t - - � less)" � � ; ., . ? • . . i I � � - ' , � � � , � Fan� � i ��Microwave : t • . � I cerUTy �that in the performance of the work for wnich ihis Derm�t I5 Issuetl I � Dtinking Fountains j - � Unnal' � ,� i' } � j � � � � � r � I ' � Shall"noS BmpIOY a0y perzan in zny �manner so�as to become subjec[.to t�e i � , t � F.A.U. � � 1 �Pole��ight � j �' I i Workers' Compen5dtlon;Ldws of Californla.� ' y . � ��.� Floor Dreins, t I ( j Weter Closet. }-'i � 1. 'I. - � . � ' � . ' ,. . _ . . � ' Date � ' ' � ' Si9nature � •' 1 1� , i. 1- . . 'L' _ ' _ , . "" '_ ' � _ 'L" ' - Fixtures.! �;..:, 1 _ �Ran e. ' i �"NOTICE:tt,after-making'this�tleclaratlon;youshoultl;becomesubjecttothe"� FIoo�Sinks�--- �-j�--,- WaterHeater� i 9-+--^ ��-a-- � Workers', ComOensatlon provislons.ot the Labor CoAe„you;mus[.,forthwlib ' ri.,- . Device Box2sy� ' . �` � , i compty �wlt�; such .provislons�or � this�Dermit shall be tleemetl reJoketl:i � - Ga4Sarvice' vOutl2t5 • � [ Water Sernce ` - �- = } ' �Si9� � � , r 1 ' . CONSTRVCT�ION LENDING AGENCV i. i �' ' '� ',' � I l . 1 � . � . � � I heraby zfflrm that there I5 a:constructlomlenOing aqency�for tha'perTormance InterceptOiS . t� ;�- Q' �_ �.� v -! �;T ' Outlets Standing Sections � i � � I� i of tha work tor. whi<h" this, Oermit � is • Issuetl '(Section 3097. Clv C) - - � � • . � Lanear•s� rvame?� ° 'T ' " � ' _ , Kitclien�Sink� . - � = s�. i ` � � Switches ! � • � ' �Trash Compactor � : ? �� �Lentler's 'Atlareu' ^. ' - . ; . � � ! ` - � " � ,�, , 4' � - s ' i � Garbage DisPoial . I � : I . � � ' �' S. . i r , . ( �OWNER BUILDER OECLARATION �� . � _ - - , � . - L3vatOneS' �� ' � � j n , y � ,�' . ' . , ! I hereby;aTfirm t�at I am exempt:from the'Contractor's�License Law tor the '} , - � ' • Gene�ato[ 00-5 KW �5-15 KW � � � , , � � � � �� '� tollowing reason (Section�4031:5 Builness anG.Profeszional Cotla: Any aty or. '� P Trap- � �.� , j� :. �' �.� � i , , j { ��county which� requiras a permit to construct, altar, improve; tlemolish�or�repalr . �.. �� � r � � Transformer ❑ 75-50 KW ` • � � any structure, pAor to Its'Issuance, also requires the�applicanf for such permit � - i'RoofD�ains � � , i i=^ � � . ' � � � �� � � Tile a signetl statemenYthat he/she Is Iitenietl pursuant to the:provisionz ot , �5U+ KW � - N'�Cont�actor'S Lltense Lawi(Chap[er,9 (commancing with'Settlon:7000) of ,;, � .- ' �; � ' , - ; � � � ' � rRainspection Fee � � $75' .,{-:3ion 3'ot the.Business anA.Professions Cotle) or that ha/she �is.exampt Showers ' . - " � � ReinSpection Fee: . $15 , � � ' ; i , strom anG the� basis for the allegetl exemptlorc'Any„violation�of'Section � ' ' " Meter ❑up to 100 amps i �Issue Pee� � ��$ 3 � 331.5 Ey,-any applicant Tor;a'permit sub�ects the��applioant to a civil � � � ` ' � ' � � ' � � � � $ 3 . . - , . . � i - ._ � � I � enalty oi not more than five hunOretl tlollan (5500): !