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HomeMy WebLinkAbout2044 Tustin Ave - Building Permits CITY OF COSTA MESA 0y ',� BUILDING DIVISION ;I vm DEVELOPMENT SERVICES DEPARTMENT PERMIT PERMIT NUM,$ER E99-00217 1 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2044 TUSTIN AV Status: ISSUED Suite No Applied: 03/17/1999 Vicinity: REAR OF HOME Issued: 03/17/1999 Parcel Nunmber: 42624402 Applicant: MILLER, KEVIN Address: Phone: Zip: • Owner: O'KIEFFE, DOUGLAS GROMAN Address 2044 TUSTIN AVE - • _ - Phone: ' COSTA MESA,CA - Zip: 92627 - Contractor: . K R M ELECTRIC INC Address: 933 RASHFORD DR ' Phone;',. (714)579-0952 - ' PLACENTIA,CA • I _Zip: 92870 - - license: 473148 - a . SCOPE OF PERMIT UPGRAD EXISTING 100 AMP TO 125 AMP ELECTRICAL METER-FOR EXISTING SFD IN SAME 'LOCATION. . FEE SUMMARY , Quantity - _ . . Quantity ISSUE FEE $22.00 - - - Temp Dist System/Lighting $0.00 0 . Temp service test • $0.00 - Busway/10011 / - $0.00 0 Res. a/c package $0.00 Standing.Section $0.00 0 New Res-(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 , New Res(3+units) • $0.00 0 Transformers up to 1 kva/kw $0.00 -0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 - 0 , Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0 Recept Outlets , $0.00 0 ' up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 -0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $27.25 1 Misc.Conduit - -$0.00- 0 Service to 1000a $0.00 0 Misc.Conductor - _ " $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 ' 0 Motors to 1 hp $0.00 • 0 • Circus(mech ride or lights). $0.00 0 - Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $49.26 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for 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 required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-6626 DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: )Y I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Cartier: Policy Number: (This section need not be completed if the penult is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: "/5- mac Date: 7-17-50 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000).IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.tic.# 9`7/7/ '/P Classa / Contractor's Signature: e- '/1- cat Date: 3-/7 -97 CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penally of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth Into which a person Is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: _ _ _ Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification end filing with the Fire Department of en RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) Date And/Or Authorized Applicant Date yQDES IBsPFCTION TYPE • gaff =ALS CODE( IBcpFrTION TYPE Dag MUSS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical L', 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-46 • StJt �` CITY OF COSTA MESA y 4 BUILDING DIVISION •1 .•...d' ' DEVELOPMENT SERVICES DEPARTMENT 4•%ariiill PERMIT PER NUMBER / E98-01091 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT c- Job Address: 2044 TUSTIN AV Status: ISSUED Suite No Applied: 10/15/1998 Vicinity: Issued: 10/15/1998 Parcel Nunmber: 42624402 . . . . Applicant: I NTRI E RI,P ETE Address: - Phone: Zip: Owner: O'KIEFFE, DOUGLAS GROMAN Address O'KIEFFE,LISA--,, - _ - - - - �. COSTA MESA,CA - - - Phone: _� - ', 2044 TUSTIN AVE - --- Zip: 92627 - , Contractor: GRAHAM EROS INC - Address: 2952 Century pl Phone:'.546-1653 - COSTA MESA,CA , Zip: _ 92626. ' ' -.License: 248604 • i SCOPE OF PERMIT 1 LIGHT AND 1 WITCH FOR THE INSTALLATION OF A SPLIT SYSTEM IN THE ATTIC, REF: M98-477. FEE SUMMARY ' ; Quantity - - •� -• , Quantity ISSUE FEE $22.00 -- - - Temp Dist System/Lighting $0.00 0 Temp service test $0.00 - Busway/100 ft r $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical'Equipment $0.