• ��� • � I � Service Sinki - -, - laue Fee . � 1: , i ;. � . Zoning Approwd By Date j ;�� I, as,owner of� the��property ormy'employees with wages ai their sola �_ � � . '� ' { � ' � ; compensation' will tlo the work, antl tha:structure.is not Intentletl or ofteretl j �� ;.' + •. -; -^ MECHANICAC : i � � qppliration'Approved By � ' Date � Tor sale �(Secfion 7044, Business; anC, Professional Cotle:: The, Contra<tor'i . , ; � � � � j LJcense Law tloei not aOPN to an.oWner of a property who bulltls oi improves '' BO11e�_ �� �� R¢frigeratlon System i ' - �� ��' � � tnereon„antl who tloes.such work himself/he�581t Or Ihrough �Is o� he� own ' � � � ' � ApD�ication laued By � Date employees, provltletl that such Impiovements are;not Intentletl or oi(eretl'tor " � � - � ❑0-100,OOOBTU ❑t00,000,BTU 1 , , sale. If, �owever, the buil0in or im rovement is soltl within one ear.of com- � Duct = Untler.Ground I 9 P v ' _ • . � � � ' ; SUMMi1RV OF FEES ' � pletion, the owneywlll �have the burtlen oi provinq �e/she tlltl not builtl or im- � - . � ' ' ' � � . ! ' � I rovaforthepurposeofsale). ' , � � =;= � 1 �' � Duct-Structural ' ! SystemRepair/Alteration ' ' �BUILDINGPERMIT $, � � SMIP : 1 $ • �� I, as owner ot the'proper[y, am exclusively con[ra<ting with�llcensetl com � - 4 ' .tractorsto wnztructthe�.project.(5ection 7044, eusiness and Ratessionz.Coae: �• _ Duct= Ventilabng _� ' . _ .' ' _ �' _ _ � �PLAN CHECK� $ � ' � � PERMIT � � ! � -The Contractor's LI<en3e Law does not apply co an owner oi D�operty who , ,� . � , . ' ' - �/�'� � � ISSUANCE �$ �� Euilds or improva5 thereon. antl who mntracts for such projacts with a con- i Exhaust System 0 Multipl8 ���, ' � `� PLUMBING j . $ .i � - . 1 � 1 : tractor(s) li<ense pursuant to the Contractor•s License Law). ' � � ' � - . .. � . � ❑ �bam exempt untler Saction ' B. & P. C. tor thls reason � Fiiepl/Fact. Blt. ICBO # ! � � � � � ' �PLAN CHECK $ ^ GRADING ' ; $ ;, �' i 1 ' 1 A � ' ' ,. .) � Date � ownei � ' �� 'i. HeatingSystem & Ducting �� . ' � �• . �ELECTRICAL $ "'� � �I , ! �� , $'� , .. - � - - 1 � � . ; MICROFI�M t $�, ' �'I nereby'�certify-that-I�have•reatl thlz'aDV�Icatlon-antl-state th`at the�above -, ^ �6100,OOOBTU�100,OOOBT� � --- -'PLANCHECK� $ � � , i Information is wrrect. I agree to�comply with all clty�and county ortlinan<ez . �' � . . � �� .� TOTAGFEE �$ 7 � antl ttate laws lating to ing , nstructlon,'antl heretiy auth Iz reora- � , - � � � MECHANICAL • $ ' a , , �5entative5 oY' 157city� ter the above-mantlonetl:pop rty.for HoOdOr Typel ❑. � ' . pein5pectionFee� ,$15 '� � , -j �� � �ESS � �' � , ' Cano ; T� e II ❑' 'J � f� � ' PLAN CHECK, � $ � �� qDVANCED PC �� $ ' 'insoectlon D es. 7 � � . . � , ' ' � ' � Signature ' f . .Data' • : - - ' � + ' ' � . � ��e{� � 3 l Registeh � � , laue Fea � { i $ 3 �1 1 � �i � 1 � Drivers"Liceni C5� � — - � - ( � _�_ ,� . ,� FINALFEE� i $,ly�_. CMF 0865-46 rev. 12/82 White - Bulltling; Canary - Appl :wnt; Pink - Accounting; GolUenrotl - Assessor - � � �2� Z�F .. W2�,2� �oy Twa���e� L�bora�orie� �f s�u��:,� c�uc'�/o�,t�, �,u. JJIOAiipo�IWaY / M:ulinpAJJwssP.O.Uo.A7 / Lonvl3n:�cRC490001 / I[�JIA2G�9�55 / 12t�16J&^.38ti / P�alU10�6n�1 TESTING UNANCN OFFlCIi: ISI<�D Notl� Susan sm,�:i / S:ml:� Ana. (:R'J:'/OJ i u�a� ssa�xcns March 28, 1983 Examination: SC83-1773 COMPRESSION TESTS ON OUNITE CYLINDERS Mr. Errol F. Heesch 12921 Aspenwood Lane Garden Grove, California 92640 PROJECT GAVI MASTAFE RESIDENCE ADDRESS 3278 Turlock Drive, Costa Mesa APCMITECT CONTRACTOP 20th Century ENGINEER SUBCONTRACTOR Vern Anthony Gunite SAMPLE FROM MIX DATE CAST DATE TESTED SPECIMEN NO. COMPRESSION TOTAL LOAD, LBS. POUNDS PER SO. IN. 28-DAY AVERAGE, PSI COMPLIANCE SI ZE : SPECIMENS Pool & Spa SPECIFIED U} t0 1 STRENGTH 3/16/83 SLUMP size 3/26/83 3/26/83 I II 10-Day 10-Day 95,000 69,000 u,390 Z,i90 3>290 10-Day tests comply with specifications. 5�" X 12" 5}" x 12" MADE 8Y DELIVENED BV Ray E. Heesch OISTRIBUTION: E. F. Heesch - 2 Vern Anthony Gunite —6eat3—Mesa Bldg. Dept./Chuck Conners � � � � � � � � CITY OF COSTA MESA B' �IL�Ii�! � D.V'c!�:V a�R 0,: i�d� f�4�: c.9 1v �y. iJ2Y..�Vi3V�.�a�if � �M1 � � 1+• V .YlK..�uy�i�'�Yi� i 2,000 psi See Below ZIZ & IV "HELD IN FIELD" RECEIVEO ON 3/2i/83 Neale Zuidema ALI. ftl'PORIS AIIf.::I111M11 II.0 �5 IIIC CONI Illl'NINL I'l1UPL11fY bl' QL�I.NIti 4UIi111111L411LN 1 UII PWIAAl1UN UI ��1➢� 1�1 PUbI:. LUNClU510N5, ON I.FU�ACIS � uUM OII R[4�NpING IIICM 15 FL5LNVLD VENDING OUH WNI I ILN �PVRUVAI. AS A MU W4L ✓ROfLCiipN 10 CIILN Il II�L VUIIUU ANU OW4LlVL5 JJU � 2 .: �c�78 U/2LOCG. 6uilditt� � Address [ Y!� / �lAsTliF� a�er �O7N l "f_76'72t�2.�-9 Contractoz �E�t,'� Y%�}/L/c= Address Pe�niC Date �I�6-(o)54Number �0710 j Issued _.__ ....... ... .... CiTY OF COST,\ ?IESA D li]'Ai2T'f C:; ]T �F nu�i.ui�ac snr•r:�rr RegisCered Deputy Ruildinc Lnspeccor Certificate of Conpllance �- ���� Date of tTiis i'ertlLlcate 'Co [lie llirector oE I3ui]ding Safeh�: I hereby certify [ltat the follou:in�, poztions of work on ehe buildings at the ahove address which required continuous inspec[lon and i;hlch I iaas employed to inspec[, were inspected by me and comp]y wi[h the provisi.ons �of [he ➢uilding Code applicaole thereto. . � 1) Concrete 3) k'elding � 5) Special�Cases 2) Mascnry v�V � 4) i2einforced Gypsir.n Svimming Pool. Size �O ^.��" Gm:ite •%/ iianu i'ack Sacks CemenC ��`� Tons of Sand � 6 Approxima�e % of water in agEzegate_ ��0 _ This t'epor[ covers work completed during week ending �� �� �i-� fiEhV�}2Y.S: � . ^ -- —^ . -RE` GIS'I - li DFF 'i BU� ILDI\C IKS OR N:une �A�–�1 o L f' � �T�3G9-/ � Address ��C�" �-171� � Leboratory �C�i/✓i�l Telephone 9%�"V 9SG Fo [m BU 6� C� 2J,�'nJ fi-� ��c+ � . ��:�'�I�� ��W' � CITY OF t;^STA MESf1 E3UILDI?:i, ::'`r�clG^l _.. bpEZ a-:�=s��....-�-- _____ . ____.. -.: _ ....__. . .__ . . . A�c . �"�,9 '74���ti�i�i�i2i%i��r�r5 t6 .� � i '��' �,- n fil In all a se wit�i �ea rtler Ilnes an0 sign all approoriate Geelarotlons, iT , _ ' ADPlica t to I so ees=xcev� tno n ry bo _ _ __ `_' �C�TYOFCOSTAMESA' , 4f T � � � • i LOTNO. BLD � � T � j�ESB' Il��dlJ' B�.Yd �- -1 � _ PE n N . TRACT NO_ '�� CO�STRUCTION PERMIT � a ` - . ! � o.; -• - �; � •' r : 1 ' 1 r i _ I ,y -.s i 1: j , i �a , 1 + ... %� < < � I � . . + � i . i ; ..� � � � � n � i A � IiCen['9 M2ilin Address ' � , � � - ' � � TYPE OF CONSTHUCTION �. I ' ,NEW ADD, , ALTERATION' �REPAIR •` � �� ' � v � !T � I . r ' ^ � � � � '1T � (• �.' � ( ' ProjectAddress-9� �-`7� wTCI%��`�'�� r f , � ,' - � ��CONVERSION �� DEMOL1 R'TpTHER � � « t « 1 m 1 : � � s � ' ' . .I � f � � � j� * '.I,; .S � ' j � � / ' � D CRIPTION'OF WOR ��A/�-IC•'i �� `'� � �,1 _ ! . . � Owner'sName (JS!