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa-, $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts '$1.00 1 - up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 - up to 100 kva/kw $0.00 0 Switches . $1.00 1 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 . , Low Voltage Equipment $0.00 0 Res Appl $0.00 ; 0 Low Volt Wiring System/Ckt - $0.00 0 Service to 200a $0.00 - - , 0 Misc.Conduit '$0.00 0 Service to 1000a $0.00 H- 0 . • - Misc.Conductor $0.00 0 Service over 1000a 'Circus(gen or ride) - - $0.00 0' Motors to 1 hp _$0.00 0 • - ,Circus(mech ride or lights). $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 - 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg -$0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $24.00 EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for 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 required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My work 'compensation Insurance carrier and policy number are: ��A Coo Cartier. r��[, Policy Number: 910 (This sect need not be comple:•if the permit Is valued at one hundred dollars($100)or less.) ❑ I certify that in the •erforma : of the work for ich is permit Is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation la s of Cali o' is end agree the ' I •••ul• be••me subject to the workers'compensation provisions of Section 700 oft e Labor Code,I shell forthwith comply with the-e prows?• s. nq Q Applicant Signature: t.( S Date: /0 /S / 6 WARNING:FAILURE TO SECO-' •RKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P NALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100000),IN ADDrrION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed oder pr•visio s • Chapter 9(commencing with Section 7000)of Division 3 of the Business and ProfessionsyesCode,and my license is In full force and effect.Lic.# �.r Ii i Class 11 oma✓ Contractor's Signature:�V ' ' _—�— Date: // CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 7$500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of properly who builds or Improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or improvement Is sold within one year of completion.the owner-builder will have the burden of proving that he or she did not build or Improve for purpose of sale.). ❑ I,as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. _ - Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,faisework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: • Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature end pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this eppfication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes ❑No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If Nes',the facility must meet the requirement of Sections 25534 end 42303 of the California Health and Safety Code). 7 if a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If Nes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I aeree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-. property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. fr / a.� it .r.A_..•, ner(s) Da And/Or •umorized Applicant sate 9411E.1 INSPECTON TYPE DATE WEALS COOS/ INSPECTION TYPE DATE KM= 1816 Fixed System Final Fire Prevention 206 Final Mechanical T 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical y-7-7 7 PM 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-46 LV' CITY OF COSTA MESA p' �+,� BUILDING DIVISION �� ., "` ' DEVELOPMENT SERVICES DEPARTMENT .) S PERMIT PERMIT UMBER 4444bosiono.4. M98-00477 ✓ (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT / Job Address: 2044 TUSTIN AV Status: ISSUED " Suite No Applied: 10/15/1998 Issued: 10/15/1998 Vicinity: ATTIC Parcel Nunmber: 42624402 Applicant I NTRI ERI,PETE Address: - - • Phone: - . • Zip: / , - / Owner: O'KIEFFE,'DOUGLAS GROMAN Address: .O'KIEFFE, LISA ` - - COSTA MESA,CA Phone: .. " _ _ 2044TUSTINAVE' = ' Zip: 92627 . • �. � , Contractor: , GRAHAMBROS INC . ' Address: 2952 Century pl . Phone: .546-1653 COSTA MESA,CA Zip:`. 92626 - License: 248604 , Arch/Eng: ' ' - Address: I - Phone: , Zip: License: , . - - - - �; , ' SCOPE OF PERMIT . INSTALL SPLIT HEAT PUMP IN THE ATTIC. / j , - --' `FEE SUMMARY ', '' • • Quantity, - - / Quantity ISSUE FEE $22.00 Repair/All Absorbtion Unit $0.00 0 Inst FAU<100 k STU $13.25 Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k STU $0.00 Ventillation-System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler _ $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 K BTU $13.25 1 Domestic Incinerator $0.00 0 Refrig Sys>100 K BTU . .. $0.00 0 Compressors/Absorption Systems Gas Piping ' $0.00 0 . , "Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace 10.00 0 - 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Dud - ." $0.00 .0 _ " Over 50 hp/Over 1,750 BTU - $0.00 0 Appliance $0.00 0 ' ' - . Boilers Fire Dampers • $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0 Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 . • Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for 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 required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS 1 WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and wi maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My worker ' m nation Igsurance carrier and policy number are: 'y��I/��J�(� Cartier: -�//'� Policy Number �( 96 7 (This section need not be completed if the permit is valu•• •f one hundred dollars($100)or less.) ❑ I certify that in the ince of the work ' • this permit is issued. I shall not employ any person in any manner so as to become subject to the workers' compensation I.•s of•: •mia,and agree - oil become subject to the workers'compensation provisions of Section 700 a(.the Labor Code,I shall forthwith comply with t :se provi. .• A� /d/ _ / y Applicant Signatur. � 'VI . Date: V 2S�-/ � 0 WARNING:FAILURE •SES R' WORKERS'•• -ENSATl• COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENALTI AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE Oq•.•,IN ADDmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST.AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am lice pc d er roySons hapter 9(commencing with Section 7000)of Division 3 of the Business nd Professions Code,and my license is in full force and effect. ft n O Class Contractor's Signet a: Date: CONSTRUCTION LENDING AGENCY: O I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he-or she is exempt therefrom end the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant fore permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If,however,the building or improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-properly tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: O I hereby certify that no excavation five(5)or more feet In depth Into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,Califomia Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: • Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If en RMPP is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes ❑No (Section 65850.2 of the Califomia Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (if yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree • • p y 'th all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-desc'•:d property f• inspection pu• .I agree not to occupy or allow occupancy of any building authorized by this permit untl finalfiinalinspection.- i, (gnat � -L•yf , l e/5 6U An.r•r .•thorized Applicant ate OOOF E INSPECI1 N TYPF USE MAU CODE] INSPFCTION TYPF �L MMAlE Air/ 1616 Fixed System Final Fire Prevention 206 Final Mechanical ^D 7- ! 1y 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Anal Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-45 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. TRACT NO. LOT NO. UNIT NO. CITY OF COSTAryI(y1l��j�$ CONSTRUCTION PERMIT A.P.# Zone Address '-"T'�ustin Ave. Costa Mesa, Ca 92627 1J 39 3 l cl • Project '``''II S Main Building: Accessory Building: Applicant's Mailing Address TYPE OF CONSTRUCTION ❑ NEW U ADD U ALTERATION W REPAIR E Owner's Name The { Y'0$ CO Phone 714-583-1%9 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front p DESCRIPTION OF WORK/USE OF BLDG. B Rear N Address P.O. Box 8064 L.guna Hills. Ca 92654 I A l Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ID FOUNDATION ❑ STRUCTURAL K Right G Address El TENANT ❑ ELECTRICAL ❑ PLUMBING El MECHANICAL s . Left R Contractor's Name Vance & Assoc Roofing Inc Phone 714-646-3211 ❑ 'OTHER Ping. Ref.# Parking Req./Provided E Address(mailing) P.O. BOX 10456 Costa Mesa, ca 92627 PROJECT DESCRIPTION SQ. FT. OCCUPANCY r�R3 Planning Notes: M City License No. 005913 CONSTRUCTION TYPE VALUATION$ 3703.00 T ZONE GRADING CU.YDS. ACRES S. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: .,.I with section 7000) of Division 3 of the Business and Professions Code, and Tear Off chakes And YPn1are with class oBll Hard; Shakes my license is In full force and effect. ELECTRICAL FEES License a - • L'& Se No. • Automatic Washer Transformer 0 15-50 KW Date -� -'• Signature Ole ..