�C� Zi� �'GlSpCG���4- � �Phor��1 r, �/��/f /,�( (� y p��/'� � . ' � Y �' 'Z NINGRE�U!ATI �� � �'� � _ �' ' i � �QddfC55 -� �i i Y 1% GL✓ �-PC/Ci . 1' i t' , � _. +� ' �—� C�/�p1�LT— �� .T�/�i.C/� �Itw�-� �Z� .i :. 1'r - I . � � /� � � TY EOFPERMIT ' IGRADING _LI FOUNDATION� - STRUCTURAL � � � A P..�' ' O ��" 'ZONE t . I " 1 ' �� ! A�ch/Eng.��-�(ll_�•�* � _LICenSe NO. O�TENANT O ELECTRICAL ��PLUMBING ❑'MECHANICAC ' � � ' ' , I . ' 'BUILDING� �' . 1 � -� �^', � � . . -_ � . . . . . , _ PWG'.ftEF.Hk �- Ir � . . f " Address ' G �"? ��// '��'. - �ccU ' t � ❑ OTHER + ,� � � - . • .• ' ! , _ -- _ � '. � TO BUILDING^ , _ ' 'qEAR V 1RD (TO B/L) r � . � I`� ; �Zf%� ��iW�lA "�PliOne �, , i6! ' . PR P RTV INE. . . � Contrectoi s Nama 'G = PRQIECT DESCRIPTION � SQ , FT - ' OCCUVANCV . . ; , , . . _ . f�. T/ p � I.y� - � . ? ' . ' eLEFTSIDE VARD � �� I � RIGHTSIDE VARD. � � j � , j � �.,, � ' ' Address (m � �� � .]�$ �� �p��---�k ��" � � - � � ` _ CONSTRUCTION T.YPF � ' VA'LUATION ' I � � �/ 1 � � �� - � 20N$ � ' GRAOINGCU.V�SC ACRES � � � � BKG.SPACE�REQ. ' '; � . P�ROVIDED (� � �_ ' CicenseNo. 7ri- '�S Z 1 i _ a i � UCENSED CONTRACTOR OECLARATION ; 1 � �, � , ' ' ' , . ' � � ' � ' � STREET WIDTH � ' ' ' PARK fEE �' Remarks: ' ��; I �, '1 . '� i � $ , F ' I'hereby affirm that I am Iicensetl�untler provislons of Charter�9 (commencing " ' � � � , . ' � ��' i ; . with sectton 7000) of Divislon 3� of t�e Business anU Professions Cotle, antl � ; � _ �, � " � � : � � . .� SFECIAL CONDITIONS: -� ' I i . ,- � � ' ' .� . , �. w u-�., � t� „ X �i�:� � , my Iicense�is In full ce ntl affect. � i�i��� Z � I � � / ,� f' , � � IJcense zss � ' ' o., � � , I { : PLUMBING , . • . ( � j ' ' ,(7'10. . µy_,� r'[7 , � •te��(��'L_ 5'g t e � p , � � � BarSnk t "i � SewerCap � 1 ' ' i � ELECTRICAL � ••r iR ER4�COMPENSATION DECLARATION� ' '� I � � 1 ' • � + ' - ' _. _ � � i .�ereby�aHi�mthatl.havea.certitiwteot.conSenTtoself-msureora.rertiflfate_i..�, ' ' ' ' � J... � , _ _ AutomaticWa5h2r I Meter ❑overl0�amp5� " __ � of Workers' Compensatlon Insurznce,�or a certitietl copy thereof (Sect BackflowPreventer �-- �-SewerConnecUon��-- �� --. �- � ' • t .--- .. ,. , "'a , 3800, Lab. ) � i �'� � � . { �-� i � ConstrucuonPole . F Su6Panel I W�~ �` � S� �286 �8Z • . � �-ATC��� ' Backflow Irrigatioh , Soler Collectors % � y � � � � • Pol' No.$7 Cortlpany �� � . � - � Cooking Unit ; � , Sub Pole � ' � ' Certifie cop Ii hereDy furnishe�. , � ' � �/ � i _' � Bathtub5 � � $ola� Piping � � � 1 ` ` � . ' : Certif tl cp Iz flletl wich the city B tl' g ��r//' t � � . � � . Dishwash2r ' � ' Motors �0 1 HP �[]1 h B " I Date' � Appllcan� � A� _L' - �la�ifi¢t5 � � � �, Sola�Tsnk � '• � � � ' � • � �� � , EXE TIO �FROM WORKERS' C�ATION DECLARATION ' • - - - ; DrvefS-�GaS� OElectric"'": ' 'f " IncSofar'�9'75�HP 076�15'+` � '} "' ` i -(This section neednot be completetl if the-permit is for one �untlree (5100)� or � � Dishwashe� I f � � SwimMing Pool w/Spa , ( �• - � , � less): � � ' , .,, , ai'- ' 4 � '� � � _ , . i 'Fan' � � '�Micrq��ave 3 ^r„�� � �� ; I � I certify,that in the performanee of the work tor�whl t permk is tssuetl, I' � D�inking Fountains � � Urinal ' - ` � � � , � shall: no mpl any person In.any m r me subject the - - 1 � � F.A.U. � ' � 1 J � "Pol2 Light '`';� �'� j� � -NOT. ErH� aftermaking this�tlaclara iom� ou•sfioulA�become��sub'ectto the-•i� FIOO�Sinks � , worke Co s tlon;Laws ot Calitor � t . r ' Floor Dremsf � Water Closet; 1 �� � ' � 1 - + ��. 3 � � t � Date' Signature ' - � , . Fixtures ( � i y y � � �� ' � � � Y � ..� � ' S ", _ _...� _ ..Water.Heater�. ' '_,�._,�; __ . � _..- . _ ...' ' ' ' "s IRan e _ _ .I ; � . j ' � Work rs'r C mpensabon provisions ot the Caboc COCe,..you must�fortnwith � ,.� �- � . ; ' � _ � - . Devic2 BoxCS � � � � t ) � compty �with' wcn provis�ons�,or ;this ��Dermlt shpll be jtl2emetl� revdketl ' : � � Gas SerJice, + 4•Outlats � ��. � �Wate �Service � � � � p; � '� '� ! � � � � K' � , ., , 5�9� � * � , ' ' j !' ; ' ' CONSTRUCT�ION'LENDING AGENCV ' � �' t � ' '� , � � � ' ' ' � ^ . . . ' ' i n ` -� , � �" Y�� i � r � . � 1 - 1 1 " - 1 - . . .Y1 �IILsE`5 � h� � . � �, � � I hereCy a4firm tnat [here Is;a'wnstruction•lentling a9ericy;(or the.performan<a � ��; Intereeptors �" � � ^' � � � ,r � t l : '} .; �1 t � ' �(StahdingSecbons�; --r . � � �. � � of the work tbr whwh Ih�s� permit -is , issuetl u(Sectiop ;3097' Civ C � ^ � � � ��� ' � ' J J � J , n- � �' a ' ' ; - ' � - - � i i�eneers Name, � ( � � .. • ' � `. - 4 .- �. : �^ . - � i ; : ! Kitchen'Sink� _f j �� � � I - ,�, � _ � ': i �s: r� �:: Switche@ r..1, � � j, F'�� i• , �.T;ash Compactor;.�.� _4 '. j I •: ' ;: i � Lentlers4 Aatlrea�' ` •.` �.• � . � Q. . . 1 :; _ .. I _ . ^ . . ', _ .. ."` �,. . � 1 c .� �, - � OWNER BUILDER oECL'AR%{TION: � ' � . � : i :`' t � ' -�t � Y . L,�` � R � LaVatOneS(j � j t � " � � � f'� �, � ,-, ' s ;. � �e ; Garbage�Disposal �� ; � j _ t ; `; ' ' ` I hereby'aftirm that I am'exemptSt�orti [na�Contrabtor4�License Law Tor th9 .�� i-� _ � �• � i , ' Gene�aCac� �0 5 KW �5 15�KW. �� -"� � � l,, �� �i - ' f " following r2asonx(SecLon':7031:5 Business aptl ProfeSslonallCotle: Any Lity or � �? T�api a ; i'�- y �_: q � r i t' ' -1: r -� � ''^ - �� '� r�' � , �County which'requves a pertnit�to.const�uct, alte�, imp�ove; tlemollshm� repai� � . �� � � � � Y � .. -� � l ; � L . _ ; � � , Tiansformer O 15-50 KW � � t r � 1Q i� � � � ) t v � " ,.{" � "any stru<tdre; p�br to its.issuance, also requires the applicant'-for such permlt T. � RooftDfainS, �'" T . '. ' � "�" � ` -, tlle a si9netl statement that he/she is Ilcenutl pursuant to [helprovisions of' t _ -_ ' � ' � �- " � I � � �� � O5U'� KW �� • I � • ! ��� � � i � ; ! ' f'": Contiactor's�License Law�(Chapter 9 (EommenGng�with'Sectlony�7000) bt 1 � � : ' ;.. '� ' - 1 " ! ° ' " - - . • ! "r� ,,. � � � .� ( � Rem;pection Fee J� iY) $j5, �• �. kf''iiston;3 of the�Business'anE[Professions-Cotle)•'or�that�he/she:is�exempt � = I ShoYJe�S � � � � y� � ' Reinspeetion�Fee; �$15. i'ti, ',. . ' , ` , � - : � .. ' � ! '"deretrom-antl the,ba5i5 for the allegetl axemption;Any,viol5tion�oPSactlon : � + �. � ' { _ � MCte� ❑up to 1�0'ampi �� I ���� ��IssuO Pee'• . �: $'f3 , 7031-5 by,any applicant tor�a.permit�suE�ects,tne.applicant.to a'.Nvil ; " �' ' " . ,� � � � • ; � 1 � 1 � � � � a - .. - � , .