� PLUMBING FEES - '"ORKERS'COMPENSATION DECLARATIONConstruction Pole Sub. • 0 50+ KW treby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps 3800, Lab. C.) Policy No. —102-16.1--�1 =01�mU 12C3pany 14itual Tne ranCe Backflow Irrigation Sewer Ca Dishwasher Meter Dover 100 amps H Certified copy is hereby furnished. -- P Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Dryers Gas Electric ❑ ❑ Sub Panel Date 7 19_89 Applicant vance & Assoc Roofing Inc Fan Motors ❑O-1 HP 01 Yt-8 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors — (This section need not be completed if the permit is for one hundred ($100) orF.A.U. Inc.Solar 09-15 HP ❑i6-15+ less). Dishwasher Solar Piping I certify that in the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fixtures Microwave Workers' Compensation Laws of California. - Date -Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light I NOTICE: If,after making this declaration,you should become subject to the - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Outlets Range • comply with such provisions or this permit shall be deemed revoked. I CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches Sign • I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections Lender's Name Lender's Address Kitchen Sink Water Service Generator 005 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P--Trap • structure, prior to its issuance, also requires the applicant for such permit Laundry Trays to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains 'he Contractor's License Law (Chapter 9 (commencing with Section 7000)of ivision 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3 Ierefrom and the basis for the alleged exemption. Any violation of Section /031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). - DEVELOPMENT SERVICES REQUIREMENTS: U I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered Zoning Approved By Date for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By n Date ereon Law does not apply to owner f a property or wro builds or improves B//t thereon, -- and who doesa such work oemntshimself/herselfaror through his or her own Application Issued By Dat sale, iyees, ever,th that such improvements are not intentletl or offerftl fqr Boiler Hood or Type I 0 'salt. Ii, However, the building or improvement Is sold within one year of com- CanopyTypeSUM ARV OF FEES pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground II0 d`� il:f P rove for the purpose of sale). BUILDING PERMIT $ 3 -- SMIP $ 5 ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK tractors to construct the project (Section 7044,Business and Professions Code: - $ PERMIT The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU ❑100,000 BTU PLUMBING $ ISSUANCE $ builds or improves thereon. and who contracts for such oro sects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware thatPLAN CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compensation Insurance should be provided to me. Exhaust System 0 Multiple 0 System Repair/Alteration ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG ELECTRICAL $ GRADING $Fire Dampers MICROFILM $ PLAN CHECK 50% $ 2 Date 7 12_89 Owner _ Heating System& Ducting Registers MECHANICAL $ TOTAL FEE $ J I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,000 BTU Information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relating to building construction, and hereby authorize repre- sentatives of this city enter upon the above-mentioned property for Inspection is 7-12-89 Signature Date Reinspection Fee $15 Issue Fee $ 301 00C37773-V.070771 � Drivers' License or SS 9t 0I 37.. z,07777Y TOT _ 41 0865-46,rev. 5/88 White - Building; Canary -Applicant; Pink - Accounting; Goldenrod - Assessor l'E' O f LW/b'% l InE1 10:7J4 W 4 1 \ CONSTRUCTION AND PLANNING PO .L SPA- APPROVALS Permit# Date Inspector APPROVALS Permit a Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ; %I 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnc1. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. - v� 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System h 61. APPROVAL TO DECK 11. Property Sewer Line & House Congection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16'. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19: Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20: Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas D Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: ' 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer C- 43. Backflow Irrigation , 44. Landscape Irrigation System _ 45. Sound Attenuation 46. Handicap Regulations /// 47. FINAL STRUCTURE & BUILDING Fkir 48. Special Requirements Completed (G,//�� �I 1/ 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date e Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MES CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. A P # Zone Project Address 20. Tustin Ave. Costa Mesa, Ca 92627 1133 ot 3 Zt, — f �y S Main Building: Accessory Building: Applicant's Mailing Address TYPE OF CONSTRUCTION LJ NEW U ADD U ALTERATION y,2s REPAIR E Z The Arrbros Co 714-583-1909 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front • 0 Owner's Name Phone DESCRIPTION OF WORK/USE OF BLDG. B Rear N Address P.O. Box 8064 Laguna Hills, Ca 92654 A I TYPE OF PERMIT ❑ GRADING LI FOUNDATION U STRUCTURAL C Right N Arch/Eng. License No. K G Address 77 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL s Left R Contractor's Namn Vance & Assoc Roofing Inc Phan?14-646-3211 ' ❑ OTHER I Ping. Ref.# Parking Req./Provided E i Address(mailing) P.O. Box 10456 Costa Mesa, Ca 92627 PROJECT DESCRIPTION SQ. FT. OCCUPANCY R� Planning Notes: M I. CON ST RUCTION TYPE VALUATION $ 3703.00 T City License No. 005913 ZONE GRADING CU.YDS. ACRES T. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Tear Off shakes and replace with Class B Nardi Shakes with section 7000) of Division 3 of the Business and Professions Code, and my license is in full ford 1§effect. ELECTRICAL - FEES License Class `1 nse No. Date__7 X2-89 Signature PLUMBING FEES Automatic Washer Transformer ❑ 15.50 KW -"nRKERS'COMPENSATION DECLARATION Construction Pole Sub. 0 50+ KW reby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers Workers' Compensation Insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps 3800, Lab, o.INL-1-161-030253018 Libert M.rtual Insurance _ Policy No.WI.G company y Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps 8 Certified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel Certifietl,cppy filed with the city Building Division. Bathtubs Sewer Connection `— I Date /-IL Applicant—VAnra R Assnc Roofing Inc Fan Motors❑0.1 HP 01%'B EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors (This section need not be completed if the permit is for one hundred ($100)or Dishwasher Solar Piping P.A.U. Inc.Solar 09.15 HP 016.15+ '1 ' I certify that in the performance of the work for which this permit is issued, I Fixtures Microwave shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Workers' Compensation Laws of California. tDevice Boxes Pole Light Date Signature - - Floor Drains Swimming Pool w/Spa 9 NOTICE:Compensation making this ions ff h, you r d become subject to the Outlets Range Workers'omplsuch Dsionsio of the Labor Code, you et forthwith Floor Sinks Urinal 9 comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY Switches Sign Gas Service Outlets Water Closet g I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued (Section 3097 Civ. CJInterceptors Water Heater Garbage Disposal Standing Sections I Lender's Name Lender's Address Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION ' I hereby affirm that I am exempt from the Contractor's License Law fir the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays • any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is IlCensed pursuant to the provisions of Roof Drains 1gP1e Contractor's License Law(Chapter 9(commencing with Section 7000)of '&1-vision 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3 r:ferefrom and the basis for the alleged exemption. Any violation of Section /031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: LI I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 Zoning Approved By Date crnpensation, will do the work, and the structure is not intended or offered f:r sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By �� Date License Law does not apply to an owner of a property who builds or improves — ,thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 Application