�:- � ,' l�enalty ot mt more t�an five.hunCretl tlollers 5500 : � i� -. ; ,' , . Seivice S�nk i � Issue Fea F ✓$ 3 • /! *� +� � i �4 ! , ,� '( . ( I � . �� I . . 1 ��1 .._ i � � ( i+% .i < . �Zonin9APPro�ved�BY ' Date � � i LJ I,�as owner otf the;property or�my employees,with wages,as their sole ; .,.. . ' C1 'j� 1�"� � i . (�' -S ' i. � compensztion will.tlo the work; anA;the�structure.is not intentletl or offeretl 1_' ; s� - MECHANICAL' �'. I : '• { • .: ! � s: is, : ' ? i ; � � i�. :.5� APPlicdtion APProved BY ��` '� ete E • � � for salef�Secflon 7044', Business antl�Protessional Cotle:IThe�Contra<tor'S ! , . . f � - �, .(� ,4 tn� i � rt, � : - � (,;r` �� � : Ucense Law does not apply to`an owner of a property:who bulltls or improyes � gOiIC� � " 1 '; � : � Refrigeration System � ' i � ' m �� �. �� > >' j} !� ; `.j �jj � � � � i � . . � t�ereon,iantl jwho �tloes�such'work fiimsel�/herselt or Ihrough hls or her own � � ' � �- " � �� ' ' ' ! ' � 1 � s �� APP ��tion lisued By ' " Date : i employees, provitletl th5t 5uch�imOrovements areinot Intendetl or offeretl ior � i s . ❑0:100,OOOBTU ❑100,000_BTU' :j f ' •� , • -. r• � • � ' � �i : ._a� � �: � { sale. It, however, the GUIIGIn or im rovement is soltl witnin one;year�ot com- 4 Duct-- Under�Ground , � .. � .. � � `� � -� 9 P � . , � t � 1 . . ; �x � ' „ ( � SUMMARV OF�FEESi�I � t i`. �' ' f , � pletion, tha owrarvwl0 have the burtlen o� proving he/she tlitl not builtl or Im- � . � . s. /'�� n ! �roveforthepurposeot.sale)�. t �, ; �..- , t ( ; ( �: I' Duct-Strucfural � 1 ; SystemFiepair]Alteiation ! �I y�� i, a�+gUILDINGPERMIT $. �`� j'; SMIP �� � � � $ { `D•�� I, as ownei oi the pioperty, am ezclusively conlracting�wlthllicensetl com � � - � � � � � ' � ?� �� v. ' � � .� �.{ . _tractorsto constructthe;proiect.(Section 7044,.Business,antl,Brofessions COHe:.,J,..,�. Duct Ventilatingy„{_; _, �,., ; „ __ )__ j, ,_� ., !,__ 4 , ' � � 4!PLAN CHECK ; '.,$' SJS'�� .PERMIT . j �!' (�� •y . ' I The Contractor's Clcense Law tloes noC appry to an bwner of property who. , � . � � � �� �� � �.� 1 i `..d` ISSUANCE � $ i� ��+` � � � � builtls or improvei chereon.'antl who contracts for such pro�ects wit� a con- � � Exhaust System ❑ Multiple �� ? � � � r '� � � �.PLUMBING f $ a' � t � �� �, [ � �( ' tractor(s) Ilcense vursuant to Me Contractor's License Law)i � j i . ' ' ' ' � �- � ,;� � r�{` � � � � �'r, � tGRADING �� $ { �� ' •y� � E + � ,PLAN CHECK -7� $ ' 0 �I�am exempt unGer Section - � , ' B, & P. G Tor fh�s rea5on i Firepl/Fact. BIt. ICBO # � � '� � ; r- � �. � ,�;,> >�� ;R � y�. 5 r � +-{ �� � � � �' � � � t $ f ��. � Date ? , � ' owner, � ! :. '� � :. 1 '� �. Heatin �S stem&Ductin � i � � �.• .� .��fE�ECTRICAL °; v $ �� + .'� �` i'' � � � : � �-I-hereb i 9� Y � 9 �. . . { , 1 � -• ' p` ' �PLANCHECK� f:, °$ .sl ll� 1� MICROFILM � $ � �7 � "� y-cert�fy-mat�lrhave reatl•this��application-antl-state-that�tha�above�-�- - 06100,OOO,BTU��100,OOOBT' - - -+���.•.7 . - � i - � xj �} � �.y IntormaHan is rect. I'agr to mD�Y �'�th all dty antl county ortllnances �� . i � 1 1- �} . :: 1 l � '� 7 �* � 1 ��'' j !" ;'�" ,/ , TOTAL FEE, '� $ � MECHANICAL r - � $ v" � �. - antl+state law I In9 t il ' wnstructloq'antl hereby authorize repre- � � � , i p 'i �+ �4 . ( ' sentatives of � 'cl e upon the above-mentioneG ,Vrop .tor � � Huod or Type I ❑' � • r' : Reinspeetion Fee� , � '�$157 � IpL'AN CRECK h� �'•'� t � �� '1� LESS ��� . y ''�� ; insaectlon p e , � � � �; Ca:no T e II 0= r i i � . . � . � a �� $ � � �t � . t� p^j �p � '� Signature � 7 1 q� li � ; j , � � . � i � , �� � � ' ADVAPiCED�PC ; $ ! �rivers' Llcen or�; 5� '• � Registare i � i ` ! laue Fee � �'. S 3� ��� ���•' I "' i� �� Iv�� � FINAL':FEE� �$;_Q 3 Q-Z � .- : � . _ _ -.__ `""^"' ' __-'__ """ '" ""'"___"'" "._ '^_^ _" T.. __.._.__..___. . � . � . .-. '._'-.-_"_' '._._ � � � CMF 0865-46 mv. 12/82 White - Builtling; Canary - ApPliwnt; Plnk - Accounting; Goltlenrotl - Aszessor .. ' � � � � - -' - - - - -"-"• " " ' -"-" " "- "" - ' 3" "" "�� /� . . . .. . . - _ " . . � ...r..�...;; ., : �.;� �� � ' CONSTRUCTION AND PLANNING � L.,APPROVALS . Permit #� � Date Inspector � � ,1.. Temporary Electricai Service or,Pole-. , ' {' ' '- 2: Soil Pipe-Undrgrnd.- - ' � , . `- 3: Electrical Conduit UtilitJ-Undrgrnd. ' '4. Electricat Conduit-Undrgrnd. � - � � i, 5. Steel-Reinforcement� � , - cf>4�3: � 6: tElectrical UFER Gind. . 7. Footings , � " . 1� 8. Foundation . � ' 9.�Water Pipe-Undrgrnd. � ' '' 10. Structural Floor SYstem � � � , 11. ,Property Sewer Line & House Cqnnec[ion 12. Sewer CaP . . , 13. Roof Drains � � . . 14. �Rough Plumbing ' - � '15. ;Rough Electiical-Conduit � - . � r . ,- ;16} Rough;Electric Wiring . � - i 17.PRough,VJiri'ngSign � - 18.••Rough Electrical-T Bar Ceiling � 19.`.Rou9h Heating & Air Conditioning � � � , z0. Rough Factory Fireplace . � �21.,Ducts,iri•Structure� C.22. Ducts, Ventilating � ' r > >. �- 23..Gas �ipe,Rough & Test � � �24.�Roof�Framing - � 25, Roof,�SKeathing . 26. T-Bar.Ceiling (Structural)i & Monocoat .27.�FrarrSe'ai�d Flashing 28.'Lathiri,g&�Siding� � , � 29. Insulation � �' fi " '"30. DryWall•.Nailing ;�� : �. „ '. . . �,.: '�'31. Plaster�;Biown Coat,;' 32.: Electrical.Power Meter-Final � 33. FinalrtElectric � 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test � � 36. Hood or Canopy � 37. Final Facto;y Fireplace 36. Final Plumbing , � 39. WaterServ ee-Final . { 40. Gas Service-Final � �� � ' 41. Solar pomestic-Final ' 42. Backflow Breventer � �. .� 43. Backflow Irrigation . 1 � r 44. landsrape Irrigation System� 45. Sound Attenuation ' <� 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completetl � j I49. Electric Release to Edison . ;` . I50. Gas Release to Southem California:Gas Co � ' I 51. CERTIFICATE OF OCCUPANCY V0. Dafe _ �.- � . PO . SPA � - - ` _ �; o '. APPROVALS . �Permit � � � - Date � I'nspeetor _ : 52. Pool & Equipment Location, � - � � � ..'� J r. � ,''.' . � �. �� ' 53. Steel Reinforcement - � - '� .3.�; ' ` � 54. Forms� ' � � � _ ' � � ; 55. Elec[rical Bonding ' - � � � - _ � ,ry � 56. Rough Plumbing & Pressure Test � " � � ` '•� � � ' ^ 57. APPRbVAL TO COVER-GUNITE ' 58. Electrical Conduit-Undror.,d. � � '� ' �i t 59. Gas Pipe, � Undrgrnd., Test � ' �� � � • �: ' , 60. Backwash Lines, P-Trep, O Undrgrnd.