Issued By Date -1/ employees, provided that such improvements are not intended or offered foryP sale. If, however, the building or improvement Is sold witnin one year of com- Canopy Type II 0 SUMMRY OF FEES ��J pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground • prove for the purpose of sale). BUILDING PERMIT $ 0. SMTP $ b- ❑ I,.as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System _ PLAN CHECK $ PERMIT -tractors to construct the project(Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU 0100,000 BTUPLUMBING $ ISSUANCE $ builds or improves thereon.and who contracts for such oroiects with a con- ENERGY P.C. $ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ proof of their Worker's Compensation insurance should be provided to me. • ELECTRICAL $ GRADING $ 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt.imp* Fire Dampers MICROFILM $ — PLAN CHECK 50% $ //__ Date Owner Heating System& Ducting Registers MECHANICAL $ TOTAL FEE V/3�0 I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 BTL PLAN CHECK 25% $ information is correct. I agree to comply with all city and county ordinances $ and state laws relating to building construction, and hereby authorize repre- sentatives of this city to en upon the above-mentioned property for inspection purposes Signature - / ..-61-,-i. . // Date 77-12-89 _ _� 04 r . Reinspection Fee $15 Issue Fee $ 3 01 i-0CJ7i fi-C:03777] TJ OT :.J.;-' Drivers' License or SS 9F :7/17 ' _n T''.f• `,1f,„ 0865-46,rev.5/88 White - Building; Canary -Applicant; Pink -Accounting: Goldenrod -Assessor CONSTRUCTION AND PLANNING PO L SPA • APPROVALS Permit# Date Inspector APPROVALS Permit# »- Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings T' 58. Electrical Conduit-Undrgrnd. - TI 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test y' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System / 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough &Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power'Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations L/,, ,.,�1e' 47. FINAL STRUCTURE & BUILDING ai/I/�'( r7�y- 48. Special Requirements Completed (V '✓V 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY -- No. Date 21056 rtt rctUt11' -v 1)Nov 7 1963 I 11 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 317 COSTA MESA.CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING For Office Use Only BUILDING ADDRESS 2oHy TS�,'T A✓P'IIwe. • RECEIPT NO. 2 TRHIT HO. COSTA MESA, CALIFORNIA USnc RECEIV DIY DATE RECEIVED DATE ISSUED__ OWNER Cape Series Inc. //l.7G-62 /a-a -&i MAIL BUILDING ADDRESS 504 No. Newport Blvd. ADDRESSFIRE _ o' TEL ZONE TYPE ✓ GROUP k7'� CITY Newport Beach, Calif.ND.646 9341 ARCHITECT TE APPROVED DATE OR ENGINEER Brent S. Tobey No1j-IY46985 ADDRESS 1320 Carmelita, Laguna Beach ZONING c', 20NC�J/ NO.OF I USE OF NEWS W n IPPII�`/J PLANA eU1LD1 'OVA _ ` CONTRACTOR Cape Series Inc. LEGAL Lot 2 Tra t 5212 ADDRESS 504 No. Newport Blvd. DESCRIPTION Tom, A.P.NO. '—Z/ CITY Newport Beath, Calif. L� NOTE: NO SAVE OVERHANG SHALL BE LESS THAN C..N LIO. 221233 NOU46-9341 Or TO SIDE a REAR P.L. {T EAVES OF LOT114, 83x44.33x38. 33 Iw NooN LOTS v( ALLOWED (U.B.C.REQUIREMENT) USE OF YARDS APPROVED YARDS APPROVED EXISTING BLDG. none MAIN BUILDING ACCESSORY BUILDING - (FROM C/L STREET) SETBACK LINE FRO/ ,�gyp�} S '(-PSTG/) FT. CENTER OF STREET -CD 2 'rb REAR YARD1515 FRONT SIDE YARD I LEFT 0 I RIGHT 0 ! 6D _ R.SIDE 6 PT. FT. DESCRIPTION OF WORK r L.SIDE `v/FT. FT. th NEW X ALTERATION ADDITION REAR 'J FT. FT. z DISTANCE BET. BET.MAIN A G REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS. UI CI BUILDING. NO.OF VAR.# DATE SIZE w92 sq. ft. ROOMS 4 STORIES 1 C.U.P. APPROVED o EXTERIOR WALL ROOF �/¢p / �C, -G I. COVERING stucco COVERING cedar shake APPRqBT /v WA DATE / 3 Di USE OF BUILDING AND WORK TO BE PERFORMED YYY -9 Siijala family refi cl C. 1092 N `.,i 80.FT. B C I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE X' 0 AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COM• PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O LL PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. VALUATION „ G �' $10, 101.00 PERMIT FEE $ II 3 ^9� SIGNATURE OF ��� t7+�t i/ 00 X y PERMITTEE �4 /'` T $ L . .EC O n. AUTHORIZED AGENT 33. 30 TOTAL FEE $