�. ; . � � 61. APPROVAC TO DECK ' � - - 62. Backwash&�Receptor-Final . � � Ts. I.; 63. Heater & Vent-Final : _ � - - �; . 64. Plumbing System - Final -? _ �-`. �{ ;. -65. Electrical-Final � � ��� � � »'y � '66. �Solar System-Pinal � � � � '� �� � ` "'1'-"} � 67. Fencing & Access ADP�oval � '- � �' � ' ' - , 68. APPROVED FOR PLASTERING � ._ � t� 69: POOUSPASYSTEMSFINAL � , I ��FIRE DEPT. REQUIREMENT � � ' • - ' � . r �- APPROVALS Pe�mit # ' � � ;_ , _ � 70. Underg�ound Hydro • . � � '71. Product Piping O Gas ❑ Oil � � � � 72. Underground Flush � � � � 1 73. Undergrnd. Storage Tank �� Gas �❑ Oil � � • � - F 74. Overhead Hydro � ,: � � � � 75. Dry Chemical , ' 76. Dry Standpipe ' � � ' ' ?i 77. FIXED SYSTEM FINAL. ' �� � i 78. FIRE PREV. FINAL � � � � , . Notes: _ _ _ �_ � ["-F- _ n . _ . � i � . 3-3/- 3-30 �7 G_zo �/- g9 OWNER HELTZSR ENTERPRISES JOB ADDRESS 3 Turlock �. GENERAL CONTRACTOR e ze: No. ROUGN PLUMB�NG PFOP. SWR. LINE SPRINHLING SYST MISCELLANE�US HOUSE CON. ROUGH NEAi1NG ANO AiR C0� TEMPORARV SERVICE OR POl UNDERGROUNP ❑ POWER ROUGH WIRING TRENCHES RMS � FLOOR SYST6M BONO 9EAM �� STEEL RE SHEATHING FRAME AND FLASHING LATHING - IN � PLASTER, 9ROWN COA F EL REINF. DATE SUBCONTRACTOR ING P _ ��r��l� W��r��r� �� BUIL�ING, FINAL , 35251 ^ � � "4' V COSTA MESA BUILDING-SAFETV DEI P.O. BOX 1200 COSTA MESA. CALIFOR For Applicant io Fill in Completety� BUILDING .� _� ... _ . .n i _ ._. �� owNea Heltzer Enterprises-Costa Mesa MAIL 740 No, La Brea Ave. � ADDRESS . cirv Los Angeles No�. (213) CONSTRUCTION , 9�1�r LENOER United California Bank BRANCH Main Office ADDRESS6OO SO, SpLlilg St. Los Angeles ARCHISECT TEL. C213�, OR ENGINEER David Freedman No. �653-38� aooaess113 N. San Vicente. Beverly Hill CONTRACTOIi George J. Heltzer � � ADDRESS '%4O N. Ld Brea Ave. TEL. �'z1,3� ciTv Los Angeles No. qq�_�i ; uc No. 3144 uc�No. 1900 SIZE NO.OF BLIX'.S. OF LOT � I NOW ON I.OT USE OF SIZE OF VSE OF BUILDING A Single Residence ROOF COVERING K TO BE PERFORMED Plan i�407B Rev I hereby acknowledBe that I have reatl this application antl state that tha above informetion is correct antl agree to comply wiM all laws ragulating building construction, and' I shall not'employ any perzon in violation of the workman's compensation laws af the State ot California. 1 hereby. certify.that I am properly licensed as a controctor under Me Siaae ot California eusiness and Protessions Cotle, Divisicn 9, Chapter 9, and that such licenses are in full force and effect, or I am exempt from,Me pr visions of the State ot Californie Business and Protessions Code, � ision 3, Chapte� SiBnature of Permittee Authorizetl Agent PAIU ,tUS 30-77cr�s.c007_040� *** 1 �3.45 APPLICATION FOR BUILDING PERMIT RECEjJlpD�� DAy$REC�tV7E� Dq�J�EIcSS�6UED E% � b �tXB O ro`d '� BUILDING AODRESS .�--�--� OF VAROS APPROV ED DISTANCE BET MAIN BLDGS. VAR. a1E C.U.P. �W TAX 0 VALUE BLOCK US E O F N E W 5' fN r-�/�.f BU�LDING W�.�7.T /�y VARDSAPPROVEO ACCESSORV BUILDING BET. MAIN &� �2�G SQ. FT,� - �9� ° � � THE AMOUNTSHOWN UNDER VAL ATION IS FOR THE PVRP�E OF ESTABLISHING A PERMIT FEE ONLV: VALUATION ..• / pv - PERMIT FEE $/� $�!J-'�q„s � � PLqN CHECK $ S � � Gi c,-U ' .... . O�t) � TOTAL b 0 > ¢ 7 m `o LL